Fixation methods in mandibular reconstruction using fibula grafts: a comparative study into the relative strength of three different types of osteosynthesis.
BACKGROUND
Bone staples made of a nickel titanium alloy exert dynamic compression, require little dissection, and may provide an alternative to conventional fixation in mandibular reconstruction with a free vascularized fibula graft.


METHODS
To evaluate its stability relative to conventional methods of fixation with interosseous wires or miniplates, an in vitro model using beech dowels was developed. Torsional stiffness and strength and compression stiffness and strength were examined.


RESULTS
The compression test results showed that maximum strength of interosseous wires is significantly less than memory staples, which in turn are significantly weaker than titanium miniplates. Miniplates are significantly the most rigid form of fixation. Torsional testing showed no significant difference in strength between staples and miniplates and only a marginal difference in elasticity. Interosseous wires show a rapid decrease of strength and rigidity during torsional stress.


CONCLUSIONS
When considering interosseous wires the least and miniplates the most stable form of fixation by which bone healing can occur, memory staples can provide enough stability to ensure consolidation.
Strackee
S D
SD
Department of Plastic, Reconstructive and Hand Surgery, Academic Medical Center, Amsterdam, The Netherlands. mail@sstrackee.demon.nl
Kroon
F H
FH
Bos
K E
KE
D001860:Bone Plates; D016025:Bone Transplantation; D005360:Fibula / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008334:Mandible / Q000601:surgery*; D008422:Materials Testing; D013524:Surgical Flaps; D017792:Surgical Stapling