A Prospective Study of Efficacy and Complications Postoperatively of Three-dimensional Miniplates in Fixation of Mandibular Fractures.

Deepanjan Dey; Mainak Mallik; Santanu Suba

Volume : IX, Issue : VI, June - 2020

A Prospective Study of Efficacy and Complications Postoperatively of Three-dimensional Miniplates in Fixation of Mandibular Fractures.

Deepanjan Dey, Mainak Mallik, Santanu Suba

Abstract :

Introduction : The treatment of mandibular fractures have evolved over time. Presently these fractures are treated by either rigid fixation or semi–rigid fixation. Some of the disadvantages of the rigid fixation methods have been addressed by the miniplates. A further refinement of the fixation system is in the form of three dimensional (3D) miniplates. These rectangular plates with their geometric configuration provide more stability to fractures against sheå, bending and torsional forces and have fewer complications. Aims and Objectives : Despite its apparent advantages in the literature, this 3D miniplating system has not been used in India quite frequently. Hence, this study was conducted to assess the efficacy of the 3D miniplates in the treatment of mandibular fractures and the postoperative complications. Methodology : This prospective institute based interventional study was carried out in the Department of Plastic and Reconstructive Surgery, Medical College & Hospital, Kolkata. Every patient meeting the inclusion criteria between August 2016 and July 2018 was included. The parameters that were studied were patient particulars in terms of age, sex, etiology, location and type of the fracture, orthopantomograms, CT scan, particular mini–plate plate chosen for fracture reduction and fixation, postoperatively mobility after fixation, complications and adequacy of reduction. Results : A total of 15 patients with mean age of 32.6 years and 73.3 % males were included. Road traffic accident was the most common etiology and parasymphysis was the most common location of the fracture. 60% of the patients had pre–operative occlusal abnormality which was corrected. None of the patients had any mobility of the fracture segments and all underwent adequate reduction as evident on radiographs. Two patients had wound infection with wound dehiscence and one patient had paresthesia of the inferior alveolar nerve postoperatively (statistically not significant). The complications resolved over time by conservative management. None of the patients had any hardware related complications. Conclusion : The 3D miniplates are efficacious in the treatment of mandibular fractures. They produce stable fixation of fractures with very few complications and so are cost effective in the long run. Their application is convenient and their use involves relatively less implant material, avoids the need for prolonged MMF (maxillomandibular fixation) in the postoperative period. The only drawback is that they are difficult to fix in case the fracture line passes through the mental foramina.