title: Surgical treatment of comminuted mandibular fractures using a low-profile locking mandibular reconstruction plate system.
abstract: OBJECTIVE
  The treatment of comminuted mandibular fractures is challenging due to the severity of associated injuries and the need for a careful diagnosis with adequate treatment planning. Recently, open reduction and stable internal fixation (OR-IF) with a load-bearing reconstruction plate have been advocated for reliable clinical outcomes with minimal complications. This clinical prospective study evaluated OR-IF in the surgical management of comminuted mandibular fractures with a new low-profile, thin, mandibular locking reconstruction plate.
  
  
  METHODS
  We prospectively assessed OR-IF of comminuted mandibular fractures with a low-profile locking mandibular reconstruction plate in 12 patients (nine men, three women; mean age 32.2 [range 16-71] years) between April 2010 and December 2011. The clinical characteristics and associated clinical parameters of patients were evaluated over a minimum follow-up period of 12 months.
  
  
  RESULTS
  Traffic accidents caused 50% of the fractures, followed by falls (25%). Four patients (33.3%) had associated midfacial maxillofacial fractures, while five patients had other mandibular fractures. Seven patients (58.3%) needed emergency surgery, mostly for airway management. Anatomical reduction of the comminuted segments re-established the mandibular skeleton in stable occlusion with rigid IF via extraoral (33.3%), intraoral (50%), or combined (16.7%) approaches. Immediate functional recovery was achieved. Sound bone healing was confirmed in all patients, with no complications such as malocclusion, surgical site infection, or malunion with a mean follow-up of 16.3 (range 12-24) months.
  
  
  CONCLUSIONS
  OR-IF using a low-profile reconstruction plate system is a reliable treatment for comminuted mandibular fractures, enabling immediate functional recovery with good clinical results.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan ; Division of Oral-Maxillofacial Surgery, Kagawa Prefectural Central Hospital, Takamatsu, Kagawa, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Kanno
authors.affiliation: Division of Oral-Maxillofacial Surgery, Kagawa Prefectural Central Hospital, Takamatsu, Kagawa, Japan.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Sukegawa
authors.affiliation: Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Nariai
authors.affiliation: Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Tatsumi
authors.affiliation: Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ishibashi
authors.affiliation: Division of Oral-Maxillofacial Surgery, Kagawa Prefectural Central Hospital, Takamatsu, Kagawa, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Furuki
authors.affiliation: Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan.
authors.forename: Joji
authors.initials: J
authors.lastname: Sekine
keywords: Mandibular comminuted fracture; mandibular reconstruction plate; maxillofacial trauma; open reduction and internal fixation