Anchor lag screw vs conventional lag screw in mandibular fractures: A series of 30 cases

Abstract

Lag screw osteosynthesis is a well proven technique. Its application is limited by the fact that the spherical head of the screw act as wedge. Combining this screw with a bioconcave washer has broadened the range of applications for lag screw osteosynthesis in the maxillofacial region. PurposeThe aim of the study was to compare the efficacy of anchor lag screw with conventional lag screw in anterior mandibular fractures. Patients and methodThirty patients with anterior mandible fractures with no concomitant fractures, infection or extraoral communication, who visited our outpatient Department of Oral and Maxillofacial Surgery, were included in the study after obtaining their informed consent. Patients were randomly divided into two groups; where Group A underwent fixation using conventional lag screw and Group B anchor lag screw. The fixation system used included 2 mm titanium lag screws of sizes 25 mm, 27 mm and 30 mm and 3 mm titanium bioconcave washer. At each follow up visit, clinical data was collected detailing clinical presentation of healing and radiographic findings. ResultsRadiographic features at post surgery evaluation indicated loss of bone contact around the screw head and bone resorption in five patients of Group A, thus causing loosening of lag screw whereas none of the patient in Group B, was found to have any such complication. ConclusionsThe findings support the hypothesis that bioconcave washer aids in holding up the farthest fragment at the interface of the fracture fragment. Application of bioconcave washer provides easy loading of lag screw.