Angled Eccentric Osteosynthesis, a New Technique for Simple Mandibular Fractures

Abstract

Working and balancing sides are subject to torsional and the tensile stresses, respectively. Tension banding principle denotes the principle of plating along the tension line for stable internal fixation on the balancing side of the mandibular fracture, which is the theoretical basis for the miniplate osteosynthesis. On the contrary, Arbeitsgemeinschaft fϋr Osteo - synthesefragen/Association for the Study of Internal Fixation (AO/ASIF) introduced the idea of stable fixation which confirms the stability of the fracture segment across the fracture line of the working side. Merging the principles of the miniplate osteosynthesis and compression osteosynthesis, the author suggests a new technique of angled eccentric osteosynthesis in case of simple mandibular fractures. The drilling holes are eccentrically positioned away from the fracture gap and intentionally angled to each other. The advancement of the miniscrews through these eccentrically angled drill holes will exert an axial load toward the fracture gap providing an interfragmental compressive force

A Comparative Study of Cortical Lag Screws and Miniplates for Internal Fixation of Mandibular Symphyseal Region Fractures

“…In this study, less difference in pixel density in the lag screws group than that in miniplates group reveal the support effect of lag screws on the bone healing process. That was in agreement with Jadwani in 2011 (28), and other studies (29,30) who mentioned the primary advantage of the lag screws lies in providing compression to the fragments so that primary bone healing can be achieved.…”

Evaluation of Dynamic Compression Miniplates in Treatment of Mandibular Angle Fractures Using Trocar

“…Traditional 6-week treatment of closed reduction with Maxillomandibular fixation (MMF) or open reduction with wire osteosynthesis and MMF has given way to Open Reduction and internal fixation (ORIF) osteosynthesis techniques with early mobilization and restoration of jaw function, improved airway control, nutrition, patient comfort and hygiene, and an early return to work (3). In treatment planning for a mandibular fracture, there are two schools of plate osteosynthesis, one advocating compression osteosynthesis and the other favoring the miniplate osteosynthesis (4).…”

“…The (AO) Swiss Association for internal fixation (ASIF) introduced the idea of axial compression into the limb fractures. As applied to the mandible, the idea of compression osteosynthesis was fortified with dynamic compression miniplates (DCP) (4,6). During function the balanced side of the mandible is subject to bending, which exerts tensile forces on alveolar part of the mandible (7).…”

“…Several studies have been done using conventional miniplates for fixation of the fracture of the angle of the mandible by extra oral approach (4,10…”