The need for rigid fixation of combined parasymphyseal and bilateral subcondylar fractures.
Both miniplate and larger fracture plate fixation techniques have been utilized successfully in the treatment of mandibular fractures. Parasymphyseal fractures which occur in conjunction with bilateral subcondylar fractures, however, represent a special fracture pattern that is not well managed with miniplate fixation. Miniplates do not have the tensile strength to resist the strong, muscular-deforming forces that act on these fractures. This fracture pattern is best managed with anatomic symphyseal reduction and internal fixation with a 2.7 mm mandibular fracture plate and a 2.0 mm tension band plate. The subcondylar fractures can then be managed with either intermaxillary fixation or open reduction. This approach provides good functional results and can prevent late complications.
Wheatley
M J
MJ
Department of Surgery, Division of Plastic and Reconstructive Surgery, Oregon Health Sciences University, Portland Veterans Administration Medical Center, Portland, Oregon, USA.
Meltzer
T R
TR
D000293:Adolescent; D001860:Bone Plates; D001863:Bone Screws; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D019248:Jaw Fixation Techniques; D008335:Mandibular Condyle / Q000293:injuries*; D008337:Mandibular Fractures / Q000145:classification / Q000601:surgery*; D009119:Muscle Contraction / Q000502:physiology; D009334:Neck Muscles / Q000503:physiopathology; D010027:Osteotomy; D011183:Postoperative Complications / Q000517:prevention & control; D013718:Tensile Strength