Arch Craniofac Surg.  2014 Aug;15(2):53-58. 10.7181/acfs.2014.15.2.53.

Microplate Fixation without Maxillomandibular Fixation in Double Mandibular Fractures

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, Kyung Hee University School of Medicine, Seoul, Korea. jsburm@gmail.com

Abstract

BACKGROUND
Maxillomandibular fixation (MMF) is usually used to treat double mandibular fractures. However, advancements in reduction and fixation techniques may allow recovery of the premorbid dental arch and occlusion without the use of MMF. We investigated whether anatomical reduction and microplate fixation without MMF could provide secure immobilization and correct occlusion in double mandibular fractures.
METHODS
Thirty-four patients with double mandibular fractures were treated with open reduction and internal fixation without MMF. Both fracture sites were surgically treated. For bony fixations, we used microplates with or without wire. After reduction, each fracture site was fixed at two or three points to maintain anatomical alignment of the mandible. Interdental wiring was used to reduce the fracture at the superior border and to enhance stability for 6 weeks. Mouth opening was permitted immediately.
RESULTS
No major complications were observed, including infection, plate exposure, non-union, or significant malocclusion. Five patients experienced minor complications, among whom the only one patient experienced a persistant but mild malocclusion with no need for additional management.
CONCLUSION
This study showed that double mandibular fractures correction with two- or three-point fixation without MMF simplified the surgical procedure, increased patient comfort, and reduced complications, due to good stability and excellent adaptation.

Keyword

Mandibular fractures; Jaw fixation techniques; External fixators

MeSH Terms

Dental Arch
External Fixators
Humans
Immobilization
Jaw Fixation Techniques*
Malocclusion
Mandible
Mandibular Fractures*
Mouth
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