COMPARATIVE STUDY BETWEEN TWO DIFFERENT OSTEOSYNTHESIS DEVICES FOR FIXATION OF SUBCONDYLAR FRACTURE

Document Type : Original Article

Authors

1 Associate Professor of Oral and Maxillofacial Surgery, Faculty of Dental Medicine for Girls, Al-Azhar University

2 Lecturer of Oral and Maxillofacial Surgery, Faculty of Dental Medicine for Girls, Al-Azhar University

3 Associate Professor of Oral and Maxillofacial Surgery, Faculty of Dental Medicine for Girls, Al-Azhar University.

Abstract

Statement of problem: Management of subcondylar fracture with proper reduction of temporomandibular joint position and function is a challenge, different osteosynthesis devices are used with great diversity in their types, numbers, positions, and results.
Purpose: Comparative study between the efficiency of single miniplate and single minidynamic compression plate in restoration of ramus height, condylar angulation, and tempromandibular joint function in subcondylar fracture cases.
Material and Method: 14 patients indicated for open reduction and fixation of subcondylar fractures were divided into two groups each of 7 patients. Group A: subcondylar fractures were fixed using 2.0 single miniplate along posterior border of ramus. Group B: a single 2.0-mm minidynamic compression plates (DCP), were applied along posterior border of ascending ramus for fracture fixation in the other seven patients. Intermaxillary fixation for 10 days was applied for both groups. Clinical and radiograhic follow up were performed at 1, 3, 6 months using panorama and CT.
Results: At 6 months postoperatively, there was an improvement of mandibular functions with improvement of inter-incisal opening from 19.1mm and 20.1 mm in group A and B respectively to 35.6mm and 30.8 mm. Which was significantly different (P value =0.04). The shortening in ramus height improved from 3.2mm and 5.2mm in group A and B to 0.8 mm and 0.6 mm, also sagittal angulation of condyle improved from 1.6º and 4.7º in both group respectively to 0.2º and 0.3º with no significant difference between two types of mini-plate. There were no signs of infection, malunion, nonunion or device failure in both groups. except for one case of group A, that suffered from malocclusion with displacements of the fractured segments immediately after the operations, that responded to elastic traction within 15 days.
Conclusion: Single 0.2 mm miniplate or mini DCP aided by intermaxillary fixation are successful devices in fixation of subcondylar fracture without complication, with superiority of mini DCP in proper condylar reduction and stable fixation.

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