EVALUATION OF RHOMBIC THREE DIMENSIONAL PLATE IN TREATMENT OF MANDIBULAR SUBCONDYLAR FRACTURES IN ADULT PATIENTS FROM ALEXANDRIA

Abstract

INTRODUCTION: Open reduction–internal fixation (ORIF) of extracapsular condylar fracture is necessary when there is a displacement of 10–45◦, or a shortening of the ramus by more than 2 mm. The two miniplates is considered the gold standard in fixation of condylar fractures. however, it needs a certain size of the proximal segment restricting its use to low condylar neck fracture. Recently a 3D rhombic plate was introduced, which can be used with high condylar neck fracture, while still providing good anatomical positioning and stability. OBJECTIVES: To evaluate both clinically and radiographically the three dimensional rhombic plate compared with the two miniplates in the fixation of mandibular subcondylar fractures. MATERIALS AND METHODS: This prospective clinical study was performed on 20 patients with extracapsular condyle fractures. Patients were divided into 2 groups. Group I was treated with the three dimensional rhombic plate and group II was treated with two miniplates. RESULTS:There was a significant difference in the maximal mouth opening between the two groups at 3 months postoperatively in favor of the study group, however there was no significant difference in mandibular mobility throughout the follow up period.20% of patients from group (I) and 30% of patients from group (II) had lateral deviation in mouth opening on the first week.This was absent in both groups on the third week postoperatively.The difference between the two groups was not statistically significant one week. The mean bone density in the study group was statistically significantly higher than the control group at 3 and 6 months postoperatively. CONCLUSIONS:The application of the Rhombic plate for the stable osteosynthesis of condylar fractures ensures satisfactory treatment results, both from the clinical and the radiological points of view