Comparison of two L shaped Plate on Plate Versus Single Conventional L Miniplate in Fixation of Subcondylar Mandibular Fractures

Abstract

Aim: To compare and evaluate treatment outcome and postoperative complications in subcondylar fractures of mandible-single L shape plate versus two L shape plate-using plate on plate technique.

Materials and methods: The clinical trial had a total of ten patients (ten unilateral subcondylar fracture sites), which were divided randomly into two groups of five each. Group I patients underwent open reduction and internal fixation with single L shaped miniplate and Group II ORIF was done with two L shaped miniplates by plate on plate technique.

Results: Both the groups showed comparable results in terms of postoperative complications. Few cases in Group I presented with minor occlusal discrepancy which was easily corrected with transitional inter-maxillary fixation(IMF) for 1 week, and none of the Group II cases required postoperative IMF, but stability in Group II was better than Group I.

Conclusion: The results of this trial suggested that the treatment of mandibular condylar fractures with 2 (2-D) plates placed one over the other is better suited than conventionally practiced single-plate fixation. Increased 3-dimensional stability, low morbidity and infection rates are the advantages offered by 2-plate technique of ours.

Keywords: 3D plates; Miniplates; Plate on plate; Subcondylar fracture.

Fig. 1

Preoperative OPG showing left subcondylar fracture

Fig. 2

Postoperative OPG showing single L plate fixation for left subcondylar fracture and lag screw fixation for right parasymphysis fracture

Fig. 3

Intraoperative clinical picture showing the use of plate on plate technique

Fig. 4

Preoperative OPG showing left subcondylar fracture

Fig. 5

Postoperative OPG showing left subcondylar fracture fixed with L-shaped plate on plate with additional fragment fixed with a 2-hole plate

Fig. 6

PA mandible showing left subcondylar and right parasymphysis fracture

Fig. 7

Postoperative PA and lateral view showing left subcondylar fracture fixed with L-shaped plate on plate and parasymphysis fracture fixed with conventional miniplates

Fig. 8

Postoperative OPG view showing left subcondylar fracture fixed with L-shaped plate on plate and parasymphysis fracture fixed with conventional miniplates. (Same patient as of Figs. 6 and 7)

Fig. 9

Preoperative OPG showing left subcondylar fracture and parasymphysis fracture

Fig. 10

Postoperative OPG showing left subcondylar fracture fixed with L-shaped plate on plate and parasymphysis fracture fixed with conventional miniplates