Assistant Professor, Department of Oral and Maxillofacial Surgery, SRM Kattankulathur Dental College and Hospital, SRM Institute of Science and Technology, Potheri, Kattankulathur, Chengalpattu District, Tamil Nadu, India.
Associate Professor, Department of Oral and Maxillofacial Surgery, SRM Kattankulathur Dental College and Hospital, SRM Institute of Science and Technology, Potheri, Kattankulathur, Chengalpattu District, Tamil Nadu, India.
J Oral Maxillofac Surg. 2021 Jun;79(6):1330.e1-1330.e12. doi: 10.1016/j.joms.2020.12.023. Epub 2020 Dec 24.
The management of the condyle fractures continue to be a source of perineal controversy in the field of oral and maxillofacial trauma. The aim of this study was to compare the surgical feasibility, functional outcome, and stability of fixation between the conventional miniplate and 3-dimensional plate in the management of adult mandibular unilateral subcondylar fractures.
A prospective randomized clinical study with well-structured inclusion and exclusion criteria was carried out. Patients were allocated into Group A (Miniplates) and Group B (3-D Plates). The primary outcome variables were time taken for fixation, maximum mouth opening, occlusal stability, increase in angulation, and increase in the gap between fractured segments in the radiograph. The secondary outcome variables were needed for intermaxillary fixation (IMF) with guiding elastics and jaw movements. Statistical analysis was done using χ test and student's t test with P value less than 0.05 indicating statistical significance.
Forty-four patients (40 male and 4 female) were enrolled, with 22 patients in each group. Time taken for fixation using 3-D plates was significantly lower than conventional miniplates (9.6 ± 0.9 minutes with P value 0.001). Although clinical parameters showed improved results for Group B, there was no statistical significance. Radiological parameters ie increase in angulation, and increase in the gap, showed statistically significant results. Group A had significant increases in the angulation of the fractured condyle at the end of the third and sixth months with a P value of 0.008 and 0.0001, respectively. The gap between the fractured segments was significantly increased in Group A at the end of the first and third months, with a P value of 0.022 and 0.003, respectively.
Our results concluded that 3-D plate offers superior fracture fragment stability and less displacement of the fractured segments. It has an added advantage of the ease of adaptation and shorter operating time.
髁突骨折的治疗一直是口腔颌面创伤领域的一个热点问题。本研究旨在比较传统微型钢板和三维钢板治疗成人单侧下颌髁突骨折的手术可行性、功能结果和固定稳定性。
进行了一项前瞻性随机临床研究，纳入和排除标准明确。患者被分为 A 组（微型钢板）和 B 组（三维钢板）。主要观察指标为固定时间、最大张口度、咬合稳定性、角度增加和骨折段之间间隙增加。次要观察指标为需要使用颌间固定（IMF）弹性体和颌骨运动。使用 χ 检验和学生 t 检验进行统计学分析，P 值小于 0.05 表示具有统计学意义。
共纳入 44 例患者（40 例男性和 4 例女性），每组 22 例。使用三维钢板固定时间明显短于传统微型钢板（9.6±0.9 分钟，P 值=0.001）。尽管 B 组的临床参数显示出改善的结果，但无统计学意义。影像学参数即角度增加和间隙增加显示出统计学意义。A 组在第 3 个月和第 6 个月时骨折髁突的角度增加有显著统计学意义，P 值分别为 0.008 和 0.0001。A 组在第 1 个月和第 3 个月时骨折段之间的间隙明显增加，P 值分别为 0.022 和 0.003。
我们的结果表明，三维钢板提供了更好的骨折碎片稳定性和更小的骨折段移位。它具有易于适应和操作时间更短的优点。
