Single versus Double Plate Fixation in Condylar Neck Fractures: Clinical Results and Biomechanics Simulation

Area of Science:

• Oral and Maxillofacial Surgery
• Biomechanical Engineering
• Orthopedic Research

Background:

• Open reduction of mandibular condyle neck fractures presents surgical challenges due to limited access and proximity to facial nerves.
• Optimal fixation methods for narrow fractured segments remain debated, as traditional plating techniques may not be suitable.

Purpose of the Study:

• To compare the biomechanical stability and force resistance of single-long-plate versus double-short-plate fixation for mandibular condyle neck fractures.
• To evaluate clinical outcomes associated with each fixation method.

Main Methods:

• Comparative analysis of clinical data from patients treated with single-long-plate (n=9) and double-short-plate (n=12) fixation.
• Mechanical testing using a Sawbones mandible model to assess displacement under compression.
• Finite element analysis (FEA) to simulate stress distribution and displacement patterns.

Main Results:

• Clinical outcomes showed no significant differences in malocclusion or facial palsy rates between the two fixation groups.
• Sawbones model compression tests revealed similar posterior displacement but significantly greater anterior displacement with single-long-plate fixation.
• FEA indicated higher overall displacements in both anterior and posterior regions for the single-plate group, with distinct stress concentration points for each method.

Conclusions:

• Double-short-plate fixation provides superior biomechanical stability and force resistance compared to single-long-plate fixation for mandibular condyle neck fractures.
• Despite biomechanical differences, clinical outcomes regarding malocclusion and facial nerve function were comparable in this study.
• The findings suggest double-short-plate fixation may be a more robust option for managing these complex fractures.