Combination of Rigid and Nonrigid Fixation Versus Nonrigid Fixation for Bilateral Mandibular Fractures: A Multicenter...

Area of Science:

• Oral and Maxillofacial Surgery
• Trauma Surgery
• Orthopedic Surgery

Background:

• Bilateral mandibular fractures present complex treatment challenges.
• Internal fixation rigidity is a key factor influencing outcomes.
• Optimal fixation strategies require comparison of different rigidity levels.

Purpose of the Study:

• To compare complication rates and functional outcomes in patients with bilateral mandibular fractures treated with varying degrees of internal fixation rigidity.
• To evaluate the efficacy of mixed fixation (rigid anterior, nonrigid posterior) versus nonrigid fixation for both fractures.

Main Methods:

• International, multicenter randomized controlled trial involving adults with bilateral mandibular fractures.
• Comparison of mixed fixation versus nonrigid fixation for bilateral mandibular fractures.
• Primary outcome: complications within 6 weeks; Secondary outcomes: complications at 3 months, Helkimo dysfunction index, and mandibular mobility.

Main Results:

• No statistically significant difference in overall complication rates at 6 weeks or 3 months between mixed fixation and nonrigid fixation groups.
• Patients with moderate or severe fracture displacement showed a higher complication rate.
• No significant differences in functional outcomes (Helkimo index, mandibular mobility) between the groups.

Conclusions:

• Mixed fixation (rigid anterior, nonrigid posterior) demonstrates comparable complication rates and functional outcomes to nonrigid fixation for bilateral mandibular fractures.
• Fracture displacement is a significant factor influencing complication risk.
• Treatment strategies can be guided by the similar outcomes observed between these fixation methods.