Principles of Internal Fixation of the Craniomaxillofacial Skeleton

Ehrenfeld, Michael; Manson, Paul N.; Prein, Joachim; Alpert, Brian; Antonyshyn, Oleh; Assael, Leon A.; Audigé, Laurent; Bentley, Robert; Bos, Rudolf Rm; Chadwell, Jon B.; Cienfuegos, Ricardo; Colson, Douglas J.; Cornelius, Carl‐Peter; Disegi, John A.; Ellis, Edward; Figari, Marcelo; Gellrich, Nils‐Claudius; Hanson, Beate; Haug, Richard H.; Kellman, Robert M.; Ketola-Kinnula, Tanja; Koltai, Peter J.; Krakovitz, Paul; Kunz, Christoph; Kushner, George M.; Lim, Thiam-Chye; Lindqvist, Christian; Mast, Gerson; Meijer, Jiska; Mullen, Robert L.; Rahn, B. A.; Richards, R. Geoff; Centeno, Carlos Ries; Rudderman, Randal; Schoen, Rudolf; Shumrick, Kevin A.; Stanley, Robert B.; Sugar, Adrian; Ueeck, Brett A.; Bakelen, N. B. van; Sickels, Joseph E. Van; Westermark, Anders

doi:10.1055/b-002-85491

Cited by 27 publications

(5 citation statements)

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“…Finally, our FEA and polymeric model testing outcomes are similar and comparable with earlier studies [1][2][3][4][5][6][7][8][9]19]. The similar displacement patterns of the FEA and polymeric model testing, together with the comparability with earlier studies [6-9, 36--38], show that our study was conducted correctly.…”

Section: Discussionsupporting

confidence: 89%

“…Therefore, 10 mm or lower mandibular height fracture fixation requires a stronger osteosynthesis system. In this case, the load-sharing principle is not valid and the load-bearing principle should be applied [6][7].…”

Section: Discussionmentioning

confidence: 99%

“…(1) the osteosynthesis plate must provide enough rigidity to avoid fragment displacement during functional movement achieved through rigid fixation by placing solid plates at the lower border (load-bearing principle), and (2) the Champy technique suggesting the use of semi-rigid fixation with miniplates in which the tensile forces are neutralized by placing the plates in the so-called ideal line of osteosynthesis, resulting in interfragmentary stability between the bone segments (load-sharing principle) [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

“…According to current clinical understanding and literature, a decrease in mandibular body height in an atrophic mandible results in a narrow range between the tension and compression zones [10][11][12][13]. In a severely atrophic mandible, the tension and compression zones more or less overlap each other and the load-sharing principle is not valid anymore [6][7][8][14][15]. Following Champy's theory, many studies started using expensive and time-consuming cadaveric or polymeric bone models [16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

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Optimisation of osteosynthesis positioning in mandibular body fracture management using finite element analysis

Daqiq,

Roossien,

Wubs

et al. 2023

Eur J Trans Clin Med

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Background: This proof of principle study aims to investigate the applicability of finite element analysis (FEA) in Oral and Maxillofacial (OMF) surgery, by studying the effect of mandibular body height and osteosynthesis positioning on unilateral mandibular body fractures based on Champy's technique. Material and methods: Mandibles made of polyurethane foam (Synbone®), with heights of 18, 14, and 10 mm were used to create a FEA model with a unilateral straight-line fracture, fixated with a standard commercially available 6-hole 2 mm titanium miniplate. Two different FEA programs were used for the comparison, namely: Solidworks and Comsol Multiphysics. The FEA outcomes were compared with a series of mechanical tests with polymeric models fixed in a customised device and loaded onto a mechanical test bench. Results: First, the study illustrated that the optimal plate position appeared to be the upper border. Second, lower mandibular height increases instability and requires a stronger osteosynthesis system. Conclusions: FEA's and polymeric model testing outcomes of unilateral non-comminuted fractures were highly comparable with current opinions of mandibular fracture management. The promising outcome of this study makes it worthwhile to do more extensive analysis in order to determine whether FEA alone is sufficient for optimisation of fracture management.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Optimisation of osteosynthesis positioning in mandibular body fracture management using finite element analysis

Daqiq,

Roossien,

Wubs

et al. 2023

Eur J Trans Clin Med

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“…The accompanying compression forces are compensated by the interfragmentary stability of the fracture. (2) The load bearing principle involves positioning a rigid solid plate at the lower border to avoid fragment displacement during functional movement of the mandible [1][2][3][4] .…”

mentioning

confidence: 99%

Biomechanical assessment of mandibular fracture fixation using finite element analysis validated by polymeric mandible mechanical testing

Daqiq,

Roossien,

Wubs

et al. 2024

Sci Rep

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The clinical finite element analysis (FEA) application in maxillofacial surgery for mandibular fracture is limited due to the lack of a validated FEA model. Therefore, this study aims to develop a validated FEA model for mandibular fracture treatment, by assessing non-comminuted mandibular fracture fixation. FEA models were created for mandibles with single simple symphysis, parasymphysis, and angle fractures; fixated with 2.0 mm 4-hole titanium miniplates located at three different configurations with clinically known differences in stability, namely: superior border, inferior border, and two plate combinations. The FEA models were validated with series of Synbone polymeric mandible mechanical testing (PMMT) using a mechanical test bench with an identical test set-up. The first outcome was that the current understanding of stable simple mandibular fracture fixation was reproducible in both the FEA and PMMT. Optimal fracture stability was achieved with the two plate combination, followed by superior border, and then inferior border plating. Second, the FEA and the PMMT findings were consistent and comparable (a total displacement difference of 1.13 mm). In conclusion, the FEA and the PMMT outcomes were similar, and hence suitable for simple mandibular fracture treatment analyses. The FEA model can possibly be applied for non-routine complex mandibular fracture management.

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The Head and Neck

Richards¹,

Dafydd

2014

Key Notes on Plastic Surgery

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Principles of Internal Fixation of the Craniomaxillofacial Skeleton

Cited by 27 publications

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Optimisation of osteosynthesis positioning in mandibular body fracture management using finite element analysis

Optimisation of osteosynthesis positioning in mandibular body fracture management using finite element analysis

Biomechanical assessment of mandibular fracture fixation using finite element analysis validated by polymeric mandible mechanical testing

The Head and Neck

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