Comparative study of three dimensional rhombus plates versus standard two mini plates for treatment of mandibular subcondylar fractures regarding stability and feasibility.

Abstract

While reviewing the available literature of mandibular subcondylar fractures treatment two main debates were noticed. Closed versus open treatment modalities and which type of hardware gives best postoperative outcomes as occlusion, mandibular movements, maximum mouth opening and midline shifting. Two mini plates fixation was proved to be the most stable fixation device of subcondylar fracture and gives the best outcomes so it could be used as control group to assess new plate design the three dimensional rhombus plate. This study was conducted on 20 patients suffering from mandibular subcondylar fractures indicated for open reduction and rigid fixation using plates and screws. Patients were equally divided into two groups: Group A: (study group) In this group (Ten patients) subcondylar fractures fixed with three dimensional rhombus plate. Group B: (control group) In this group (Ten patients) subcondylar fractures fixed with two mini plates (2.0). Radiographic follow up of the patients immediately postoperative and after two months were done using computed tomograms to assess stability of fixation and clinical follow up of the occlusion, midline shifting, lateral and protrusive movements of lower jaw and maximum unassisted mouth opening and time of fixation and cost of plates and screws and unexpected events and complications during and after surgery. All collected data tabulated and statistically analyzed and following results were revealed. There was no statistically or clinically significant difference between the two groups in all clinical and radiological outcomes except time of fixation and cost of hardware in which study group took less time of fixation and less cost of hardware. Future studies with more number of patients is recommended.