MANDIBULAR FRACTURE OSTEOSYNTHESIS - A COMPARISON OF 3 TECHNIQUES

The authors report on a retrospective study of 205 consecutive patient s at the Maxillofacial Unit of The Royal Melbourne Hospital to assess if adherence to Champy's principles in placement of miniplates in mand ibular fractures minimises morbidity, 205 well documented cases of man dibular fractures treated with internal fixation, January 1985 to Apri l 1990 were studied, The patients were assigned into three groups acco rding to the type of fixation; 83 patients had miniplate fixation acco rding to Champy's principles, 40 patients had miniplate fixation ignor ing Champy's principles, 82 patients had transosseous wire (TOW) fixat ion. Outcome was measured by preoperative variables (age, gender, mech anism of fracture, site and number of fractures, nerve function, assoc iated injuries and treatment delay) and postoperative variables (durat ion of admission, duration of intermaxillary fixation (IMF), malocclus ion, infection, dehiscence, union, removal of fixation and nerve funct ion which were assessed and compared. The results show that the preope rative variables were statistically similar in all groups. The postope rative variables indicated a statistically higher complication rate fo r the transosseous mire group compared with the miniplate groups, and morbidity was reduced in the group following Champy's principles. The morbidity rates in this study compare favourably with other studies ev en though the patients in this study had a much higher incidence of mu ltiple fractures, Titanium miniplates appear as effective as miniplate s constructed of other materials used in previous studies, especially when Champy's principles are followed.