[Treatment of mandibular fractures with different fixation techniques--results of a prospective fracture study]

In a prospective study 150 adult patients with mandible fractures were analysed. Criteria for entry into the study were fractures of the mandibular body with and without associated condylar fractures. The fractures must fit to the Spiessl-classes F1 and F2, L1 to L4, W0 to W3 and the patients must have had a sufficient dentition to judge their occlusion. Not included were patients with combinations of mandible and Le Fort fractures, comminuted and defect fractures and patients who could not communicate preoperatively in order to have a full preoperative examination. The patients were equally distributed among 3 different treatment groups. Group 1 was treated conservatively with MMF, only displaced fractures which needed open reduction were internally fixed with wire osteosynthesis. Group 2 received rigid internal fixation with AO 2.7-plates from an intraoral approach, group 3 internal fixation with miniadaption-plates also from an intraoral approach. Using a standardized treatment protocol the patients were followed in defined intervals up to a maximum of 2 years after therapy. Group 1 presented with the lowest complication rate, group 2 with the highest rate of overall complications as far as disturbances of the occlusion and sensory disturbances were concerned. Except one plate fracture in group 3 with subsequent pseudarthrosis, which required a reosteosynthesis with a rigid plate, no major complications in bone healing were observed.