A comparative analysis of the efficacy of cortical screws as lag screws and miniplates for internal fixation of mandibular symphyseal region fractures: a randomized prospective study.

The management of facial trauma is one of the most rewarding and demanding aspects of oral and maxillofacial surgery. Being the most prominent mobile bone of the facial skeleton, mandible fracture occurs more frequently than any other fracture. In this study, open reduction and internal fixation was performed for isolated mandibular symphyseal region fractures using cortical screws (as lag screws) in 40 patients and using miniplates in 40 patients. Clinical and radiological evaluations were made at 6 months postoperatively. Primary stability of fracture segments, postoperative swelling, restricted lip mobility, infection, wound dehiscence, implant removal, and mal-union or non-union of fracture segments was evaluated. Primary stability was achieved in 100% of cases treated with cortical screws, whereas for patients treated with miniplates, 97.5% attained primary stability, while one case (2.5%) showed persistent clinical mobility. Postoperative complications were noted in 13 (16.25%) of the total 80 patients. The duration of postoperative swelling was less in patients treated with cortical screws compared to patients treated with miniplates. It is concluded that cortical screw fixation is an effective procedure for the treatment of symphyseal region fractures, but the procedure is somewhat technically sensitive.