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Open Rigid Internal Fixation of Low-Neck Condylar Fractures of the Mandible: Mechanical Comparison of 16 Plate Designs

Background: In the literature, no information on plates for low-neck mandibular condylar osteosynthesis can be found, despite the fact that 30 plate designs have already been published. The aim of this study was to compare any dedicated plates for possible use in low-neck condylar fracture osteosynt...

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Autores principales: Kozakiewicz, Marcin, Zieliński, Rafał, Konieczny, Bartłomiej, Krasowski, Michał, Okulski, Jakub
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7215721/
https://www.ncbi.nlm.nih.gov/pubmed/32331209
http://dx.doi.org/10.3390/ma13081953
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author Kozakiewicz, Marcin
Zieliński, Rafał
Konieczny, Bartłomiej
Krasowski, Michał
Okulski, Jakub
author_facet Kozakiewicz, Marcin
Zieliński, Rafał
Konieczny, Bartłomiej
Krasowski, Michał
Okulski, Jakub
author_sort Kozakiewicz, Marcin
collection PubMed
description Background: In the literature, no information on plates for low-neck mandibular condylar osteosynthesis can be found, despite the fact that 30 plate designs have already been published. The aim of this study was to compare any dedicated plates for possible use in low-neck condylar fracture osteosynthesis. Methods: The force required for 1-mm displacement of the fixed fracture fragments and incidents of screw loosening were recorded on polyurethane mandibles among 16 designs of titanium plates fixed by 6-mm screws in a 2.0 system. Results: Double-straight plate fixation was the mechanical gold standard (15.2 ± 3.5 N), followed by A-shape Condylar Plates (14.9 ± 2.1 N), X-shape Condylar Plates (14.2 ± 1.3 N) and Auto Repositioning Plates (11.8 ± 2.4 N). Screw loosening was uncommon, as a minimum of three screws were placed into the condylar part. Fewer screws were lost from the ramus part of the fixation if the plate was attached to the condylar part by three screws. Often, the stability of the ramus screws was lost when there were only two fixing screws in the condyle (p < 0.001). Conclusions: It is advisable to consider the mechanical advantages as one decides which plate to choose for open rigid internal fixation in low-neck condylar fractures, or to only be aware of the significant differences in mobility within the fracture line after fixation with different dedicated plates.
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spelling pubmed-72157212020-05-22 Open Rigid Internal Fixation of Low-Neck Condylar Fractures of the Mandible: Mechanical Comparison of 16 Plate Designs Kozakiewicz, Marcin Zieliński, Rafał Konieczny, Bartłomiej Krasowski, Michał Okulski, Jakub Materials (Basel) Article Background: In the literature, no information on plates for low-neck mandibular condylar osteosynthesis can be found, despite the fact that 30 plate designs have already been published. The aim of this study was to compare any dedicated plates for possible use in low-neck condylar fracture osteosynthesis. Methods: The force required for 1-mm displacement of the fixed fracture fragments and incidents of screw loosening were recorded on polyurethane mandibles among 16 designs of titanium plates fixed by 6-mm screws in a 2.0 system. Results: Double-straight plate fixation was the mechanical gold standard (15.2 ± 3.5 N), followed by A-shape Condylar Plates (14.9 ± 2.1 N), X-shape Condylar Plates (14.2 ± 1.3 N) and Auto Repositioning Plates (11.8 ± 2.4 N). Screw loosening was uncommon, as a minimum of three screws were placed into the condylar part. Fewer screws were lost from the ramus part of the fixation if the plate was attached to the condylar part by three screws. Often, the stability of the ramus screws was lost when there were only two fixing screws in the condyle (p < 0.001). Conclusions: It is advisable to consider the mechanical advantages as one decides which plate to choose for open rigid internal fixation in low-neck condylar fractures, or to only be aware of the significant differences in mobility within the fracture line after fixation with different dedicated plates. MDPI 2020-04-22 /pmc/articles/PMC7215721/ /pubmed/32331209 http://dx.doi.org/10.3390/ma13081953 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kozakiewicz, Marcin
Zieliński, Rafał
Konieczny, Bartłomiej
Krasowski, Michał
Okulski, Jakub
Open Rigid Internal Fixation of Low-Neck Condylar Fractures of the Mandible: Mechanical Comparison of 16 Plate Designs
title Open Rigid Internal Fixation of Low-Neck Condylar Fractures of the Mandible: Mechanical Comparison of 16 Plate Designs
title_full Open Rigid Internal Fixation of Low-Neck Condylar Fractures of the Mandible: Mechanical Comparison of 16 Plate Designs
title_fullStr Open Rigid Internal Fixation of Low-Neck Condylar Fractures of the Mandible: Mechanical Comparison of 16 Plate Designs
title_full_unstemmed Open Rigid Internal Fixation of Low-Neck Condylar Fractures of the Mandible: Mechanical Comparison of 16 Plate Designs
title_short Open Rigid Internal Fixation of Low-Neck Condylar Fractures of the Mandible: Mechanical Comparison of 16 Plate Designs
title_sort open rigid internal fixation of low-neck condylar fractures of the mandible: mechanical comparison of 16 plate designs
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7215721/
https://www.ncbi.nlm.nih.gov/pubmed/32331209
http://dx.doi.org/10.3390/ma13081953
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