Open Reduction and Internal Rigid Fixation of Unilateral Displaced Subcondylar Fractures Using a Single Trapezoidal Plate Versus the Traditional Two Miniplates. A Comparative Study.

Purpose: The aim of this study was to compare clinically and radiographically between the single three-dimensional Trapezoidal plate versus the traditional two non-parallel miniplates in ORIF of unilateral displaced subcondylar fractures.
Patients and Methods: A total of 24 patients suffering from unilateral displaced subcondylar fractures were randomly divided into two equal groups; Group I patients were treated using single trapezoidal plates while Group II patients were treated using the traditional two miniplates. The clinical parameters include; the Hardware application time, maximum interincisal opening, Protrusive, ipsilateral and contralateral movements, mandibular mobility index, Helkimo index of mandibular dysfunction, facial nerve weakness and plate fracture. Radiographic parameters included: Vertical height of the ramus, anteroposterior and mediolateral condylar angulations. All the clinical and radiographic outcomes were assessed and statistically analysed preoperatively and at all post-operative follow-up intervals.
Results: Group I showed a statistically significant lower hardware fixation time in comparison to Group II.
Both groups showed no significant difference regarding MMO, protrusive, ipsilateral and contralateral movements. Moreover, the difference regarding vertical ramus height, anteroposterior, and mediolateral condyle angulations was statistically insignificant.
Two patients of group II had Plate fracture at the 1-month follow-up interval. Transient weakness of the frontal branch of the facial nerve was observed immediately post-operatively in two patients of group II and recovered completely within 3 months.
Conclusion:
The results of the present study support the superiority of the single Trapezoidal plates in ORIF of displaced subcondylar fractures with special recommendation for high subcondylar fractures.