Miniplate Group Research Articles

COMPARISON OF TRANSOSSEOUS WIRING AND MINI PLATES IN THE MANAGEMENT OF ANTERIOR MANDIBULAR FRACTURES

Objective: The purpose of this study was to compare transosseous wiring and mini plates in the management of anterior mandibular fractures. Materials and Methods: A total of 200 participants were included in the study (100 in each Group).Patients in Group A were subjected to transosseous wiring with maxillomandibular fixation. Patients in group B were subjected to miniplate fixation. Patients’ follow up was done on the first, second, fourth, and eighth week for the assessment of infection and malocclusion and were recorded. Results: In this study, the mean age was 30 years with standard deviation ± 1.62. Sixty percent of the patients were male, and 40% of patients were female. Regarding the infection in the Transosseous wiring group, the postoperative infection was found in 15(15%) patients, and in the Mini plates group, the postoperative infection was found in 4(4%) patients. While malocclusion in Transosseous Group, postoperative malocclusion was found in 10(10%) patients, and mini plates group postoperative malocclusion was found in one patient(1%). Conclusion: The major operative morbidity proved to be infection followed by a malocclusion. As the rate of infection and malocclusion was found more in transosseous wiring as compare to mini plates, which concludes that Mini plates technique is best than transosseous wiring technique in the management of anterior mandibular fractures.

Comparison Between Conventional Titanium Miniplates and Indigenous Detachable Custom made 3D Titanium Plates (VAS 3D Bone Plate) for Fixation of Mandibular Fracture in Mental Foramen Region: A Randomized Clinical Trial and Finite Element Analysis.

To overcome limitation of 3D plate for fracture fixation in mental foramen region, by designing an indigenous custom made detachable 3D titanium plate (VAS 3D bone plate) and comparing it with two miniplate fixations for fractures of aforementioned region. Finite element analysis (FEA) of VAS plate and randomised clinical trial was performed and compared with miniplates. Twenty fractures in 19 patients with fracture in mental foramen region were divided randomly into two groups (Group I-fixation by miniplates and Group II with VAS plate) and evaluated for ease of fixation, neurosensory deficit, bite forces, occlusion and adequacy of fracture fixation. FEA of VAS plate revealed better performance for stress distribution, deformation and rigidity. A total of 20 mental foramen region fractures in 19 patients (18 male and 1 female) were treated. Group II had better results for bite forces and lingual control. Except for two patients with screw exposure in Group II and transient neurosensory deficit (resolved by 6months), no other complications were observed. Ease of fixation was significantly better in miniplate group. VAS plate was successful in providing satisfactory fixation and was observed to be better in terms of lingual control and masticatory efficiency.

Effect of fixation method on intergonial width stability after mandibular setback via bilateral sagittal split osteotomy

Q4: Horizontal changes occur following bilateral sagittal split osteotomy (BSSO) in skeletal class III patients. The aim of this study was to assess the ostoperative changes in intergonial (IG) width and compare them between the positional screw and miniplate fixation methods in BSSO. This study evaluated patients who had mandibular prognathism and underwent BSSO for mandibular setback. Internal fixation was performed bilaterally, either with positional screws in the lateral ramus or with a miniplate. Postero-anterior cephalograms were obtained preoperatively (T1), at 1 month postoperative (T2), and at 6 months postoperative (T3). The IG widths and the alterations in IG width postoperative (T2−T1, T3−T2) were measured. No correlations were observed between the amount of setback and changes at T2 −T1 or T3−T2. The IG width values decreased after mandibular setback and internal fixation with both methods. Statistical analyses showed a significant difference between T3 and T1 in the miniplate group (P=0.045). No significant difference in the postoperative change in IG width (T2−T1 and T3−T2) was found between the two fixation groups. The magnitude of this change was smaller for positional screws when compared to miniplates for fixation. The amount of mandibular setback showed no correlation with postoperative changes in IG width..

Comparison of the effect of two internal fixation methods for proximal clavicle fractures.

OBJECTIVE To compare the effect of two internal fixation methods in the treatment of proximal clavicle fractures. METHODS Fifty patients with proximal clavicle fractures received surgical treatment. They were divided into a clavicular T-plate group and a double mini-plates group. The duration of the operation, blood loss during the operation, fracture healing time, and incision infection were evaluated between the two groups. RESULTS Operation time (t=2.063, P=0.058), intraoperative bleeding (t=1.979, P=0.062), and fracture healing time (t=1.082, P=0.066) were not statistically significant in the two groups. The patients were followed up for 12-18 months; one patient in the T-plate group had early removal of nails, but no clinical symptoms. At the 2-month follow-up, the ASES score in the double mini-plates group was significantly better than in the T-plate group (P<0.001); but at the 6-month follow-up, 1-week before removal of internal fixation and the final follow-up, the two groups had no significant differences (P>0.05). CONCLUSIONS Both internal fixations have similar clinical results in the duration of operation, blood loss during the operation, and fracture healing time. The double mini-plates fixation presents advantages by reducing complications and speeding fracture healing; thus it is a more effective method to treat proximal clavicle fractures.

Comparison of different treatment techniques in the mandibular condyle fracture.

Mandibular condyle fractures can be treated conservatively by intermaxillary fixation (IMF) or by open reposition and internal fixation. Although many studies have discussed for the optimal treatment method, the issue remains controversial. In this study, we aimed to compare conservative techniques in the mandibular condyle fractures. Twenty four unilateral condyle fracture patients aged between 18 and 48 years were treated according to one of three different modalities. Bracketing, arch bar or mini screw was applied to all non-surgery patients to obtain IMF. Eight patients were treated with only IMF meanwhile eleven patients were treated with one or double-sided amplifier occlusal splint according to the status of fractured segments, in addition to IMF. Remaining five patients have undergone open reduction and fractured segments immobilized with mini plates. Pre- and post-operative images were recorded with a computerized tomography device. Clinical and radiological examinations were performed by orthodontists and surgeons at baseline and at 6 months of treatment. The condyle lengths of the patients with unilateral fracture after recovery were compared with the unaffected side. The length between the most protruding point of the condyle and the mandible was measured and the length difference was only 5.94 mm in patients who were treated by IMF. The length difference of patients who used brackets and splints was 3.36 mm (p<0.05). The length difference of patients who were repaired by plate screws was 1.80 mm (p>0.05). However, there was no statistically significant difference (p>0.05) between the groups in the IMF, occlusal splint and IMF and mini plate groups, between the trauma side and the opposite side. None of the patients developed ankylosis, open mouth, limitation of mouth opening, facial asymmetry, laterognathia, and retrognathia. The occlusion of the patients who were not known to have pre-trauma occlusions were directed, repositioned and provided an appropriate occlusion. The use of IMF with an occlusal splint is a more conservative and acceptable treatment modality than open reduction in selected cases.

Conventional 2D miniplate versus 3D four-holed and eight-holed miniplates in the management of mandibular angle fractures

ObjectiveTo compare the efficacy of conventional 2D miniplate with 3D 4-hole and 8-hole miniplates in the management of mandibular angle fractures. MethodsA prospective study was conducted on 24 patients with isolated mandibular angle fractures that were divided into three following groups (n = 8 each) based on the osteosynthesis technique used:Group A- conventional 2D four-holed miniplateGroup B- 3D- 4-holed miniplateGroup C- 3D- 8-holed miniplatePost-operative pain, inter-incisal opening, range of motion, bite force and incidence of complications were assessed at various time intervals up to a period of six months. ResultsA steady improvement in all parameters was seen in the three groups over six months. A significantly greater amount of 1 week post-operative trismus was observed in the 8-holed miniplate group (p < 0.05). Six months after the surgery, however, the difference in pain, inter-incisal opening, range of motion and bite force among the three groups was found to be statistically insignificant (p > 0.05). The incidence of complications was greatest in Group B (25 %). ConclusionThe conventional 2D miniplate system still holds its place as the method of choice for management of mandibular angle fractures.

Posterior open-door laminoplasty secured with titanium miniplates vs anchors: a comparative study of clinical efficacy and cervical sagittal balance

ObjectivePosterior open-door laminoplasty (PODL) is a common procedure for treating multilevel cervical spondylotic myelopathy (MCSM). Little information is available regarding the cervical sagittal balance and surgical efficacy of PODL when securing with different methods. Therefore, this study aims to investigate the clinical outcomes and the changes in cervical sagittal parameters and balance associated with PODL secured with titanium miniplates vs anchors.MethodA retrospective analysis was performed on the clinical data of 79 patients with MCSM who were treated in our institution from January 2015 to December 2016. Among them, 42 patients were treated by PODL secured with titanium miniplates (group A) and 37 patients by PODL secured with anchors (group B). Surgical time, intraoperative blood loss, hospital stay, hospitalized cost, VAS scores of neck pain, JOA scores, neck disability index (NDI), and improvement rate of spinal neurological function (IRNF) were recorded before surgery and at 12 months after surgery. Before surgery, at 1 month and 2 years after surgery, the following radiological parameters were recorded and compared on the lateral cervical X-ray images: the distance from the vertical axis of C2 sagittal plane to the posterior superior edge of C7 (C2-7 SVA), the inclusion angle of tangent between C2 and C7 trailing edge (C2-7 Cobb angle), and the intersection angle between the upper edge of T1 and the horizontal line (T1 Slope).ResultComparing the two groups, there were no significant differences in surgical time, intraoperative blood loss, hospital stay, VAS, JOA, and NDI scores before surgery (P > 0.05); however, the hospitalized cost of group A were much higher than those of the group B (P < 0.05). At 2 years after surgery in the two groups, there was a significant reduction in VAS and NDI scores (P < 0.05), and JOA scores increased significantly (P < 0.05). In addition, there were no significant differences in VAS, JOA and IRNF between the two groups (P > 0.05); however, NDI scores of group A were better than those of group B (P < 0.05). In radiological parameters, before surgery, the two groups showed no significant differences in C2-7 SVA, C2-7 Cobb angle, and T1 slope (P > 0.05); however, after surgery, C2-7 SVA and T1 slope increased (P < 0.05), while C2-7 Cobb angle decreased (P < 0.05). At 2 years after surgery, the two groups did not differ significantly in C2-7 Cobb angle and T1 slope (P > 0.05), while C2-7 SVA of group A was superior to that of group B (P < 0.05). The difference value of C2-7 SVA measured before and after surgery was correlated negatively with that of NDI scores (P < 0.05).ConclusionPODL secured with titanium miniplates or anchors achieved good clinical efficacy in the treatment of MCSM. However, the patients with miniplates feel a better cervical functional status, while those with anchors spend less on hospitalization. Both methods lead to anteversion of cervical spine, but cervical sagittal balance after miniplates is better than that of anchors.

Comparing clinical outcomes of using 3 versus 5 titanium miniplates in laminoplasty for multilevel cervical myelopathy: A prospective cohort study

Study designProspective cohort study. ObjectiveThe aim of this study was to compare clinical outcomes, radiographic changes, and complications of cervical expansive open-door laminoplasty（EOLP）for cervical multilevel myelopathy, using either 3 or 5 titanium miniplates. Summary of background dataCervical EOLP is a common and effective operation for cervical myelopathy. Standard procedures utilise either 3 or 5 titanium miniplates; however, no definite conclusion has been given yet on the relationship between clinical outcomes and the quantity of titanium miniplates. MethodWe performed a prospective study of 92 patients who underwent EOLP with either 3 (n ​= ​34) or 5 (n ​= ​58) titanium miniplates at our institution from March 2012 to June 2016. Clinical and radiologic outcomes and complications were compared. ResultCompared with the 5 titanium miniplates group, the 3 titanium miniplates group had shorter operation times and less blood loss (P ​< ​0.05) and needed fewer costs (P ​< ​0.01) during index hospitalisation. The preoperative cervical curvature angle decreased in both groups and revealed no significant differences. There was no significant difference between the two groups in the Japanese Orthopedic Association (JOA) score, JOA recovery rate, loss of range of motion (ROM), anteroposterior diameter (APD), or spinal canal complications (P ​> ​0.05). ConclusionCervical EOLP using 3 titanium miniplates is associated with shorter operation times, less blood loss, and lower operation costs compared with using 5 titanium miniplates. The translational potential of this articleExpansive open-door laminoplasty (EOLP) is an effective procedure for treating multilevel cervical spondylotic myelopathy. The present study indicated that 3 titanium miniplates could achieve similar clinical outcomes but with shorter operation times, less blood loss and operation costs compared with 5 titanium miniplates. These findings may provide some references for clinical applications.

Effects of orthopedic skeletal Class III correction in growing subjects using skeletal anchorage and Class III elastics

Aim of the study: The objective of this study was to evaluate the skeletal and dental effects of intermaxillary Class III elastics using bone anchored miniplates compared to an untreated Class III control group.Subjects and methods: 24 subjects (14 females and 10 males) having skeletal Class III malocclusion with maxillary deficiency with an age range of 8-11 years old were divided into two groups 12 patients each (n=12). Group A constituted treatment with Class III elastics anchored to 4 titanium miniplates, 2 anchored in the zygomatic buttress of the maxilla and 2 miniplates anchored in the symphyseal region of the mandible at the lateral/canine region. Group B (n=12) constituted untreated skeletal Class III cases (control group). The treatment and observation periods for both groups were 8 months. Lateral cephalometric radiographs were taken for the patients at start of treatment (T1) and at the end of the treatment/observation periods (T2). The radiographs were analyzed by performing lateral cephalometric analysis. Independent student t test was done to compare variables between the two groups.Results: There was correction of the skeletal Class III in the miniplates group with statistically significant increase in angle SNA (mean 3.50° ± 0.68), A-Nperp (mean 4.04mm ± 1.20), ANB (mean 4.06◦±0.95) and Witts appraisal (mean 4.91mm ± 1.76) .Slight mandibular retrusion occurred with a reduction in angle SNB (mean -0.56◦ ±0.57). Changes in B-Nperp were (-1.85mm±1.36).Overjet correction was obtained and no significant changes in the maxillary incisor angulation was observed. There was proclination of mandibular incisors by (mean 6.43◦±2.11).Conclusions: The use of intermaxillary Class III elastics and miniplates in the orthopedic treatment of skeletal Class III is a successful technique with more skeletal than dental effects.

Titanium Lag Screw Versus Miniplate Fixation in the Treatment of Anterior Mandibular Fractures

The use of plates for open reduction and internal fixation of mandibular fractures has become a widely accepted method in the past 3decades. However, the anterior mandible is well suited to lag screw fixation owing to the thickness of its bony cortices. Hence, the purpose of the present study was to comparatively evaluate clinical outcomes of fixation using lag screws and miniplates in anterior mandibular fractures. Fifty patients reporting to the department of oral and maxillofacial surgery with noncomminuted anterior mandibular fractures were randomly divided into 2 groups of 25 patients each. Patients in group A were treated with 2.5-mm lag screws 22 to 26mm in length and those in group B were treated with 2.0-mm 4-hole miniplates with a gap using monocortical screws. Subsequent follow-up was performed at 3, 6, 12, and 24weeks postoperatively. The primary determinants included radiographic analysis of the fracture gap and biting efficiency of the patients in groups A and B. The secondary determinants included evaluation of duration of surgery, occlusion before and after injury, and postoperative complications. Results were evaluated using χ2 and unpaired t tests. The mean age of the patients in this study was 29.1±8.32years (range, 18 to 67yr). The mean postoperative fracture gap was considerably larger in group B. The mean duration of surgery (minutes) was 37.60±9.30 for group A and 47±6.55 for group B. The difference was statistically significant (P=.001). The lag screw group showed faster improvement in biting efficiency compared with the miniplate group. Lag screw fixation was found to have good stability and rigidity, was inexpensive, and was less time consuming in treating anterior mandibular fractures compared with miniplates.

Evaluation of the miniplate-anchored Forsus Fatigue Resistant Device in skeletal Class II growing subjects: A randomized controlled trial.

To evaluate the use of direct miniplate anchorage in conjunction with the Forsus Fatigue Resistant Device (FFRD) in treatment of skeletal Class II malocclusion. Forty-eight females with skeletal Class II were randomly allocated to the Forsus plus miniplates (FMP) group (16 patients, age 12.5 ± 0.9 years), Forsus alone (FFRD; 16 patients, age 12.1 ± 0.9 years), or the untreated control group (16 subjects, age 12.1 ± 0.9 years). After leveling and alignment, miniplates were inserted in the mandibular symphysis in the FMP group. The FFRD was inserted directly on the miniplates in the FMP group and onto the mandibular archwires in the FFRD group. The appliances were removed after reaching an edge-to-edge incisor relationship. Data from 46 subjects were analyzed. The effective mandibular length significantly increased in the FMP group only (4.05 ± 0.78). The mandibular incisors showed a significant proclination in the FFRD group (9.17 ± 2.42) and a nonsignificant retroclination in the FMP group (-1.49 ± 4.70). The failure rate of the miniplates was reported to be 13.3%. The use of miniplates with the FFRD was successful in increasing the effective mandibular length in Class II malocclusion subjects in the short term. The miniplate-anchored FFRD eliminated the unfavorable mandibular incisor proclination in contrast to the conventional FFRD.

In vitro biomechanical evaluation of a monocoque plate-spacer construct for cervical open-door laminoplasty.

PurposeTo evaluate biomechanical differences between two surgical procedures for cervical open-door laminoplasty using human cadaveric spines.MethodsTwenty-four cervical vertebrae (C4-C6) from eight fresh-frozen human cervical spines were subjected to mechanical testing after being instrumented for open-door laminoplasty using a newly designed plate-spacer device with a monocoque structure (plate-spacer group; n = 12) or by conventional miniplate-alone fixation (miniplate group; n = 12). Cantilever bending testing was performed by applying a compressive load in the cranio-caudal direction to the base of the spinous process of the reconstructed laminar arch constructs until failure and strength and stiffness of the laminar arch were determined. The results are presented as mean ± standard deviation.ResultsThe plate-spacer group was approximately twice as strong as the miniplate group (27.6 ± 16.5 N vs. 13.5 ± 7.3 N, p < 0.05). Stiffness in the plate-spacer group exhibited the same trend (19.6 ± 9.3 N/mm vs. miniplate group: 11.4 ± 6.9 N/mm, p < 0.05).ConclusionThe fixation with the monocoque plate-spacer construct for open-door laminoplasty provided higher structural properties when compared against the plate-alone fixation. The spacer in the plate-spacer construct appears to contribute by preventing large deformations of the laminar arch caused by bending in cranio-caudal direction. Future studies will be required to investigate stress/strain distribution in the laminar arch constructs.

Management of anterior mandibular fractures using four fixation methods: A clinical comparative study

Purpose: To compare the surgical outcomes of three-dimensional (3D) mini-plates for fixationof anterior mandibular fractures (AMFs) and those of bone plates and lag screws.Materials and methods: Patients with AMFs, who met the inclusion criteria, were equallydistributed into 4 groups. Those in Group I were treated with double 2.0 mm mini-plates, patientsin Group II were treated with double lag screws, 2.3mm locking plates were used in group III,while in Group IV 2.0 mm 3D mini-plates were used. Prior to the surgical intervention, MMF wasperformed to verify the centric occlusion in all patients. After hardware fixation, the MMF wasintraoperatively released, and the adequacy of fixation and occlusion was verified. The operationtime and postoperative outcomes were also analyzed.Results: Sixty patients (41 males and 19 females) were included in this prospective study.There were no significant differences in demographic data. The clinical examination showed stablefixation with no mobility in all cases. None of the patients in the 3D mini-plates group showedclinical manifestations of infection or dehiscence. The incidence of malocclusion was the highestin the mini-plates group. There was no statistically significant difference among the groups in allparameters, except for infection and paresthesia. They were significantly greater in double miniplatesand 2.3 mm locking plate groups respectively.Conclusion: The use of 3D mini-plates is a viable option for fixation of AMFs. It has advantagesof both lag screws and bone plates. A 3D mini-plate provided sufficient inter-fragmentary stabilitywith a relatively low rate of complications when compared with other conventional fixationtechniques.

Mini-plate fixation via sinus tarsi approach is superior to cannulated screw in intra-articular calcaneal fractures: A prospective randomized study

Intra-articular displaced calcaneal fractures are common fractures and are often treated with surgical interventions. Sinüs tarsi approach provides secure access to lateral wall and joint facets. The aim of the study is to compare cannulated screw (CS) fixation and mini-plate (MP) fixation via sinus tarsi approach with Sanders types 2 and 3 fracture of calcaneus. Sixty patients with Sanders types 2 and 3 calcaneal fracture underwent surgical intervention were randomly allocated into two groups as group MP fixation and group CS fixation regarding osteosynthesis method for 5-year period. Open reduction via sinüs tarsi approach was performed in both groups. Demographic variables, time to surgery (TS), operation duration (OD), length of hospital stay (LOS), surgical complications, and reoperations were recorded. Pre- and postoperative Gissane and Böhler angles; calcaneal length, height, and width; ankle anterior-posterior (AP) and lateral X-rays; and computed tomography were also recorded for radiological evaluation and fracture characteristics. Maryland Foot Score (MFS) was used to evaluate functional outcomes. Preoperative age, type of fracture, calcaneal length, height, and Gissane and Böhler angles, TS, LOS, and OD were not different between the groups. The postoperative calcaneal widening was significantly better restored in group MP compared with that of group CS. The incidence of reoperation and algoneurodystrophy was statistically higher in group CS than group MP. MFS in group MP was also higher than group CS at final visit. MP fixation via sinus tarsi approach is superior to CS fixation in Sanders types 2 and 3 calcaneal fractures.

Comparison between patient specific implants and conventional mini-plates in Le Fort I osteotomy with regard to infections: No differences in up to 3-year follow-up

Individually designed osteotomies and milled or printed patient-specific osteosynthesis materials are rapidly becoming a standard in maxillofacial reconstructive surgery. The benefits of using patient-specific implants (PSIs) in orthognathic surgery are especially clear in complex cases, and for this reason they are rapidly becoming common practice. We have earlier reported the benefits related to the use of PSIs as reposition and fixation system in Le Fort I osteotomy. The aim of this study was to compare complications associated with fixation with PSIs (31 patients) versus conventional mini-plates (37 patients) in Le Fort I osteotomy. No statistically significant differences in infection, reoperations or soft tissue problems were observed between the two systems used. Interestingly, three of the 37 patients in the mini-plate group underwent reoperation due to insufficient advancement or malocclusion, whereas none of the patients in the PSI group needed reoperation. In conclusion, PSIs are reliable for use in orthognathic surgery, with no signs of infection associated complications.

Herbert Cannulated Bone Screw Osteosynthesis in Anterior Mandibular Fracture Treatment: A Comparative Study With Lag Screw and Miniplate

The Herbert bone screw (HBS) is a successful and minimally invasive method of fracture fixation that is used routinely in orthopedic surgery. The aim of this study was to evaluate the clinical and radiographic performances of the HBS in the treatment of anterior mandibular fractures and compare it with the common and established treatment modalities, the lag screw (LS) and the 2.0-mm miniplate (MP). This study implemented a randomized clinical trial and enrolled a sample of patients with anterior mandibular fractures. The primary predictor variable was treatment group categorized as HBS, LS, or MP fixation of the fracture. Primary outcome variables were the presence of interfragmentary mobility and radiodensitometric appraisal of fracture healing progression. The secondary outcome was the postoperative clinical evaluation. Other variables collected were grouped into demographic, fracture location, and intraoperative clinical data. All recorded data were documented, tabulated, computed, and analyzed. Statistical significance was set at the 5% level. Twenty-one patients were selected and randomly allocated to 1 of 3 groups based on the fixation modality used. There were no relevant differences in demographic data for the 3 groups. There were no statistically relevant differences in clinical evaluation outcomes. However, there was a statistically significant difference in the gain of mean postoperative bone density between the HBS and MP groups (P=.012) and between the LS and MP groups (P=.045), but not between the HBS and LS groups. Cannulated HBS osteosynthesis provides a successful and minimally invasive treatment modality for the management of anterior mandibular fractures.

Custom Implant for Reconstruction of Mandibular Continuity Defect

The purpose of this study was to compare the daily food intake rate and the rate of screw loosening between 2 groups of rabbits with mandibular continuity defects: custom implant (CI) group and 5-hole mini-plate group. Two types of cylindrical implants were printed, and their physical strength was compared. In this study using rabbits, 1 group (n=5) received a CI for the reconstruction of a mandibular continuity defect (CI group) and the other group (n=5) received a 5-hole mini-plate without a bone graft (reconstruction plate [RP] group). After reconstruction, the daily food intake rate and the rate of screw loosening were examined postoperatively. Histologic examination in the CI group was performed 3months after the operation. The design that mimicked the mandible showed greater physical strength. The amount of time required to achieve 50% recovery was shorter in the CI group than in the RP group (P=.011).The total number of loosened screws in the CI group was lower than that in the RP group at 3months postoperatively (P=.008). New bone formation in the porous CI was evident in the CI group. Rabbits with mandibular continuity defects treated with CIs for reconstruction showed faster recovery of the daily food intake rate and fewer loosened screws than those treated with a 5-hole mini-plate without bone graft.

Comparison of the effects of absorbable rod and mini-plate fixation for the treatment of oblique metacarpal fractures

Objective To assess the clinical results of metacarpal fracture fixation by mini-plates and absorbable rods. Methods From January 2013 to May 2016, 95 metacarpal fractures in 80 cases were assigned to absorbable rod fixation group (31 fractures in 29 cases) and mini-plate fixation group (64 fractures in 51cases). Results Postoperatively all the cases were follow-up for 3 to 12 months (average, 7.6 months). All fractures healed. The clinical results of both groups were assessed by the upper extremity functional evaluation criteria issued by TAFS. In the mini-plate group 31 fractures were graded as excellent, 25 as good and 8 as poor. In the absorbable rod group 19 fractures were graded as excellent, 11 as good and 1 as poor. There were no statistically significant differences between the two implant types. Conclusion Both types of implants seem to be equally effective and safe for metacarpal fracture fixation. The absorbable rod fixation is an easy procedure for oblique metacarpal fracture. It achieves the rigidity required for internal fixation. It will break down over time leaving no foreign body and stress shield, and does not require a secondary surgery to remove the implant. It is an ideal and effective treatment. Key words: Metacarpal bones; Fractures,bone; Absorbable rod; Mini-plates

A Comparative Prospective Study of Two Bone Plating Methods for Fractures of the Mandibular Symphysis or Parasymphysis

Mandibular symphysis and parasymphysis fractures are a common type of injury to facial skeleton. The purpose of this prospective study was to evaluate outcomes for 2 bone plating techniques used in the treatment of mandibular symphysis/parasymphysis fractures. Thirty patients reporting to the department with mandibular symphysis/parasymphysis fractures were divided into 2 groups (group A and group B). A prospective study was carried out in 30 patients with defined inclusion and exclusion criteria. Patients were followed for 3 months postoperatively for occlusion, distraction of lower border radiologically, paraesthesia, infection, failure of bone plate (plate fracture) and screw loosening, postoperative segmental stability and radiological evaluation of fixation. Fifteen patients were treated by open reduction and single miniplate fixation below apices of teeth with arch bar acting as tension band (Group A) and 15 with conventional titanium miniplates following Champy's rule i.e. Two miniplates (Group B). Distraction of lower border was seen in both groups (as in group A-1 patient and group B-2 patients), which was noticed radiographically at all follow ups. There was no occlusal discrepancy present in both groups after 3 months post operatively. The fracture segments were stable in both groups at all times. Paraesthesia was noticed in both groups, which gradually decreased in 1 month and resolved completely by 3rd month follow up. The degree of paraesthesia, distraction of lower border, occlusal discrepancy was not statistically significant between the two groups. Infection was noticed in both groups at the end of 2 weeks, which was treated with antibiotics. The result between both the groups was not significant though. Hardware failure (plate fracture and screw loosening) was not found in both groups. Osteosynthesis by both techniques is effective in providing immediate post operative function but the distinct advantage of less hardware has made the use of a single miniplate quite popular in the recent times.

Comparison of postoperative changes in the distal and proximal segments between conventional and sliding mini-plate fixation following mandibular setback.

ObjectiveThe purpose of the present study was to evaluate the postoperative three-dimensional (3D) changes in the proximal segments after mandibular setback sagittal split ramus osteotomy and to compare the changes between the conventional mini-plate fixation and semi-rigid sliding plate fixation.MethodsCone-beam computed tomography (CBCT) images were used to evaluate the postoperative 3D changes in the proximal segments during the healing process. CBCT images were superimposed using the symphysis and the lower anterior mandible as references.ResultsThere were no statistically significant differences between the conventional mini-plate and semi-rigid sliding plate groups (p > 0.05). With respect to the distribution of changes greater than 2 mm in the landmarks, the right condylion, right coronoid process, and left condylion showed ratios of 55.6%, 50.0%, and 44.4%, respectively, in the semi-rigid sliding plate group; however, none of the landmarks showed ratios greater than 30% in the conventional mini-plate group.ConclusionsThere were no statistically significant differences in postoperative changes in the segments between the conventional mini-plate and semi-rigid sliding plate groups. Nevertheless, while selecting the type of fixation technique, clinicians should consider that landmarks with greater than 2 mm changes were higher in the semi-rigid sliding plate group than in the conventional mini-plate group.