Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2023 Oct;39(5):448-454.
doi: 10.1111/edt.12851. Epub 2023 May 4.

Manual versus rigid intraoperative maxillo-mandibular fixation in the surgical management of mandibular fractures: A European prospective analysis

Federica Sobrero  1 , Fabio Roccia  1 , Valentines Vilaplana  2 , Antonio Mari Roig  2 , Elisa Raveggi  1 , Guglielmo Ramieri  1 , Maximilian Goetzinger  3 , Gian Battista Bottini  3 , Ali O Rizvi  4 , Sean Laverick  4 , Predrag Knežević  5 , Emil Dediol  5 , Mario Kordić  6 , Anamaria Sivrić  6 , Dimitra Ganasouli  7 , Stylianos N Zanakis  7 , Drago Jelovac  8 , Vitomir S Konstantinovic  8 , Anže Birk  9 , Aleš Vesnaver  9 , Alessandro Rabufetti  10 , Paolo Scolozzi  10 , Fatma Eriş Derkuş  11 , Utku Nezih Yilmaz  11 , Constantinus Politis  12 , Kathia Dubron  12
Affiliations
Multicenter Study

Manual versus rigid intraoperative maxillo-mandibular fixation in the surgical management of mandibular fractures: A European prospective analysis

Federica Sobrero et al. Dent Traumatol. 2023 Oct.

Abstract

Purpose: Intraoperative stabilisation of bony fragments with maxillo-mandibular fixation (MMF) is an essential step in the surgical treatment of mandibular fractures that are treated with open reduction and internal fixation (ORIF). The MMF can be performed with or without wire-based methods, rigid or manual MMF, respectively. The aim of this study was to compare the use of manual versus rigid MMF, in terms of occlusal outcomes and infective complications.

Materials and methods: This multi-centric prospective study involved 12 European maxillofacial centres and included adult patients (age ≥16 years) with mandibular fractures treated with ORIF. The following data were collected: age, gender, pre-trauma dental status (dentate or partially dentate), cause of injury, fracture site, associated facial fractures, surgical approach, modality of intraoperative MMF (manual or rigid), outcome (minor/major malocclusions and infective complications) and revision surgeries. The main outcome was malocclusion at 6 weeks after surgery.

Results: Between May 1, 2021 and April 30, 2022, 319 patients-257 males and 62 females (median age, 28 years)-with mandibular fractures (185 single, 116 double and 18 triple fractures) were hospitalised and treated with ORIF. Intraoperative MMF was performed manually on 112 (35%) patients and with rigid MMF on 207 (65%) patients. The study variables did not differ significantly between the two groups, except for age. Minor occlusion disturbances were observed in 4 (3.6%) patients in the manual MMF group and in 10 (4.8%) patients in the rigid MMF group (p > .05). In the rigid MMF group, only one case of major malocclusion required a revision surgery. Infective complications involved 3.6% and 5.8% of patients in the manual and rigid MMF group, respectively (p > .05).

Conclusion: Intraoperative MMF was performed manually in nearly one third of the patients, with wide variability among the centres and no difference observed in terms of number, site and displacement of fractures. No significant difference was found in terms of postoperative malocclusion among patients treated with manual or rigid MMF. This suggests that both techniques were equally effective in providing intraoperative MMF.

Keywords: internal fixation device; jaw fixation techniques; mandibular fractures; multi-centric study; open fracture reduction; prospective study.

PubMed Disclaimer

References

REFERENCES

    1. Roccia F, Iocca O, Sobrero F, Rae E, Laverick S, Carlaw K, et al. World Oral and Maxillofacial Trauma (WORMAT) project: a multicenter prospective analysis of epidemiology and patterns of maxillofacial trauma around the world. J Stomatol Oral Maxillofac Surg. 2022;123:e849-57.
    1. Chrcanovic BR. Factors influencing the incidence of maxillofacial fractures. Oral Maxillofac Surg. 2012;16:3-17.
    1. Ehrenfeld M, Prein J, Assael L, Ueeck B, Gellrich NC, Schoen R, et al. Mandibular fractures. In: Ehrenfeld M, Manson PN, Prein J, editors. Principles of internal fixation of the craniomaxillofacial skeleton. Trauma and orthognathic surgery. Stuttgart: Georg Thieme Verlag KG; 2012. p. 137-79.
    1. Ellis E. Open reduction and internal fixation of combined angle and body/symphysis fractures of the mandible: how much fixation is enough? J Oral Maxillofac Surg. 2013;71:726-33.
    1. Ellis E. An algorithm for the treatment of noncondylar mandibular fractures. J Oral Maxillofac Surg. 2014;72:939-49.

Publication types

LinkOut - more resources