title: A Biomechanical Comparison of Three 1.5-mm Plate and Screw Configurations and a Single 2.0-mm Plate for Internal Fixation of a Mandibular Condylar Fracture.
abstract: The most stable pattern of internal fixation for mandibular condyle fractures is an area of ongoing discussion. This study investigates the stability of three patterns of plate fixation using readily available, commercially pure titanium implants. Finite element models of a simulated mandibular condyle fracture were constructed. The completed models were heterogeneous in bone material properties, contained approximately 1.2 million elements and incorporated simulated jaw adducting musculature. Models were run assuming linear elasticity and isotropic material properties for bone. No human subjects were involved in this investigation. The stability of the simulated condylar fracture reduced with the different implant configurations, and the von Mises stresses of a 1.5-mm X-shaped plate, a 1.5-mm rectangular plate, and a 1.5-mm square plate (all Synthes (Synthes GmbH, Zuchwil, Switzerland) were compared. The 1.5-mm X plate was the most stable of the three 1.5-mm profile plate configurations examined and had comparable mechanical performance to a single 2.0-mm straight four-hole plate. This study does not support the use of rectangular or square plate patterns in the open reduction and internal fixation of mandibular condyle fractures. It does provide some support for the use of a 1.5-mm X plate to reduce condylar fractures in selected clinical cases.
authors.affiliation: Department of Maxillofacial Surgery, Westmead Hospital, Westmead, New South Wales, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Aquilina
authors.affiliation: Computational Biomechanics Research Group, School of Biological, Earth and Environmental Sciences, Sydney, New South Wales, Australia.
authors.forename: William C H
authors.initials: WC
authors.lastname: Parr
authors.affiliation: Department of Orthopaedic Surgery, Spine Service, St. George Hospital Clinical School, University of New South Wales, Sydney, Australia.
authors.forename: Uphar
authors.initials: U
authors.lastname: Chamoli
authors.affiliation: Division of Zoology, School of Environmental and Rural Science, Armidale, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Wroe
authors.affiliation: School of Engineering, University of Newcastle, Newcastle, Australia.
authors.forename: Philip
authors.initials: P
authors.lastname: Clausen
keywords: ORIF; condylar fractures; finite element analysis