Selection of Internal Fixation Devices for Mandibular Fractures: How Much Fixation Is Enough?

ABSTRACT

Internal fixation techniques for mandibular fracture vary considerably from one geographic location to the next, from region of the mandible to another, and from one surgeon to the next. This article presents factors that should be considered when choosing internal fixation schemes to apply to fractures of the mandible. Recommendations are based upon personal experience and outcome studies from the clinical literature.

KEYWORDS

Internal fixation - mandibular fracture

REFERENCES

• 1 Choi B H, Kim K N, Kang H S. Clinical and in vitro evaluation of mandibular angle fracture fixation with two-miniplate system.  Oral Surg . 1995;  79 692-695
• 2 Choi B H, Yoo J H, Kim K N. Stability testing of a two-miniplate fixation technique for mandibular angle fractures. An in vitro study.  J Cranio-Maxillo-Fac Surg . 1995;  23 123-125
• 3 Kroon F H, Mathisson M, Cordey J R, Rahn B A. The use of miniplates in mandibular fractures. An in vitro study.  J Craniomaxillofac Surg . 1991;  19 199-204
• 4 Rudderman R H, Mullen R L. Biomechanics of the facial skeleton.  Clin Plast Surg . 1992;  19 11-29
• 5 Tate G S, Ellis E, Throckmorton G S. Bite forces in patients treated for mandibular angle fractures-implications for fixation recommendations.  J Oral Maxillofac Surg . 1994;  52 734-736
• 6 Ellis E, Karas N. Treatment of mandibular angle fractures using two mini-dynamic compression plates.  J Oral Maxillofac Surg . 1992;  50 958-963
• 7 Ellis E, Sinn D P. Treatment of mandibular angle fractures using two 2.4 mm dynamic compression plates.  J Oral Maxillofac Surg . 1993;  51 969-973
• 8 Ellis E, Walker L. Treatment of mandibular angle fractures using two noncompression miniplates.  J Oral Maxillofac Surg . 1994;  52 1032-1036
• 9 Ellis E, Walker L R. Treatment of mandibular angle fractures using one noncompression miniplate.  J Oral Maxillofac Surg . 1996;  54 864-871
• 10 Potter J, Ellis E. Treatment of mandibular angle fractures with a malleable non-compression miniplate.  J Oral Maxillofac Surg . 1999;  57 288-292
• 11 Ellis E, Tharanon W. Facial width problems associated with rigid fixation of mandibular fractures.  J Oral Maxillofac Surg . 1992;  50 87-94
• 12 Söderholm A-L, Lindqvist C, Skutnabb K, Rahn B. Bridging of mandibular defects with two different reconstruction systems: an experimental study.  J Oral Maxillofac Surg . 1991;  49 1098-1105
• 13 Gutwald R, Büscher P, Schramm A. Biomechanical stability of an internal mini-fixation-system in maxillofacial osteosynthesis.  Med Biol Eng Comp . 1999;  2 280
• 14 Ellis E. Use of lag screws for fractures of the mandibular body.  J Oral Maxillofac Surg . 1996;  54 1314-1316
• 15 Ellis E, Ghali G E. Lag screw fixation of anterior mandibular fractures.  J Oral Maxillofac Surg . 1991;  49 13-21
• 16 Hylander W L, Johnson K R. Jaw muscle function and wishboning of the mandible during mastication in macaques and baboons.  Am J Phys Anthrop . 1994;  94 523-547
• 17 Ellis E, Dean J. Rigid fixation of mandibular condyle fractures.  Oral Surg . 1993;  76 6-15
• 18 Hammer B, Schier P, Prein J. Osteosynthesis of condylar neck fractures: a review of 30 patients.  Br J Oral Maxillofac Surg . 1997;  35 288-291
• 19 Choi B-H, Kim K-N, Kim H-J, Kim M-K. Evaluation of condylar neck fracture plating techniques.  J Cranio-Maxillofac Surg . 1999;  27 109-112
• 20 Schilli W, Stoll P, Bähr W, Prein J. Mandibular fractures. In: Prein J, ed. Manual of Internal Fixation in the Cranio-Facial Skeleton Techniques Recommended by the AO/ASIF Maxillofacial Group Berlin: Springer-Verlag 1998: 87
• 21 Champy M, Loddé J P, Schmitt R. Mandibular osteosynthesis by miniature screwed plates via a buccal approach.  J Max-Fac Surg . 1978;  6 14-19
• 22 Niederdellmann H. Fundamentals of healing of fractures of the facial skull1. Biomechanics. In: Kruger E, Schilli W, eds. Oral and Maxillofacial Traumatology, Vol 1. Chicago: Quintessence 1982: 125-128