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The Use of Microplates for Internal Fixation of Comminuted Mandibular Fractures

Tae Joon Choi, Young Hun Chung1, Jae Young Cho2

  • 1Department of Plastic Surgery, Kyung Hee University Medical Center.

Annals of Plastic Surgery
|December 12, 2018
PubMed
Abstract

Insights

Microplates offer a viable solution for internal fixation of comminuted mandibular fractures, achieving complete bone healing with minimal complications. This method provides stability and aids in restoring occlusion for effective fracture reconstruction.

Area of Science:

  • Oral and Maxillofacial Surgery
  • Trauma Surgery
  • Biomaterials Engineering

Background:

  • Microplates are established for simple mandibular fractures but less accepted for comminuted types.
  • Comminuted mandibular fractures present unique challenges in achieving stable internal fixation.

Purpose of the Study:

  • To evaluate the efficacy and applicability of microplate systems for internal fixation of comminuted mandibular fractures.
  • To assess the outcomes and complication rates associated with microplate use in complex fracture patterns.

Main Methods:

  • Open reduction and internal fixation using titanium microplates (0.5- or 0.6-mm) and monocortical microscrews (1.0- to 1.3-mm).
  • Three-level fixation strategy applied to the lower border, upper border (with interdental wiring), and middle of the mandible.
  • Maxillomandibular fixation used selectively for premature occlusal contact post-fixation.

Main Results:

  • All 14 patients achieved favorable and complete bone healing over a 3-55 month follow-up period.
  • Minor complications included malocclusion (n=5) and localized infection (n=1), managed conservatively.
  • No major complications requiring reoperation or further orthodontic intervention were reported.

Conclusions:

  • Three-level microplate fixation is suitable for reconstructing comminuted mandibular fractures without significant bone defects.
  • Microplates facilitate precise anatomical reduction and stable fixation due to their size and malleability.
  • This technique preserves periosteal blood supply, aids occlusion restoration, and provides adequate stability.

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