Analysis of reconstruction of mandibular defects using single stainless steel A-O reconstruction plates

This report reviews the results and complications of immediate reconstruction using a single stainless steel A-O plate after resection of mandibles invaded by malignant tumors.

Thirty-four patients were retrospectively evaluated. According to the extent of the tumor, hemimandibulectomy or segmental resection were performed in 4 and 30 cases, respectively. Five of 34 cases required a myocutaneous flap to close soft tissue defects.

Nine of the 34 patients died during the follow-up period. Complications occurred in 7 of these patients: plate exposure was caused by local tumor recurrence (4 cases), screw loosening (1 case), and temporomandibular joint pain (2 cases). Twenty-five of the 34 patients (73.5%) were alive, with a mean follow-up of 47.4 months (range 6 to 115 months). Eighteen of the 25 surviving patients with the single A-O plate reconstruction did not show any complications. Thirteen of these (52%) patients had not undergone secondary reconstruction. Five of the 25 patients received secondary reconstruction for cosmetic or masticatory function reasons. Postoperative complications occurred in 7 of the 25 surviving patients (28%): extraoral plate exposure (2 cases), fracture of the plate (1 case), mandibular fracture (1 case), screw loosening (3 cases), and screw fracture (1 case).

On the basis of the findings, it was concluded that a single A-O reconstruction plate can be used for temporary, or sometimes even permanent, reconstruction after mandibular resection.