[Functionally stable osteosynthesis of the mandible by means of an excentric-dynamic compression plate. Results of a follow-up of 25 cases].
The stability of internal fixation is enhanced by axial compression on the fracture ends. If internal fixation of the mandible is achieved by a compression plate at the lower border of the mandible (compression side), distraction of the fracture ends on the occlusal side occurs which has to be counteracted without damaging the roots of the teeth on the occlusal side (traction side) or without damaging the inferior alveolar nerve. From experiments on models it was seen that an acceptable solution to this problem is given by the use of the combined compression plate and tension band plate or the "Excentric Dynamic Compression Plate" (EDCP). In this paper 25 clinical cases of internal fixation of the mandible by means of the EDCP are examined and discussed. The following relevant facts were reviewed on all patients: -- kind of trauma -- age -- dentition -- localization of the fracture -- local and general additional injuries -- time of operation -- material used for internal fixation -- type of occlusal immobilisation during operation -- use of antibiotics -- skin closure -- mobilisation -- hospital stay -- duration of work disability -- complications -- scarring -- neurological disablement -- malocclusion In this paper emphasis is layed upon internal fixation by means of the EDCP. The clinical evaluation of the 25 cases clearly demonstrates that the main indication for internal fixation with the EDCP is given in fractures of the horizontal ramus of the mandible, because in this localisation the plate has to be applied beneath the inferior alveolar nerve. A further indication for internal fixation with the EDCP are fractures of the angle of the mandible. In these cases the tension band principle by means of a tension banc archbar or a tension band plate cannot be applied, because of missing teeth on the proximal fragment, or a non erupted wisdom tooth. These indications can be summarized as follows: -- In fractures of the angle of the mandible--when ever possible compression plate and tension band plate, otherwise EDCP -- In fractures of the horizontal ramus--EDCP -- In fractures of the mandibular front--DCP.
D001860:Bone Plates; D001863:Bone Screws; D005592:Fracture Fixation / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008337:Mandibular Fractures / Q000601:surgery*
Die funktionsstablie Osteosynthese am Unterkiefer mittels exzentrisch-dynamischer Kompressionsplatte (EDCP). Ergebnisse einer Nachuntersuchung der ersten 25 Fälle