Small and large titanium plates are equally effective for treating mandible fractures.
OBJECTIVE
The use of small titanium plates for the management of mandibular fractures continues to be a source of controversy because of their load-sharing properties. The purpose of the present study was to determine whether the use of small plates for mandibular fractures is as efficacious as large plates in a large level I trauma center.


METHODS
Consecutive subjects presenting with mandibular fractures were randomly allocated to the use of either small plates (group 1) or large plates (group 2). The primary predictor variable was the plate size. The primary outcome variable was fracture union. The secondary outcomes included complications and operative time. Statistical analysis was performed using the Wilcoxon rank sum test for ordinal and continuous variables and the χ(2) test or Fisher exact test for proportions.


RESULTS
A total of 127 consecutive subjects with a fracture of the mandible were enrolled in the study. Of the 127 subjects, 53 completed the required follow-up of at least 6 weeks. There was no difference in the rate of fracture union between the 2 groups (P = .95).


CONCLUSIONS
The study findings suggest that the use of small plates and monocortical screws for mandibular fractures results in favorable outcomes compared with using larger plates and bicortical screws.
Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA 30322, USA. gfboulo@emory.edu
Gary F
GF
Bouloux
Shuo
S
Chen
Jonathan M C
JM
Threadgill
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials / Q000737:chemistry; D001860:Bone Plates; D001863:Bone Screws; D020878:Device Removal; D004867:Equipment Design; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D017102:Fracture Healing; D005599:Fractures, Ununited / Q000145:classification; D006801:Humans; D019248:Jaw Fixation Techniques; D008297:Male; D008335:Mandibular Condyle / Q000293:injuries; D008337:Mandibular Fractures / Q000145:classification / Q000601:surgery*; D008875:Middle Aged; D010343:Patient Admission; D011183:Postoperative Complications; D013530:Surgical Wound Infection / Q000209:etiology; D013997:Time Factors; D014025:Titanium / Q000737:chemistry; D016896:Treatment Outcome; D055815:Young Adult
D001672:Biocompatible Materials; D014025:Titanium