Department of Oral and Maxillofacial Surgery, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India.
Int J Oral Maxillofac Surg. 2021 Jun;50(6):756-762. doi: 10.1016/j.ijom.2020.10.009. Epub 2020 Dec 4.
Subcondylar fracture of the mandible accounts for 25-35% of all mandibular fractures. In the past, most subcondylar fractures were managed non-surgically. The traditional method of fixation for subcondylar fractures uses two miniplates; however some bench studies have reported that trapezoidal plates are superior. The aim of this study was to compare the outcomes of subcondylar fractures fixed either with two non-parallel straight miniplates or with one trapezoidal plate. A randomized clinical trial was designed and implemented. Fifty-two consecutive patients with subcondylar fractures were recruited. All patients underwent surgery via a retromandibular approach. The time taken for fixation of the plate after fracture reduction and postoperative outcomes and complications were compared between the groups. The trapezoidal plates were superior in terms of ease of adaptation and time taken for fixation (P= 0.0001). Plate fracture was observed only in the two miniplates group, in four (16%) patients. Outcomes were similar in the two groups in terms of occlusion, mouth opening, protrusion, and lateral excursion. In conclusion, both systems - two miniplates and the trapezoidal plate - provide functionally stable fixation. The outcome was significantly better for the trapezoidal plate than for two miniplates regarding the time taken for insertion and ease of adaptation, but not for other parameters.
下颌骨髁突骨折占所有下颌骨骨折的 25-35%。过去，大多数下颌骨髁突骨折采用非手术治疗。下颌骨髁突骨折的传统固定方法是使用两块微型板；然而，一些 bench 研究报告称，梯形板更优越。本研究旨在比较使用两块非平行直微型板或一块梯形板固定下颌骨髁突骨折的结果。设计并实施了一项随机临床试验。招募了 52 名连续的下颌骨髁突骨折患者。所有患者均通过下颌后入路进行手术。比较了两组患者骨折复位后固定板的时间、术后结果和并发症。梯形板在适应性和固定时间方面具有优势（P=0.0001）。只有在两块微型板组中观察到 4 名（16%）患者的板骨折。在咬合、张口、突出和侧移方面，两组的结果相似。总之，两种系统-两块微型板和梯形板-都提供了功能稳定的固定。在插入时间和适应性方面，梯形板的效果明显优于两块微型板，但其他参数则不然。
