Which fixation methods are better between three-dimensional anatomical plate and two miniplates for the mandibular subcondylar fracture open treatment?

Sukegawa, Shintaro; Kanno, Takahiro; Masui, Masanori; Sukegawa‐Takahashi, Yuka; Kishimoto, Tsukasa; Sato, Ai; Furuki, Yoshihiko

doi:10.1016/j.jcms.2019.01.033

Cited by 30 publications

(28 citation statements)

References 31 publications

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Section: Discussionmentioning

confidence: 99%

“…Commonly, two straight mini-plates are used in fixation of the mandibular condyle base and neck fractures [18,24,25,38]. This technique serves as a reference in the evaluation of the treatment results with 3D mini-plates [7,10,18,24,25,38]. The individual shapes of 3D mini-plates are mainly compared in clinical trials to the double straight mini-plates fixation technique.…”

Section: Discussionmentioning

confidence: 99%

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The Use of Titanium 3D Mini-Plates in the Surgical Treatment of Fractures of the Mandibular Condyle: A Systematic Review and Meta-Analysis of Clinical Trials

Sikora

Chęciński²,

Nowak³

et al. 2021

JCM

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Introduction: Fixing fractures of the base and neck of mandibular condyles is demanding due to the difficulties in surgical access and the various shapes of bone fragments. Classic fixation techniques assume the use of straight mini-plates, utilized for other craniofacial bone fractures. Three dimensional mini-plates may provide a reasonable alternative due to their ease of use and steadily improved mechanical properties. The multitude of different shapes of 3D mini-plates proves the need for their evaluation. Aim: This paper aims to summarize the clinical trials regarding the use of various types of 3D condylar mini-plates in terms of need for reoperation and the incidence of loosening and damage to the osteosynthetic material. Materials and Methods: A systematic review was conducted in accordance with PICOS criteria and PRISMA protocol. The risk of bias was assessed using ROBINS-I and RoB 2 Cochrane protocols. The obtained data series was analyzed for correlations (Pearson’s r) respecting statistical significance (Student’s t-test p > 0.05) and visualized using OriginLab. Results: 13 clinical trials with low overall risk of bias regarding 6 shapes of 3D mini-plates were included in the synthesis. The number of reoperations correlates with the number of fixations (r = 0.53; p = 0.015) and the total number of screw holes in the mini-plate (r = −0.45; p = 0.006). There is a strong correlation between the number of loosened osteosynthetic screws and the total number of fractures treated with 3D mini-plates (r = 0.79; p = 0.001 for each study and r = 0.99; p = 0.015 for each mini-plate shape). A correlation between the percentage of lost screws and the number of distal screw holes is weak regarding individual studies (r = −0.27; p = 0.000) and strong regarding individual mini-plate shape (r = −0.82; p = 0.001). Three cases of 3D mini-plate fractures are noted, which account for 0.7% of all analyzed fixation cases. Discussion: The reasons for reoperations indicated by the authors of the analyzed articles were: mispositioning of the bone fragments, lack of bone fragment union, secondary dislocation, and hematoma. The known screw loosening factors were poor bone quality, bilateral condylar fractures, difficulties in the correct positioning of the osteosynthetic material due to the limitations of the surgical approach, fracture line pattern, including the presence of intermediate fragments, and mechanical overload. Fractures of the straight mini-plates fixing the mandibular condyles amounts for up to 16% of cases in the reference articles. Conclusions: There is no convincing data that the number of reoperations depends on the type of 3D mini-plate used. The frequency of osteosynthetic screw loosening does not seem to depend on the 3D mini-plate’s shape. Clinical fractures of 3D mini-plates are extremely rare.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Use of Titanium 3D Mini-Plates in the Surgical Treatment of Fractures of the Mandibular Condyle: A Systematic Review and Meta-Analysis of Clinical Trials

Sikora

Chęciński²,

Nowak³

et al. 2021

JCM

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“…Fracture consolidation is a fundamental biological process of bone repair in human and animal models. Many methods have been suggested to enhance bone healing and decrease the time of fracture union (31)(32)(33). Open reduction and proper stabilization of fractured bones with using intramedullary fixation pin is easy in application, inexpensive and the basic principles of repair are followed.…”

Section: Discussionmentioning

confidence: 99%

A retrospective study of fracture cases managed in the veterinary teaching hospital; 181 cases (2014-2018)

Muhamad¹,

Ali²,

Abbas³

et al. 2021

IJVS

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over the years 2014 -2018. From a total of 734 clinical cases, 181 were diagnosed as fractures. From cases, dogs represented 49.72% (90/181), whereas cats represent 18.23% (33/181) and birds represented 22.09% (40/ 181). The etiology of the fractures multifactorial, but car accidents represented the main cause of fractures particularly in dogs. Femoral fractures were reported as the most prevalent types of fractures that represented 26.51% (48/181), followed by fractures in radius-ulna 19.33% (35/181), tibia-fibula 13.81% (25/181) and the pelvis 9.94% (18/181). All the cases were diagnosed on the bases of case history, clinical signs, physical examination and finally confirmed by using digital X-ray which offered an excellent scope and contrast than the traditional method. From a total of 181 cases, 6 cases were found hopeless, 45 cases underwent surgical internal fixation and the remaining 130 cases were fixed by external coaptation. Internal fixations were found to be very convenient and without any difficulties, on the contrary to the cases with external cooptation were not. We recorded postoperative inflammation in 4 cases, as well as mal-union was recorded in 5 cases and incomplete alignment in 2 cases was found. We concluded that fractures in pet animals are common in Sulaimani province, which must be considered, and the best-employed methods of fracture repair were the internal fixation techniques, particularly intramedullary pinning.

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“…ORIF in condylar fracture is considered as the gold standard for both condylar base and neck fractures. 7 Although ORIF may be recommended for condylar fractures in adult and in children with mixed dentition, this recommendation requires further investigation. 8 Therefore, as our surgical treatment indication, we selected condylar fractures in the neck and the base.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Open Reduction and Internal Fixation of Mandibular Condyle Fracture by Intraoperative Cone-Beam Computed Tomography in a Hybrid Operating Room

Sukegawa

Masui

Kanno

et al. 2020

Journal of Craniofacial Surgery

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Condylar fractures are the most common fractures of the mandible, and treatment of mandibular condylar fractures by maxillofacial surgeons is a very important procedure. However, the surgical approaches have anatomical limitations. Therefore, it is difficult to evaluate the reduction achieved in open reduction and internal fixation because of the uncertainty in securing a sufficient operative field. As a potential solution, the authors evaluated the benefits of intraoperative cone-beam computed tomography (CBCT) with high image quality performed in a hybrid operating room. Intraoperative CBCT is easy to perform in a hybrid operating room, and it is possible to quickly evaluate high-quality CT images, including 3D images. Because the state of reduction of mandibular condylar fractures also affects the prognosis of treatment, more precise reduction and fixation should improve prognoses. The use of CBCT in a hybrid operating room also avoids re-operation, and patients benefit from minimum invasive surgery. Intraoperative CBCT is a very useful strategy for evaluation of mandibular condylar fracture surgical treatment.

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Which fixation methods are better between three-dimensional anatomical plate and two miniplates for the mandibular subcondylar fracture open treatment?

Cited by 30 publications

References 31 publications

The Use of Titanium 3D Mini-Plates in the Surgical Treatment of Fractures of the Mandibular Condyle: A Systematic Review and Meta-Analysis of Clinical Trials

The Use of Titanium 3D Mini-Plates in the Surgical Treatment of Fractures of the Mandibular Condyle: A Systematic Review and Meta-Analysis of Clinical Trials

A retrospective study of fracture cases managed in the veterinary teaching hospital; 181 cases (2014-2018)

Evaluation of Open Reduction and Internal Fixation of Mandibular Condyle Fracture by Intraoperative Cone-Beam Computed Tomography in a Hybrid Operating Room

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