Evaluation of Efficacy of Various Fixation Devices in Management of Anterior Mandibular Fractures: A Prospective Clinical Study

Abstract

Aim:The aim of this study was to evaluate the efficacy and reliability of fracture management in the anterior mandible using miniplates (MPs), lag screws (LSs), three-dimensional (3D) plates, and Herbert screws. Materials and Methods: The study consists of forty patients randomly divided into four groups of ten, undergoing open reduction internal fixation of anterior mandible fractures using MPs, LSs, 3D plates, or Herbert screw. All the patients were evaluated for stability of fracture fragments, duration of procedure, requirement of maxillomandibular fixation, and other associated complications. Results: The results of this study showed that each fixation device has its own merits and demerits. The rectangular plates achieved good stability, but its placement and adaptation was challenging in certain clinical scenarios when the anterior mandibular height was less, especially in females and in situations where the fracture line was in close proximity to the mental foramen. The placement of LS and Herbert screw was technique sensitive but did achieve good initial stability in addition to shortening the procedure time. The MPs were more versatile but required more operating time and hardware for the management of the anterior mandibular fractures. Conclusion: All of these modalities were able to achieve satisfactory final outcome. The rigid fixation techniques achieved similar results with less hardware and required lesser times. The MP fixation techniques, on the other hand, are more versatile and less technique sensitive.

Evaluation of Herbert Screws & 3D Miniplates in Comparison to Double Miniplates in Fixation of Anterior Mandibular Fractures

“…Another difficulty is faced during adaptation of the hardware owing to the parabolic shape & contour of the mandible at this area. 16 Many surgeons consider Chimp's principles with miniplates osteosynthesis as the mainstay for fixation of mandibular fractures due to many advantages offered by this method. 17,18 With the continuing revolution in fixation methods and improvements in biomechanics other fixation techniques gained more popularity.…”