Das Manthan Kumar, Mishra Madan, Singh Gaurav, Mondal Shubhamoy
Department of Oral and Maxillofacial Surgery, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India.
Natl J Maxillofac Surg. 2023 Jan-Apr;14(1):47-54. doi: 10.4103/njms.njms_129_22. Epub 2023 Apr 14.
Randomized Control Trial.
A prospective, clinico-radiographic, comparative study was planned to evaluate the treatment outcome and postoperative complications in isolated mandibular angle fractures using 2.0-mm system single linear 4 hole with gap miniplate versus 4 hole rectangular grid plate, both stabilized with 4 8-mm monocortical screws.
Thirty patients with isolated mandibular angle fractures were randomly categorized into two groups with 15 patients each. Group 1 patients were treated with single 2.0 mm × 4 hole linear miniplate along the superior border and Group 2 patients were treated with a 2.0 mm × 4 hole rectangular grid plate on lateral cortex of mandible. Pain, swelling, occlusion, bite force, maximum inter-incisal opening, intraoperative time, facial nerve injury, fracture stability, and postoperative complications were assessed and compared at regular intervals up to 12 months.
There was no major difference in terms of treatment outcome in both systems and both were equally effective without any statistically significant difference in any of the parameters. None of the patients presented with any of the complications except for postoperative infection which was reported by 1 patient from each group at 3 months postoperatively and were managed conservatively.
Both plating systems are equally effective; however, the rectangular grid plate could be a safe and effective alternative to the single miniplate when adaptation and fixation is not possible along the external oblique ridge of the mandible (e.g., fracture with bone loss along the superior border).
随机对照试验。
计划进行一项前瞻性、临床影像学对比研究,以评估使用2.0毫米系统单线性4孔带间隙微型钢板与4孔矩形网格钢板治疗孤立性下颌角骨折的治疗效果和术后并发症,两种钢板均用4枚8毫米单皮质螺钉固定。
30例孤立性下颌角骨折患者随机分为两组,每组15例。第1组患者沿下颌骨上缘用单块2.0毫米×4孔线性微型钢板治疗,第2组患者在下颌骨外侧皮质用2.0毫米×4孔矩形网格钢板治疗。在长达12个月的时间内定期评估和比较疼痛、肿胀、咬合、咬合力、最大切牙间开口度、手术时间、面神经损伤、骨折稳定性和术后并发症。
两种系统在治疗效果方面无显著差异,两者同样有效,任何参数均无统计学显著差异。除术后感染外,两组均无患者出现任何并发症,每组各有1例患者在术后3个月报告有术后感染,均经保守治疗。
两种钢板固定系统同样有效;然而,当下颌骨外斜线无法进行钢板适配和固定时(如下颌骨上缘骨质缺损骨折),矩形网格钢板可能是单微型钢板的一种安全有效的替代方案。