AN EVALUATION OF THE WURZBURG TITANIUM MINIPLATE OSTEOSYNTHESIS SYSTEM FOR MANDIBULAR FIXATION

We present an 8-year experience with the Wurzburg noncompression titan ium miniplate system for the rigid fixation of the mandible during ele ctive head and neck cancer surgery in a consecutive series of 100 pati ents. One half of the miniplates were used to hx mandibulotomies under taken for surgical access. The remaining half were in patients undergo ing reconstruction of segmental mandibular defects, the vast majority (92%) with vascularised bone grafts. One to four variously shaped mini plates were used per patient (mean = 1.5), plate size ranging from 4 t o 40 holes. Fifteen patients (15%) developed complications which inclu ded 3 mandibular osteoradionecrosis, 8 broken, 5 infected, and 4 expos ed plates. Three of the eight fractured plates were associated with no nunion. In this study, the main advantages of titanium miniplate fixat ion, namely ease of application, decreased fixation time and malleabil ity, were accompanied by a level of morbidity which, while comparing w ell with alternatives, may necessitate a reappraisal of this technique of fixation.