Mandibular fracture osteosynthesis: a comparison of three techniques.
The authors report on a retrospective study of 205 consecutive patients at the Maxillofacial Unit of The Royal Melbourne Hospital to assess if adherence to Champy's principles in placement of miniplates in mandibular fractures minimises morbidity. 205 well documented cases of mandibular fractures treated with internal fixation, January 1985 to April 1990 were studied. The patients were assigned into three groups according to the type of fixation; 83 patients had miniplate fixation according to Champy's principles, 40 patients had miniplate fixation ignoring Champy's principles, 82 patients had transosseous wire (TOW) fixation. Outcome was measured by preoperative variables (age, gender, mechanism of fracture, site and number of fractures, nerve function, associated injuries and treatment delay) and postoperative variables (duration of admission, duration of intermaxillary fixation (IMF), malocclusion, infection, dehiscence, union, removal of fixation and nerve function which were assessed and compared. The results show that the preoperative variables were statistically similar in all groups. The postoperative variables indicated a statistically higher complication rate for the transosseous wire group compared with the miniplate groups, and morbidity was reduced in the group following Champy's principles. The morbidity rates in this study compare favourably with other studies even though the patients in this study had a much higher incidence of multiple fractures. Titanium miniplates appear as effective as miniplates constructed of other materials used in previous studies, especially when Champy's principles are followed.
Renton
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The Royal Melbourne Hospital, Victoria, Australia.
Wiesenfeld
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D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates / Q000009:adverse effects; D001864:Bone Wires / Q000009:adverse effects; D004867:Equipment Design; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing; D006801:Humans; D007902:Length of Stay; D008297:Male; D008310:Malocclusion / Q000209:etiology; D008337:Mandibular Fractures / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D008340:Mandibular Nerve / Q000503:physiopathology; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D013193:Stainless Steel; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D013997:Time Factors; D014025:Titanium; D016896:Treatment Outcome
D013193:Stainless Steel; D014025:Titanium