Miniplate osteosynthesis of mandibular fractures at the Lagos University Teaching Hospital

To report the clinical outcome of the treatment of mandibular fractures with miniplate osteosynthesis alone, at Lagos University Teaching Hospital (LUTH).

30 patients who presented with 41 mandibular fractures at the Lagos University Teaching Hospital between May 2005 and June 2006 were selected for treatment with miniplate osteosynthesis according to the principles of Champy et al. They were grouped according to the time lapsed from injury to treatment as: early (< 24 hours), delayed (> 24 hours - < 7 days) and "late" (> or = 7 days) osteosynthesis groups. Data collected included: age and gender distribution, the aetiology of trauma, site of fractures, pre and postoperative body weight and interincisal distance and postoperative complications.

Only 28 of the 30 selected patients received miniplate osteosynthesis and were therefore included in the final analysis. In 25 of these patients (89%) miniplate osteosynthesis without maxillomandibular fixation (MMF) was used. In 3 patients (11%), supplementary MMF was combined with miniplate osteosynthesis. The male - female ratio was 5:1 and the most frequently affected age group was the 20 - 29 years age group (53%). The most frequent cause of fracture was fight and assault. The body of the mandible was the most fractured site. 14 patients (50%) each were classified as delayed and "late" osteosynthesis respectively. The time lapsed before patients attained a postoperative mouth opening of 35mm was 5 weeks while it took 6 weeks to regain lost weight. 46.4% of the patients had postoperative complications; the most frequent complication was malocclusion (23.3%). Patients in the late osteosynthesis group had a higher complication severity score (2.3) than those in the delayed osteosynthesis group (1.5).

This study suggests that most of the mandibular osteosynthesis in our environment would be delayed or "late" and would develop higher complication rate.