Immediate mobilization following fixation of mandible fractures: a prospective, randomized study.
OBJECTIVE
To compare outcomes of open reduction and internal fixation of displaced mandible fractures followed by either immediate mobilization or 2 weeks of mandibular-maxillary fixation.


METHODS
A prospective, randomized, single-blinded study was performed.


METHODS
The study was performed between January 1, 1997, and March 30, 2000. Inclusion criteria were displaced fractures between the mandibular angles, age greater than 16 years, and no involvement of the alveolus, ramus, condyles, or maxilla. All fractures were repaired by means of open reduction and internal fixation using 2.0-mm titanium plates secured either in transoral fashion or percutaneously. Data were collected at 6-week and 3- and 6-month postoperative examinations. Variables were assessed by a surgeon blinded to the history of immobilization and included pain, malunion or nonunion, occlusion, trismus, wound status, infection rates, dental hygiene, and weight loss. Twenty-nine consecutive patients were enrolled, 16 patients to immediate function and 13 patients to 2 weeks of mandibular-maxillary fixation.


RESULTS
No statistically significant differences were found between groups for any of the variables. Immediate release and temporary immobilization showed mean weight loss of 10 and 8 pounds and trismus of 4.2 and 4.6 cm, respectively. One wound separation and one infection were seen in the immobilization population, and no wound separation or infection was seen in the immediate-release group. Dental hygiene was similar between the groups. No malunion or nonunion was noted in either group.


CONCLUSIONS
In this prospective and randomized study, no significant differences were noted between the groups receiving either immediate release or 2 weeks of mandibular-maxillary fixation. The findings support the treatment of selective mandible fractures with 2.0-mm miniplates and immediate mobilization.
Kaplan
B A
BA
Department of Otolaryngology-Head and Neck Surgery, University of Virginia Medical Center, Charlottesville, VA 22908, USA.
Hoard
M A
MA
Park
S S
SS
D000328:Adult; D000704:Analysis of Variance; D001696:Biomechanical Phenomena; D001860:Bone Plates / Q000592:standards*; D001864:Bone Wires; D003766:Dental Occlusion; D004434:Early Ambulation / Q000295:instrumentation* / Q000379:methods*; D004867:Equipment Design; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D017102:Fracture Healing; D017759:Fractures, Malunited / Q000209:etiology; D005599:Fractures, Ununited / Q000209:etiology; D006801:Humans; D007103:Immobilization / Q000009:adverse effects; D008297:Male; D008337:Mandibular Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D008437:Maxilla / Q000601:surgery*; D009910:Oral Hygiene; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology; D011446:Prospective Studies; D011859:Radiography; D016037:Single-Blind Method; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss