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Biomechanical Evaluation of a Mandibular Spanning Plate Technique Compared to Standard Plating Techniques to Treat Mandibular Symphyseal Fractures.

Richardson M, Hayes J, Jordan JR, Puckett A, Fort M - Surg Res Pract (2015)

Bottom Line: The two parallel plates' group showed statistically significant lower values for peak load and stiffness compared to all other groups.No statistically significant difference was found for peak load and stiffness between the control (C) group, lag screw (LS) group, and the spanning plate (SP1) group.Conclusions.

View Article: PubMed Central - PubMed

Affiliation: University of Mississippi Medical Center, Department of Otolaryngology and Communicative Sciences, 2500 N. State Street, Jackson, MS 39216, USA.

ABSTRACT
Purpose. The purpose of this study is to compare the biomechanical behavior of the spanning reconstruction plate compared to standard plating techniques for mandibular symphyseal fractures. Materials and Methods. Twenty-five human mandible replicas were used. Five unaltered synthetic mandibles were used as controls. Four experimental groups of different reconstruction techniques with five in each group were tested. Each synthetic mandible was subjected to a splaying force applied to the mandibular angle by a mechanical testing unit until the construct failed. Peak load and stiffness were recorded. The peak load and stiffness were analyzed using ANOVA and the Tukey test at a confidence level of 95% (P < 0.05). Results. The two parallel plates' group showed statistically significant lower values for peak load and stiffness compared to all other groups. No statistically significant difference was found for peak load and stiffness between the control (C) group, lag screw (LS) group, and the spanning plate (SP1) group. Conclusions. The spanning reconstruction plate technique for fixation of mandibular symphyseal fractures showed similar mechanical behavior to the lag screw technique when subjected to splaying forces between the mandibular gonial angles and may be considered as an alternative technique when increased reconstructive strength is needed.

No MeSH data available.


Related in: MedlinePlus

Spanning plate in a selected patient. Note that a different reconstructive plate was used on the anterior mandibular surface due to the multiple comminuted mandibular segments.
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fig7: Spanning plate in a selected patient. Note that a different reconstructive plate was used on the anterior mandibular surface due to the multiple comminuted mandibular segments.

Mentions: The weaknesses of this study include the basic premise that this combination of fractures may lead to splaying of the gonial angles. While this may or may not be a common complication of this particular type of mandible fracture, its occurrence is documented in the report by Ellis III and Tharanon and is supported by the authors' experience [6]. In addition, while this study supports the use of lag screws and spanning plates in this fracture pattern, it may be that more conventional techniques such as properly applied parallel plates with or without MMF may be adequate for reduction and repair of these fractures. We do not advocate the use of the spanning plate techniques in all of these fractures, but when one desires increased stability of the repair, we offer that it may be considered as an alternative to the lag screw technique. Although not specifically described here, we have utilized the spanning plate technique clinically in select cases with positive outcomes (Figure 7).


Biomechanical Evaluation of a Mandibular Spanning Plate Technique Compared to Standard Plating Techniques to Treat Mandibular Symphyseal Fractures.

Richardson M, Hayes J, Jordan JR, Puckett A, Fort M - Surg Res Pract (2015)

Spanning plate in a selected patient. Note that a different reconstructive plate was used on the anterior mandibular surface due to the multiple comminuted mandibular segments.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4663366&req=5

fig7: Spanning plate in a selected patient. Note that a different reconstructive plate was used on the anterior mandibular surface due to the multiple comminuted mandibular segments.
Mentions: The weaknesses of this study include the basic premise that this combination of fractures may lead to splaying of the gonial angles. While this may or may not be a common complication of this particular type of mandible fracture, its occurrence is documented in the report by Ellis III and Tharanon and is supported by the authors' experience [6]. In addition, while this study supports the use of lag screws and spanning plates in this fracture pattern, it may be that more conventional techniques such as properly applied parallel plates with or without MMF may be adequate for reduction and repair of these fractures. We do not advocate the use of the spanning plate techniques in all of these fractures, but when one desires increased stability of the repair, we offer that it may be considered as an alternative to the lag screw technique. Although not specifically described here, we have utilized the spanning plate technique clinically in select cases with positive outcomes (Figure 7).

Bottom Line: The two parallel plates' group showed statistically significant lower values for peak load and stiffness compared to all other groups.No statistically significant difference was found for peak load and stiffness between the control (C) group, lag screw (LS) group, and the spanning plate (SP1) group.Conclusions.

View Article: PubMed Central - PubMed

Affiliation: University of Mississippi Medical Center, Department of Otolaryngology and Communicative Sciences, 2500 N. State Street, Jackson, MS 39216, USA.

ABSTRACT
Purpose. The purpose of this study is to compare the biomechanical behavior of the spanning reconstruction plate compared to standard plating techniques for mandibular symphyseal fractures. Materials and Methods. Twenty-five human mandible replicas were used. Five unaltered synthetic mandibles were used as controls. Four experimental groups of different reconstruction techniques with five in each group were tested. Each synthetic mandible was subjected to a splaying force applied to the mandibular angle by a mechanical testing unit until the construct failed. Peak load and stiffness were recorded. The peak load and stiffness were analyzed using ANOVA and the Tukey test at a confidence level of 95% (P < 0.05). Results. The two parallel plates' group showed statistically significant lower values for peak load and stiffness compared to all other groups. No statistically significant difference was found for peak load and stiffness between the control (C) group, lag screw (LS) group, and the spanning plate (SP1) group. Conclusions. The spanning reconstruction plate technique for fixation of mandibular symphyseal fractures showed similar mechanical behavior to the lag screw technique when subjected to splaying forces between the mandibular gonial angles and may be considered as an alternative technique when increased reconstructive strength is needed.

No MeSH data available.


Related in: MedlinePlus