Symphysis Fractures Research Articles

Finite Element Analysis of Two- and Three-Dimensional Fixation in Treating Mandibular Symphyseal Fracture Combined With Bilateral Condylar Intracapsular Fractures.

The aim of this study was to compare through finite element analysis two- and three-dimensional (2D and 3D) fixation in the treatment of mandibular symphyseal fracture combined with bilateral condylar intracapsular fractures. The authors created 2 fixation models for the above fracture, and analyzed the stress and displacement in the mandible and fixation materials under 3 loading conditions. The von Mises stress of the mandible and plates peaked during lateral occlusion, and was lowest during central occlusion. In all conditions, stresses in the fixation materials did not exceed the yield stress of titanium. The inferior border of the symphyseal fracture segments showed opposing displacements, and the mandible tended to widen in the 2D fixation model. However, the fracture displacement did not exceed 150 μm for either fixation method. The results suggested that after well reduction and fixation of condylar intracapsular fractures, either 2D or 3D fixation for symphyseal fracture can provide adequately strong fixation. Compared with 2D fixation, 3D fixation has more advantages in controlling the mandibular width and preventing the fixation materials from enduring excessive stress.

Comparitive assessment of bite forces in subjects treated for anterior mandibular fractures with 3-dimensional plates and standard miniplates

Background: Loss of masticatory function is one of the important effects of mandibular fractures. Therefore the therapeutic goal of management is to restore original anatomic form and function. Considering this, maximal bite force could be a major factor for evaluating the success of treatment. Objective: The purpose of this study was to compare the efficiency of 2.0mm 3-Dimensional plates and two standard 2.0 mm Miniplates in the fixation of anterior mandibular fractures i.e, the parasymphysis and symphysis fractures on the basis of bite force and other clinical parameters. Materials and Methods: The study was conducted on 30 patients with isolated fractures of anterior mandible region. The patients were categorized into two groups with 15 patients in each group. In group A patients were treated with 3-Dimensional miniplate and in group B patients were treated with two conventional Miniplates and these patients were evaluated pre-operatively, immediate post-op, 1st week, 4th week, 3rd month and 6th post-op months using bite force and other clinical parameters. Results: The study results revealed no statistically significant difference between the study groups with respect to root damage and mal-union. There was occlusal discrepancy, mobility of fracture segments, and post-op infection observed in Conventional plate group which was absent in 3D plate group. One patient in Conventional plates group had to undergo implant retrieval due to persistent infection and experienced neurosensory deficit even after 6th post-op month. The bite force measurement between the study groups showed statistical significant increase of bite force in the right premolar and right molar regions at 4th post-op month, 3rd post-op month and 6thpost op-month. In 3D plate group, patients showed increased bite force values in comparison to Conventional plates group throughout the follow up intervals. Conclusion: This study concluded that the use of 3D miniplates in anterior mandibular fractures

Maxillofacial Injuries in Pediatric Patients.

This study aimed to evaluate and analyse the demographic characteristics and changes in maxillofacial injuries during their development in pediatric patients. A retrospective cohort and case-control study was conducted. The sample was composed of all children (less than 10.5 years) who presented with maxillofacial injuries within a 6.5-year period (from December 2012 to April 2019). Data about age, gender, hospitalization date, mechanism of trauma, location and pattern of injuries, associated general injuries or systemic diseases, admission methods (emergency admission or not), type of anesthesia, treatment methods and hospital costs (¥) were recorded and analyzed. Data analysis included Chi-square test, Fisher exact test, and t test. Univariate and multivariate analyses were also performed. Logistic regression analysis was used to control for confounding variables. Differences at P < 0.05 were considered significant. A total of 643 pediatric patients were included in this study, with a boy-to-girl ratio of 1.77:1 (411 boys and 232 girls). The age range was 0.18 to 10.5 years (average of 3.23 ± 1.98 years). The largest age group was patients aged 1 to 2 years (200 patients, 31.1%), followed by 2 to 3 years (139 patients, 21.6%). In the majority of patients, fall at ground level was the most common mechanism of injury (391 patients, 60.8%). In addition, 613 patients (95.3%) sustained at least maxillofacial soft-tissue injuries, while 460 (71.5%) sustained only maxillofacial soft-tissue injuries and 183 (28.5%) sustained maxillofacial fractures. Lip was the most vulnerable soft tissue to be injured (283 patients, 44.0%). Patients who sustained maxillofacial soft-tissue injuries were less prone to maxillofacial fractures than those who did not. Maxillofacial fractures were highly presented in patients with dental injuries (OR = 6.783; 95% confidence interval, 3.147-14.620; P < 0.001). Older children (> 5 years old) were at higher risk of maxillofacial fractures than younger children (≤ 5 years old, P = 0.006). The risk of maxillofacial fractures (except symphysis fractures) increased with age, especially in patients aged between 5 and 10 years. Maxillofacial soft-tissue injuries were highly distributed amongst patients aged 1 to 5 years. The number of patients who sustained only maxillofacial soft-tissue injuries gradually decreased from 2013 to 2018. Patients in emergency admission (OR = 13.375; 95% confidence interval, 1.286-139.121; P = 0.030) and treated under general anesthesia (OR = 27015.375; 95% confidence interval, 1033.046-706484.218; P < 0.001) were more prone to be treated by surgery procedure. Patients with facial fractures were less frequent to be treated by surgery procedure (OR = 0.006; 95% confidence interval, 0.000-0.575; P = 0.028); however, the mandibular symphysis (OR = 18.141; 95% confidence interval, 2.860-115.069; P = 0.002) or body fractures (OR = 71.583; 95% confidence interval, 2.358-2172.879; P = 0.014) were highly treated by surgery procedure. Maxillofacial fractures in pediatric patients were significantly related to age, etiology, maxillofacial soft-tissue injury, dental injury and other general injuries. Older pediatric patients were at higher risk of maxillofacial fractures (except symphysis fractures) and lower risk of maxillofacial soft-tissue injuries than younger pediatric patients. Patients in emergency admission, fractures of the symphysis or body, and treated under general anesthesia were the main reasons for surgical management.

Surgical Reduction of Symphysis Fracture and Spontaneous Repositioning of the Mandibular Condyle: A Case Report

The condylar process is a more fragile area, which is usually fractured by indirect trauma. The objective of this study is to report the case of a 10-year-old patient who presented to the Maxillofacial Surgery and Traumatology Service of the Regional Hospital of Vale do Paraíba, in Taubaté-SP, Brazil. Physical examination revealed limited mandibular movement with painful symptoms, crossbite, and upper incisor avulsion. A face tomography showed a fracture of the mandibular symphysis (right side) and a fracture of the left condyle. Surgical reduction of the mandibular symphysis fracture was performed. After exposure and reduction of bone segments, maxillomandibular block, rigid internal fixation and conservative treatment for condyle fracture were performed. A soft liquid diet and weekly outpatient follow-up was adopted for the first two months. After 15 days of surgery, the patient had mild edema, slight limitation in mouth opening, sutures without dehiscence and without signs of infection. In the first control tomography, the treated fracture was adequately reduced and the fractured condyle remained with medial displacement in the glenoid cavity. After one year, on physical examination, the patient presented satisfactory dental occlusion, preserved mandibular movements and no signs of nerve damage. The tomography showed the fracture consolidated, and the left mandibular condyle well positioned in the glenoid cavity. After two years, the third tomography was performed, showing remodelling of the left mandibular condyle.

Management‌ ‌of‌ ‌dentofacial‌ ‌trauma‌ ‌in‌ ‌an‌ ‌adolescent‌ ‌patient:‌ ‌The‌ ‌ conservative‌ ‌and‌ ‌the‌ ‌preservative‌ ‌approach‌

Mandibular fractures are one of the most frequent occurrences in maxillofacial trauma. Age of the patient, presence of additional injuries, co-morbid diseases of the patient, trauma type, and localization of the fracture must be considered while choosing the treatment strategy. A 12-year-old female patient reported with the complaint of fallen teeth due to trauma three days back. Clinical and radiographic findings revealed symphysis fracture with left sided parasymphysis and subcondylar fracture along with avulsion of 11 and 21. Intermaxillary fixation was done with Erich arch bars and elastics for the management of mandibular fracture, and rehabilitation of edentulous space was done using the avulsed teeth as pontics which were bonded to the adjacent abutment teeth using fiber-reinforced composite.

Comparison of the mechanical properties of biodegradable and titanium osteosynthesis systems used in oral and maxillofacial surgery

To guide the selection of osteosynthesis systems, this study compared the mechanical properties of biodegradable and titanium osteosynthesis systems. SonicPins Rx and xG were subjected to pull-out tests. Additionally, 15 biodegradable (Inion CPS 2.0 and 2.5 mm; LactoSorb 2.0 mm; Macropore 2.0 mm; Polymax 2.0 mm; BioSorb FX 2.0 mm; ResorbX 2.1 mm; Osteotrans-MX 2.0 mm with plate thicknesses 1.0 and 1.4 mm; SonicWeld Rxplate/Rxpins, xGplate/Rxpins and xGplate/xGpins 2.1 mm without and with tapping the burr hole) and six titanium (CrossDrive (2006), CrossDrive (2018), MaxDrive; all 1.5 and 2.0 mm) straight, four-hole osteosynthesis systems were evaluated. All systems were subjected to tensile, bending and torsion tests. Pull-out loads of the SonicPins were comparable (P = 0.423). Titanium systems’ tensile loads were higher than biodegradable systems (P < 0.001). CrossDrive (2018) and MaxDrive systems’ tensile and torsional stiffness were lower, accompanied with higher ductility, than corresponding CrossDrive (2006) systems (P < 0.001). Bending stiffness of 1.5 mm titanium systems was comparable to, and of the 2.0 mm systems higher than, all biodegradable systems (P < 0.001). Regarding biodegradable systems, Inion CPS 2.5 mm had highest tensile load and torsional stiffness, SonicWeld 2.1 mm highest tensile stiffness, and BioSorbFX 2.0 mm highest bending stiffness (P < 0.001). On the basis of the results of this study, the CrossDrive (2018) and MaxDrive 1.5 mm titanium systems are recommended for midface fractures (e.g., zygomatic or maxillary fractures) and osteotomies (e.g., Le Fort I osteotomy), and the CrossDrive (2018) and MaxDrive 2.0 mm titanium systems for mandibular fractures and osteotomies when a titanium osteosynthesis system is used. When there is an indication for a biodegradable osteosynthesis system, the SonicWeld 2.1 mm or BioSorbFX 2.0 mm are recommended for midface fractures and osteotomies, and the Inion CPS 2.5 mm biodegradable system for mandibular osteotomies and non-load bearing mandibular fractures, especially when high torsional forces are expected (e.g., mandibular symphysis fractures).

Open reduction and internal fixation of mandibular left parasymphyseal fracture and conservative management of bilateral condylar fracture in a pillion rider- “Rules should be followed not ignored’

Maxillofacial injuries sustained through Road traffic accidents (RTAs) is one of the leading causes of hospitalization in India. Numerous factors such as ever increasing amount of two wheelers, assault conditions, lack of safety measures such as helmets, seat belts and lack of strict implementation of such rules, prevailing socioeconomic, cultural and environmental factors results in a substantial number of facial fractures from RTAs. By 2020, RTA injuries will rise as the 6th major cause of death worldwide. One of the most commonly employed means to thwart such RTAs include the use of helmet, following speed limits, obeying stop signs and traffic signals. Among two wheelers, the use of Helmets plays a crucial role in protecting the cranial vault and potentially the facial skeleton if a full face helmet is used. 25% of the RTAs are caused due to two wheelers rather than four wheelers. Pillion rider, who ride passenger behind the rider on a two wheelers more suspectible to morbid injuries due to lack of safety measures like not wearing a helmet, improper sitting patterns especially by females in India. A study showed injuries such as contusion and skull fractures are common when riding pillion. Here we report a case of mandibular symphysis fracture along with bilateral subcondylar fracture with medial displacement of the fractured segment sustained via RTA while riding pillion.

Clinical case of pubic symphysis diastasis in a pregnant woman with atypical clinical features

This article presents a clinical case of pubic symphysis diastasis in a pregnant woman with atypical clinical features. From 24 weeks of gestation, the patient noticed an intermittent low back aching pain radiated to posterior surface of the right thigh. The pain was regarded as a manifestation of lumbar osteochondrosis, and the patient did not receive specific treatment. At 39-40 weeks of pregnancy, the woman complained of severe pain in the left iliac region that appeared while lying on the left side or turning in bed. The differential diagnosis included acute abdomen and pubic symphysis diastasis. During diagnostic research, clinical features of acute abdomen were not found. The diagnostic tests such as tenderness palpation of pubic symphysis, P4 test, Patricks test, modified Trendelenburgs test, and Mennells test were positive. According to ultrasound, the width of the pubic symphysis was 8.9 mm, with a 2 mm deviation of pubic ramus relative to the sagittal plane, ill-defined margin and inhomogeneous structure of the symphysis due to hypoechogenic inclusions with a total area of about 50%. Thus, the patient was diagnosed with pubic symphysis diastasis of the 2nd degree. Given the severe pain syndrome and a high risk of pubic symphysis fracture during labor, this case required surgical delivery. The postoperative period elapsed without complication.

Internal Fixation of a Complicated Mandibular Fracture in a Filly Using a String-of-Pearls Locking Plate Assisted by a 3D Printed Model

AbstractObjective The aim of this study was to describe the successful surgical treatment of a complicated mandibular fracture with a 3.5 mm string-of-pearls (SOP) locking plate in a 5-month-old Appaloosa filly presenting with neurological signs.Study Design This is a case report.Results The neurological signs were due to severe head trauma and stabilized with medical treatment. Financial concerns initially prevented advanced imaging; radiographs identified a mandibular symphysis fracture, a fracture of the left vertical ramus that originated at the junction between the horizontal and vertical ramus and extended toward the coronoid process and rostral maxillary fractures. Following intra-dental wiring of the symphysis fracture, a lateral malocclusion developed. Computed tomography additionally identified fractures of the right wing of the basisphenoid bone, right zygomatic arch, left paracondylar process and the lateral body of the mandible. The vertical ramus fracture was repaired utilizing a 20-hole 3.5 mm SOP plate contoured to the ventral aspect of the angle of the mandible. A scaled (1:4) three-dimensional printed model aided pre- and intra-operative surgical planning. The filly was comfortable and eating well at the 4-week recheck. Radiographs showed good callus formation at the maxilla, healing of the mandibular symphysis and ramus. Just prior to the 10-week recheck, the filly suffered severe enterocolitis and was euthanatized.Conclusion The locking function of the SOP plate provided adequate stability for the fracture to heal without the expense of locking screws. The three-dimensional printed model aided in navigation of the complex fracture without the availability of fluoroscopy.

The Influence of Mandibular Gonial Angle on Fracture Site

The mandibular angle is influenced by multiple codependent morphologic dynamic factors, such as osseous anatomy, forces exerted by the muscles of mastication, occlusal loading patterns, and anatomic structures. These factors can influence the presence of a fracture in this area. Our research aimed to investigate a potential correlation between the risk of angle fractures and age, gender, fracture etiology, gonial angle size, presence of mandibular third molars, or presence of occlusal support. This retrospective cohort study was composed of patients treated for mandibular fractures between 2007 and 2018. The primary predictor variable was the gonial angle, and the primary outcome variable was the fracture site. Other study variables included demographic data, fracture etiology, third molar status, and presence of occlusal support. Appropriate univariate, bivariate, and multivariate statistics were applied, and statistical significance was set at P<.05. Of 332 isolated mandibular fractures included, 109 were angle fractures; 165, condylar; and 58, body or symphysis. The mean age of patients with angle fractures was 25.5years, compared with 31.3years and 32.7years for those with condylar fractures and body or symphysis fractures, respectively. The mean gonial angle was 125.4° in patients with angle fractures compared with 120.9° and 120.2° in those with condylar fractures and body or symphysis fractures, respectively. The variables that were found predictive of angle fractures were a wider gonial angle and the presence of third molars. Third molars and the gonial angle are predictors of the location of mandibular fractures. Wide gonial angles and the presence of third molars are predictors of mandibular angle fractures.

Retrospective Study of the Mandibular Condyle Fracture in Children and Young Adolescents

The aim of this retrospective study was to investigate etiology, clinical features, and treatment modalities of the mandibular condyle fracture in children and young adolescents. This study was conducted based on medical records and radiographic examinations of 44 pediatric patients. Patients received treatment under diagnosis of mandibular condylar fracture. They were divided into 4 groups according to their age. The involvement of condyle in the mandible fracture occurred in higher percentage in younger age groups. Falling was the most common etiologic factor in all age group, especially in children with age under 7. Condyle head was the most frequent site of fracture in age group of 4-7 whereas fracture tends to occur in lower condylar areas in older groups. In 54.5% of the mandibular condyle fracture, symphysis fracture was accompanied. Teeth injury occurred in higher incidency when condyle fracture accompanied symphysis fracture. Conservative treatments were applied to 43 out of 44 patients.

Refracture of the Mandibular Condyle in Epilepsy

Refracture of the mandible following stable internal fixation would be rare. A 28-years-old male patient was transferred to our emergency center due to fall caused by epilepsy seizure. Computed tomography (CT) showed left condylar base fracture with medial displacement and dislocation, and symphysis fracture. The fracture of condyle and symphysis were performed osteosynthesis with 2 mini-plates on ideal lines of osteosynthesis. The proximal segment of the condyle was placed totally three 7-mm-screws and 2 mini-plates. Six days after surgery, the patient transferred to our emergency center again due to fall by epileptic seizure. The patient drunk a lot of alcohol on the day before. CT indicated that left side fracture of condylar neck with medial displacement above the fixation plates, and no fracture of symphysis. The fracture line run on upper screw of posterior plate. The proximal segment of condyle could not be repositioned in the secondary surgery. The epilepsy patient following mandibular fracture might cause further epilepsy seizures. The risk factors of recurrence seizures should be evaluated including alcohol intake, less sleep and a history of noncompliance to anti-epileptic drugs.

Big Data Statistical Analysis of Facial Fractures in Korea.

BackgroundThe big data provided by Health Insurance Review and Assessment (HIRA) contains data from nearly all Korean populations enrolled in the National Health Insurance Service. We aimed to identify the incidence of facial fractures and its trends in Korea using this big data from HIRA.MethodsWe used the Korean Standard Classification of Disease and Cause of Death 6, 7 for diagnosis codes. A total of 582,318 patients were included in the final analysis. All statistical analyses were performed using SAS software and SPSS software.ResultsThe incidence of facial fractures consistently declined, from 107,695 cases in 2011 to 87,306 cases in 2016. The incidence of facial fractures was the highest in June 2011 (n = 26,423) and lowest in January 2014 (n = 10,282). Nasal bone fractures were the most common, followed by orbit and frontal sinus fractures. The percentage of nasal bone fractures declined, whereas those of orbital fractures increased from 2011 to 2016 (P < 0.001). Among orbital fractures, inferior wall fractures were the most common, followed by medial wall fractures. Among mandibular fractures, angle fractures were the most common, followed by condylar process and symphysis fractures. Although it was difficult to predict the most common type of zygomatic and maxilla fractures, their incidence consistently declined since 2011.ConclusionWe observed trends in facial fractures in Korea using big data including information for nearly all nations in Korea. Therefore, it is possible to predict the incidence of facial fractures. This study is meaningful in that it is the first study that investigated the incidence of facial fractures by specific type.

Comparison of accuracy of computed tomography scan and ultrasonography in the diagnosis of mandibular fractures

Ultrasonography (USG) allows to the examination of soft tissue and osseous tissues in the head-and-neck region. This study compared the accuracy of USG and computed tomography (CT) scan in the diagnosis of mandibular fractures. In this prospective observational study, spiral CT scan was prescribed for the lower face and, if necessary, midface and upper face in 42 trauma patients suspected of mandibular fractures, referring to Imam Reza Hospital in Tabriz. Two radiologists evaluated the CT scans. Then, another radiologist examined all the patients with USG with a frequency of 7-12 MHz. Ultrasonographic diagnostic results were recorded and compared with the results of the CT scan examinations. The results were reported using descriptive statistical methods. The specificity and sensitivity of USG were 100% and 91.1%, respectively. The USG sensitivities in the angle, condyle, condylar neck, and symphysis fractures were 100%, 91.6%, 85.7%, and 80%, respectively, and the specificity was 100% in all that anatomical regions. Among the confounding factors, the sensitivity of the USG (84.6%) was the lowest in the presence of hematoma; however, its specificity remained 100%. One case of symphysis fracture was not detected in the absence of any confounding factors in USG examination. Although the sensitivity, specificity, and diagnostic accuracy of the USG were at high levels, there were some limitations, making it difficult to definitively replace USG with CT scans, especially in the case of condylar fractures and in the presence of confounding factors such as hematoma and swelling.

Transoral Approach to Open Reduction of a Traumatic Avulsion Fracture of the Genial Tubercle Associated With a Mandibular Symphysis Fracture: A Case Report and Literature Review

Genial tubercle fracture (GTF) is rare and represents a diagnostic challenge as plain film radiography often fails to identify the fractured segment. Traumatic avulsion of the genial tubercle in conjunction with mandibular symphysis fracture may lead to posterior displacement of the tongue with the potential for airway compromise and difficulty in speech and swallowing due to loss of tongue anterior suspension. Fine cut computed tomography (CT) scan is required to confirm the diagnosis and assist further management. To our knowledge, all published cases of surgical intervention in the management of avulsed genial tubercle combined with fracture of the mandibular symphysis used an extraoral approach via submental skin incision to expose the fractured segment. To the authors’ knowledge, this is the first report to describe a transoral approach in the surgical management of GTF associated with a mandibular fracture.

Çocuklarda Mandibula Simfiz Kırığı Tedavisinde Noninvaziv Bir Yöntem

Çene kırıkları, pediatrik yüz kırıklarının önemli bir bölümünü oluşturur. Çocuklarda en sık görülen mandibula kırığı bölgesi kondildir ve bunu simfiz bölgesi takip eder. Mandibula kırıkları, çocuklarda, erişkinlere oranla daha az sıklıkla görülmekle birlikte simfiz kırıkları, erişkinlere oranla çocuklarda daha sık görülür. Bunun en büyük nedeni mandibulanın alt sınırında gelişen köpek dişi tomurcuklarının kırılmaya eğilimli stres noktası oluşturmasıdır. Mandibula kırığının yönetimi, anatomik yapıların farklı olması, kalıcı diş tomurcuklarının bulunması, büyüme ve gelişimin devam etmesi ve çocuğun kooperasyon zorluğu gibi faktörler nedeni ile daha komplike olabilmekte ve erişkinlere göre farklılıklar içermektedir. Bu nedenle erişkinlerin tedavisinde kullanılan vida ve plaklar içeren açık redüksiyon, rijid fiksasyon gibi uygulamalar yerine daha konservatif tedavi seçenekleri üzerinde durulmaktadır. Bu olgu raporunda, mandibula simfizinde kırık bulunan 4 yaşındaki erkek hastanın noninvaziv bir yöntem olan akrilik okluzal splint ile başarılı tedavisi sunulmuştur.

Comparing Functional Efficiency of Conventional 2 Plate System &amp; Perpendicular Miniplates in Mandibular Symphysis Fractures Using Bite Force as an Indicator

In the conventional method of fixation of symphyseal fractures, 2 miniplates are fixed in the interforamina region of the mandible at the lateral cortex. However, with the better understanding of tension and compression areas defined according to the place of energy insertion, it is now possible to fix miniplates at the lower border of the mandible. In this study we assumed that the application of perpendicular miniplates, in contrast to the placement of the plates on the lateral surface of the mandibular cortex, will constrict the motion in horizontal as well as vertical planes leading to better functional outcomes, which can be evaluated by measuring bite forces. The results obtained were affirmative with the hypothesis.

A Case Report of Effect of Physical Therapy on Temporomandibular Joint Dysfunction Following Mandibular Symphyseal Fracture

A Case Report of Effect of Physical Therapy on Temporomandibular Joint Dysfunction Following Mandibular Symphyseal Fracture

A RETROSPECTIVE ANALYSIS OF PEDIATRIC FACIAL FRACTURES

Introduction: Pediatric fractures despite being less common than adults is very critical as it can affect growth in the fractured areas Objectives: This study aimed to detect the incidence, pattern of fracture and treatment modalities in the last 3 years in patients with age ranging from 0-18 years treated at the oral and maxillofacial surgery department, Alexandria University.Materials and Methods: This study was conducted on patients with age below 18 years admitted to the outpatient clinic of the oral and maxillofacial department, Alexandria university, From January 2016 to December 2018. Results: The mean age was 12 years, 78.7% were males while 21.27% were females. Causes of fracture were road traffic accidents in 46.8 % of patients, falls in 38.3%, and assault in 14.89%. Regarding mandibular fractures, parasymphyseal fractures were 15.25%, condylar fractures were 13%, symphyseal fractures were 11.86%, angle fractures were 11.86% and body fractures were 10.16%. Regarding midface fractures, zygomatic fractures were 15.25%, nasal fractures were 10.16%, orbital blow out fractures were 6.78% and le fort fractures were 5%. Regarding treatment, 69.17% of the patients were treated by open reduction and fixation, closed reduction accounted for 21.18%and 9.57% needed observation only.Conclusions: The incidence of pediatric facial fractures is ascending with RTAs and falls as the leading causes. Regarding mandibular fractures, parasymphyseal and condylar fractures were the most frequent; whereas zygomatic and nasal fractures were the most common midface fractures. In addition, open reduction was the highest treatment modatality in frequency.

Study of the effect of the shape of the miniplate on the stability of mandibular symphyseal fracture using finite element analysis

Introduction: Finite element analysis is a new technology used for mechanical designing, and showing the behavior of the body when subjected to different loads as regards the resulted stresses and displacement.Aim: The aim of this research was to detect the effect of the miniplate shape on stability of the mandibular symphyseal fracture.Patients/Methods: Through this study two configurations of the miniplates were compared. The two miniplates are equal in length, width, thickness and of the same material, only they are different in shapes, one plate was straight and the other was L shaped, they are investigated using three dimensional finite element software.Results: There was no significant difference between straight and L shaped miniplate, however the L shaped miniplate was slightly superior to straight miniplate as regard plate stability.Conclusion: There is no significant difference between the different systems. The shape of miniplate may have a role in stability of mandibular fracture stability, the same plate shows different behavior when fixed at different positions double plate shows more stability than single one ,of the same shape finite element technology is helpful means for designing of different fixation systems.