Is lag screw fixation superior to plate fixation to treat fractures of the mandibular symphysis?
OBJECTIVE
The purpose of this investigation was to evaluate outcomes for patients treated with lag screw or plate and screw fixation for fractures of the mandibular symphysis.


METHODS
The investigator implemented a retrospective cohort study and enrolled a sample of patients with symphysis fractures. The primary predictor variable was treatment group categorized as lag screw or plate fixation of the fracture. The primary outcome variables were postoperative complications. Other variables collected were grouped into demographic, anatomic, radiographic, and preoperative variables. Appropriate descriptive and bivariate statistics were computed and statistical significance was set at P < .05.


RESULTS
Eight hundred eighty-seven patients met the inclusion criteria. Four hundred seventy-six were treated with bone plates and 411 were treated with lag screws. There were no significant differences in demographic data for the 2 groups. There were no statistically significant differences in occlusal or osseous healing outcomes. However, there were significant differences in treatment outcomes for several variables, including wound dehiscence, plate exposure, and the need for hardware removal between the groups.


CONCLUSIONS
Plating and lag screw techniques showed very good outcomes. There were more intraoperative difficulties placing lag screws than bone plates, but the application of lag screws was associated with fewer postoperative complications.
Department of Oral and Maxillofacial Surgery, University of Texas Health Science Center, San Antonio, TX, USA. ellise3@uthscsa.edu
Edward
E
Ellis
D000293:Adolescent; D000328:Adult; D001860:Bone Plates / Q000009:adverse effects; D001863:Bone Screws / Q000009:adverse effects; D015331:Cohort Studies; D020878:Device Removal; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation*; D017102:Fracture Healing / Q000502:physiology; D005599:Fractures, Ununited / Q000209:etiology; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008310:Malocclusion / Q000209:etiology; D008337:Mandibular Fractures / Q000145:classification / Q000601:surgery*; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D014092:Tooth Root / Q000293:injuries; D016896:Treatment Outcome; D055815:Young Adult