Fixation methods in mandibular reconstruction using fibula grafts: A comparative study into the relative strength of three different types of osteosynthesis

Background. Bone staples made of a nickel titanium alloy exert dynamic comp ression, require little dissection. and may provide an alternative to conve ntional fixation in mandibular reconstruction with a free vascularized fibu la graft. Methods. To evaluate its stability relative to conventional methods of fixa tion with interosseous wires or miniplates, an in vitro model using beech d owels was developed. Torsional stiffness and strength and compression stiff ness and strength were examined. Results. The compression test results showed that maximum strength of inter osseous wires is significantly less than memory staples, which in turn are significantly weaker than titanium miniplates. Miniplates are significantly the most rigid form of fixation. Torsional testing showed no significant d ifference in strength between staples and miniplates and only a marginal di fference in elasticity. Interosseous wires show a rapid decrease of strengt h and rigidity during torsional stress. Conclusion. When considering interosseous wires the least and miniplates th e most stable form of fixation by which bone healing can occur, memory stap les can provide enough stability to ensure consolidation. (C) 2000 John Wil ey & Sons, Inc.