title: "A" shape plate for open rigid internal fixation of mandible condyle neck fracture.
abstract: BACKGROUND
  Reduction of the fracture is crucial for proper outcome of the treatment. The stability of reduction is closed connected to the method of its fixation. The topic of condylar fracture osteosynthesis still remains highly controversial and challenging. That is why authors decided to propose novel design of the fixating plate and the example of its application. The aim of this study was to present A-shape plate dedicated to rigid fixation of mandible condyle neck fracture.
  
  
  METHODS
  A-shape condylar plate (ACP) design is prepared of 1.0 mm thick titanium alloy (grade 5) sheet: posterior and anterior bars are reinforced by widening to 2.5 mm and anatomically curved along the compression and traction lines in ramus and condylar neck. Superior three-hole-group has triangular organization and located on the level of condylar head. The inferior extensions of the bars are equipped in three holes located at each of lower tails. Connecting bar (2.0 mm wide) connects the first hole of each lower tails closing upper part of ACP in triangular shape. The connecting bar runs along compression line of condylar neck. Holes in ACP has 2.0 mm diameter for locking or normal screws. Height of ACP is 31 mm. The proposed new type of plate was compared by finite element analysis (FEA) to nowadays manufactured 9-hole trapezoid plate as the most similar device. ACP design was evaluated by finite element analysis (FEA) and later applied in patient affected with high condylar neck fracture complicated by fracture of coronoid process.
  
  
  RESULTS
  FEA revealed high strength of ACP and more stabile fixation than trapezoid plate. The result was caused by multipoint fixation at three regions of the plate and reinforced bars supported by semi-horizontal connecting bar. Clinical application of ACP was as versatile as makes possible to simultaneous fixation of high condylar neck and coronoid process fracture.
  
  
  CONCLUSIONS
  Application of proposed A-shape condylar plate would be possible in all levels of neck fractures and can be use for stabilization additionally existed coronoid process fracture.
authors.affiliation: Department of Maxillofacial Surgery (Head: Marcin Kozakiewicz), Medical University of Lodz, Zeromskiego 113, 90-549 Lodz, Poland. Electronic address: marcin.kozakiewicz@umed.lodz.pl.
authors.forename: Marcin
authors.initials: M
authors.lastname: Kozakiewicz
authors.affiliation: Department of Strength of Materials and Structures (Head: Zbigniew Kolakowski), Technical University of Lodz, Stefanowskiego 1/15, 90-924 Lodz, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Swiniarski
mesh_terms: D000328:Adult; D000497:Alloys / Q000737:chemistry; D001696:Biomechanical Phenomena; D001860:Bone Plates; D001863:Bone Screws; D004867:Equipment Design; D005260:Female; D020342:Finite Element Analysis; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery; D008335:Mandibular Condyle / Q000293:injuries* / Q000601:surgery; D008337:Mandibular Fractures / Q000601:surgery*; D009104:Multiple Trauma; D013314:Stress, Mechanical; D013499:Surface Properties; D014025:Titanium / Q000737:chemistry
chemical_list: D000497:Alloys; C031462:titanium alloy (TiAl6V4); D014025:Titanium
keywords: A-shape plate; Fracture treatment; Mandibular condyle neck