A comparative study between traditional fixation with miniplates and modified lag screws for the treatment of mandibular fractures

Abstract

Objectives: The objective of this study is to investigate two internal fixation surgical techniques for mandibular fractures in order to compare modified lag screw techniques with standard miniplates.

Materials and methods: This is an observational prospective study. Three hundred eighteen patients were operated on for mandibular fractures. The patients were divided into two groups according to the type of surgical technique used: modified lag screws (155 patients) and traditional miniplates (163 patients). Analyses were made of sociodemographic and preoperative variables, the parameters related to the fracture type and postoperative data.

Results: There were no differences between the two groups regarding their sociodemographic characteristics. The modified lag screws were primarily used with double fractures, while conventional miniplates were more often used with simple fractures. The number of complications was higher with the miniplate technique. The unfavorable fractures had an OR of 5.75 due to postoperative complications; double fractures had an OR of 8.87 and simple fractures an OR of 19.53, which, in both cases, were lower with conventional miniplates than with modified lag screws.

Conclusion: Modified lag screws provide a rigid fixation system that is as secure as miniplates, but with greater compression between the fragments, less postsurgical gap, faster ossification, and fewer postoperative complications.

Clinical relevance: The modified screw technique is a safe tool that does not require any specific osteosynthesis materials not found in a basic traumatology kit and has a lower cost, due to the reduced amount of material used.

Keywords: Lag screw; Mandibular fracture; Miniplate; Osteosynthesis.