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Comparative clinical study evaluating the use of single versus two miniplates in reduction and fixation of fractures of the mandibular condyles

Sami Faisal Jamdar, Aaminah Fatima Jamdar, Ahmad M. Aldhafeeri, Sadun Mohammad Alaqeel Albeaiji.




Abstract
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Aim: To evaluate the functional outcome and stability by comparing the single miniplate versus two miniplates for open reduction and internal fixation of mandibular condylar fractures.
Materials and methods: The prospective clinical study was performed on 36 patients (26 males and 10 females) with mandibular condylar fractures. These patients were divided into two groups of 18 each. In the first group, fixation was achieved with a single miniplate and in the second group, fixation was achieved with two mini plates. Fractures were classified based on classification given by Spiessel and Schroll (1972). All the fractures included in the study were subjected to open reduction and internal fixation. The choice of approach and fixation was planned to depend upon the level of fracture by the operating surgeon before surgery. All these patients were assessed for follow up over a period of 6 months postoperatively.
Results: The study showed that complications like occlusal derangement, change in fracture segment position after achieving good intraoperative reduction and deviation of the mouth towards the fracture side were more commonly seen in the patients treated with a single miniplate. Though other complications were also seen more in patients treated with a single miniplate the number was statistically insignificant.
Conclusion: Patients treated with two miniplates showed fewer complications when compared to patients treated with a single miniplate. Follow up period showed better occlusal stability and TMJ function with two miniplates. As our study sample size is small, it is difficult to comment on the statistical significance of the plating system used. We suggest that whenever possible two miniplates should be used to fix the condylar fractures as it provides more stable fixation

Key words: Condyle fracture, miniplates, open reduction internal fixation, Incisal opening






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