Comparative study between lag screw and miniplate fixation for straight midline mandibular osteotomy

The mandibular swing approach is a surgical approach for the resection of malignant lesions localized in the posterior oral cavity and oropharynx. We analyzed 15 years of experience with fixation of the straight midline mandibulotomy and compared two fixation methods: lag screws and miniplates. A total of 117 patients underwent a straight midline mandibulotomy during the study period; 85 had fixation with two lag screws and 32 with two miniplates. The overall complication rate was low and there was no significant difference in complication rate regarding the fixation method (9% for miniplates vs. 7% for lag screws). The most serious complication over the whole study period was non union, which occurred in only two patients, followed by orocutaneous fistula and infection. Radiotherapy did not cause serious complications and is not regarded as hazardous in midline mandibulotomy patients. We conclude that lag screw fixation is at least as safe as miniplate fixation, but because of better fragment compression, offers faster bone healing.