Effectiveness of ORIF by using one titanium plate and archbar for management of mandibular fractures in parasymphyseal region

Background: because of the limited safe space available for fixation of screws and plates in the mandible,especially in the mental foramen and apical region and evidences of metal deposits in the direct proximity of titanium osteosynthesis plates or even in peripheral organs,reduction in number / size of plates was desirable. the size and amount of osteosynthesis material used should therefore be kept minimum but without compromising desired stability. aim and objectives: this study aims to assess the effectiveness and evaluate the benefits of reduction of one plate in terms of morbidity and cost. material and methods: a prospective study was carried out in sixty nine patients of mandibular fractures in parasymphyseal and body region in the oral and maxillofacial surgery department of a tertiary care teaching hospital during january 2006 to june 2008. patients were treated by orif with one titanium plate and 0.75 ×1.25mm half round wire fixed with 0.45mm soft stainless steel (sss) wire to act as dental archbar / tension band. antibiotics were started before surgery and continued for 5-7 days post- operatively. follow-up was performed for 10 weeks and postoperative complications such as infection,wound dehiscence,neurosensory disturbances and malocclusion were recorded. archbar was removed after six weeks of surgery. data regarding age,gender,fracture side,and post operative complications were recorded on self designed performa and analyzed by spss-version13.0 to compare the results with the findings of similar studies in literature. results: a total of sixty nine patients were included in this study; amongst them 94.2% were male and 5.8% female,the ratio being 16.5:1 respectively. age ranged from 13 to 60years,with a mean age of 25.96y and sd 10.7. majority of these patients belong to age group of 21y to 30y. highest number of fracture patients were victim of motor cycle accidents 88.4%,left sided fracture were more than right side. optimal osteogenesis of fractures was observed in all patients with least morbidity and no subsequent surgery. conclusion: results of the current study suggest that treatment of fractures in the parasymphyseal and body region by combination of one plate and archbar was highly effective in providing desired stability to fractured segments,required for early function and optimal osteogenesis of reparative bone with less morbidity and cost.