Use of Three-dimensional Plates in Mid-face Fracture: A Prospective Study

Abstract

The aim of our study was to evaluate the advantages and disadvantages of three-dimensional (3D) plating system in the treatment of mid-face fractures. Thirty mid-face fractures in 18 patients at various anatomic locations were treated by open reduction and internal fixation using 3D plates. All patients were followed at regular intervals of 4th, 8th and 12th weeks respectively. Patients were assessed postoperatively for postoperative complication and occlusal stability. The incidence of neurosensory deficit, infection, masticatory difficulty, nonunion and malunion was also assessed. A significant reduction in fracture (72.2%) and occlusal stability (72.2%) was seen. The overall complication rate was (16.6%) which included two patients who developed postoperative paresthesia of lip, three patients had infection and two cases of masticatory difficulty which later subsided by higher antibiotics and 4 weeks of MMF. No evidence of nonunion and malunion was noted. Single 3D titanium plates with 1.7 mm diameter holes and 1.7 mm screws were reliable and an effective treatment modality for mid-face fracture. Because of unique biogeometrical design owing to lesser amount of hardware material (fixation device) resulting into increased stability, the fixation in mid-face fractures is better in comparison to conventional 1.5 mm miniplate fixation.