Kozakiewicz Marcin, Zieliński Rafał, Konieczny Bartłomiej, Krasowski Michał, Okulski Jakub
Department of Maxillofacial Surgery, Medical University of Lodz, 1st Gen. J. Hallera Pl., 90-647 Lodz, Poland.
Material Science Laboratory, Medical University of Lodz, 251st Pomorska, 92-213 Lodz, Poland.
Materials (Basel). 2020 Apr 22;13(8):1953. doi: 10.3390/ma13081953.
In the literature, no information on plates for low-neck mandibular condylar osteosynthesis can be found, despite the fact that 30 plate designs have already been published. The aim of this study was to compare any dedicated plates for possible use in low-neck condylar fracture osteosynthesis.
The force required for 1-mm displacement of the fixed fracture fragments and incidents of screw loosening were recorded on polyurethane mandibles among 16 designs of titanium plates fixed by 6-mm screws in a 2.0 system.
Double-straight plate fixation was the mechanical gold standard (15.2 ± 3.5 N), followed by A-shape Condylar Plates (14.9 ± 2.1 N), X-shape Condylar Plates (14.2 ± 1.3 N) and Auto Repositioning Plates (11.8 ± 2.4 N). Screw loosening was uncommon, as a minimum of three screws were placed into the condylar part. Fewer screws were lost from the ramus part of the fixation if the plate was attached to the condylar part by three screws. Often, the stability of the ramus screws was lost when there were only two fixing screws in the condyle ( < 0.001).
It is advisable to consider the mechanical advantages as one decides which plate to choose for open rigid internal fixation in low-neck condylar fractures, or to only be aware of the significant differences in mobility within the fracture line after fixation with different dedicated plates.
尽管已经发表了30种钢板设计，但在文献中找不到关于低颈部下颌髁突骨合成钢板的信息。本研究的目的是比较任何可能用于低颈部髁突骨折骨合成的专用钢板。
在聚氨酯下颌骨上记录16种钛板设计（采用2.0系统的6毫米螺钉固定）使固定骨折碎片产生1毫米位移所需的力以及螺钉松动情况。
双直钢板固定是力学上的金标准（15.2±3.5牛），其次是A形髁突钢板（14.9±2.1牛）、X形髁突钢板（14.2±1.3牛）和自动复位钢板（11.8±2.4牛）。螺钉松动情况不常见，因为至少有三颗螺钉置入髁突部分。如果钢板通过三颗螺钉固定在髁突部分，从固定的升支部分丢失的螺钉较少。当髁突中只有两颗固定螺钉时，升支螺钉的稳定性常常丧失（<0.001）。
在决定为低颈部髁突骨折的切开坚固内固定选择哪种钢板时，考虑力学优势是明智的，或者仅需了解使用不同专用钢板固定后骨折线内活动度的显著差异。
