Semi-Rigid Fixation Using a Sliding Plate for Treating Fractures of the Mandibular Condylar Process.

Byung-Kyu So,Eui-Seok Lee,Dong-Hyuck Kim,Hyon-Seok Jang,Kyeong-Soo Ko,Ho-Kyung Lim

doi:10.3390/jcm10245782

Byung-Kyu So, Eui-Seok Lee + Show 4 more

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https://doi.org/10.3390/jcm10245782

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Abstract

Occlusal displacement often occurs after surgery for condylar process fractures because it is difficult to reduce these fractures precisely. However, performing semi-rigid fixation using a sliding plate may overcome this limitation. A retrospective clinical comparison between semi-rigid and rigid fixations was performed. Among 34 patients who had unilateral condylar process fractures, 17 were treated with rigid fixation and the remaining with semi-rigid fixation using a sliding plate. For all patients, panoramic radiographs were collected 1 day and 6 months after surgery. In these radiographs, ramus height and condylar process inclination were measured, and the differences between the fractured and normal sides were assessed. Additionally, the radiographic density of the fracture area was measured. Differences in surgical outcomes and operative times between the two groups and changes in postoperative deviations within each group were analyzed. There was no statistically significant difference in ramus height and condylar process inclination between the two groups at postoperative day 1 and 6 months. Radio-density was observed to be higher in the rigid fixation group, and it increased with time in both groups. The semi-rigid fixation group had a significantly shorter operative time than the other group did. Semi-rigid and rigid fixations showed no differences in terms of effectiveness and outcomes of surgery. In terms of operative time, semi-rigid fixation was superior to rigid fixation.

Highlights

Condylar process fractures of the mandible account for a large percentage of maxillofacial trauma
Many procedures and devices have been used for the internal fixation of condylar process fractures
Rigid fixation may not be achieved if the plate is not correctly located along the strain-stress line, and multiple plates may be required for rigid fixation; it may be difficult to apply plates to the desired location if the intraoral approach is used, or the condylar segment is small [4]

Summary

Introduction

Condylar process fractures of the mandible account for a large percentage of maxillofacial trauma. Most cases are treated surgically, except for intracapsular fractures in minimally displaced cases [1,2]. Many procedures and devices have been used for the internal fixation of condylar process fractures. Wires and lag screws have been popularly used in the past, and plate and screw systems are used by most surgeons nowadays. The plate system is easier to position than lag screws, is more stable than wires, and has the suitable tensile strength to maintain fixation [3]. Rigid fixation may not be achieved if the plate is not correctly located along the strain-stress line, and multiple plates may be required for rigid fixation; it may be difficult to apply plates to the desired location if the intraoral approach is used, or the condylar segment is small [4]

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