Comparative evaluation of open reduction and internal fixation using delta plate versus conservative treatment in management of mandibular subcondylar fractures in adults

Abstract

The aim of the evaluative study was to compare the efficacy of standard conservative treatment and the open reduction internal fixation (ORIF) using the delta titanium plates in the mandibular subcondylar fractures in adults. Patients who diagnosed with mandibular subcondylar fracture in the department from January 2018 up to September 2019 were recruited into the study. The patients satisfying the inclusion criteria were randomly assigned to two groups in a 1:1 ratio (10 in each group). Group A comprised patients treated using delta titanium plates through open reduction and internal fixation and Group B comprised patients treated with closed reduction. Informed consent was taken for all the patients. All the patients of Group A underwent ORIF under GA via retromandibular approach. Pain was significantly higher in 1 and 3 month follow up in group B compared to group A. Comparison of mouth opening in both the groups show statistically significant difference at 3 and 6 month compared to baseline mouth opening. Deviation was more prevalent at 1 and 3 month follow up in group B compared to group A. Presence of mandibular deviation at 1, 3 and 6 month was statistically insignificant for both the groups.Our experience with 3D stable delta plate provides better treatment outcomes in terms of easy adaptation to the anatomy of the fracture site, better 3D stability and functional osteosynthesis.