Use of the Delta plate for surgical treatment of patients with condylarfractures.

Abstract

The purpose of this study was to summarize the results of our own experience in the application of the Delta plate for surgical treatment of condylar fractures. The research was carried out in 42 patients of the Department for Maxillofacial Surgery, Hospital of the Ministry of Interior in Kielce (Poland), who were surgically treated in the years 2013-2015 after a unilateral condylar fracture. To be qualified for surgery patients fulfilled at least two of the following criteria: (1) presence of occlusal disorders, (2) presence of displacement of fragments, (3) height decrease of the mandibular ramus of over 4mm, or (4) dislocation of the temporomandibular joint. The first of the above criteria (clinical criterion) was treated as the basic one, and the others were established based on radiological examinations. For all patients, a Delta plate fixed with four 2.0-mm screws was applied in order to achieve a stable osteosynthesis of the fracture. Clinical studies were carried out in all patients on the first day after the surgery, as well as after 1, 3, and 6 months. The results presented in this study were based on an analysis of the most extensive research material in Poland (n=42). All patients presented correct mandible mobility on all three planes, and the range of abduction after the conclusion of the treatment (i.e., 6 months after the surgery) amounted to average 47mm (range 45-54mm). In none of the cases analyzed in our study was there a breaking of the Delta plate. A rare complication observed in our own experience was the loosening and partial removal of one of the fastening screws from the bone and from the hole in the plate. This failure was observed in three patients (7%). The application of the Delta plate for the stable osteosynthesis of condylar fractures ensures fully satisfactory treatment results, both from the radiological and the clinical points of view. The use of Delta plates does not involve any significant complications. There is practically no risk of a breaking of the plate, and failures in form of the loosening of the retaining screws are very rare and do not cause any significant disturbances in the fracture healing process.