A retrospective comparative study of mandibular fracture treatment with internal fixation using reconstruction plate versus miniplates

Abstract

Purpose: This study compared the clinical success rates of mandibular fracture treatment using reconstruction plates or miniplates and clarified the selection criteria for reconstruction plates.

Methods: All patients who had surgically-treated mandible fractures from 2008 to 2017 with sufficient follow-up were retrospectively analyzed for information about the fracture condition, treatment, and outcomes.

Results: A total of 126 surgically-treated mandible fractures without mandibular condylar fracture in 105 patients (76 male, 29 female) were included. Reconstruction plates were used in 32 fractures with very good postoperative occlusal function. Four cases with complications requiring reoperation were treated using only miniplates. Variables that were statistically associated with follow-up surgery included simple versus comminuted mandible fracture, and the absence of teeth that could be used for intermaxillary fixation (P < 0.05). In the miniplates treatment for comminuted fracture, there was a significant difference in the treatment outcome depending on the number of free bone-fragments and the presence of bone-fragments requiring removal within 1 cm (P < 0.05).

Conclusion: Reconstruction plates provided better treatment outcomes for comminuted fractures and fractures without teeth. Selecting a reconstruction plate that is capable of sufficiently overloading is important in comminuted fractures with multiple free bone-fragments and bone-fragments requiring removal.

Keywords: Mandibular fracture; Miniplate; Open reduction and internal fixation; Reconstruction plate.