Effectiveness of placement of second miniplates as tension band unit in mandibular parasymphysis fractures

Abstract

Background: The ideal position of the plates and the need for additional plates are discussed
continuously. In mandible, the tensile forces at the fracture line should be neutralized with a tension
band. This study evaluated the role of the mandibular arch bar as a tension band eliminating the
need for an upper miniplate (tension band plate) in cases of parasymphysis fractures.
Materials and Methods: In this randomized control trial, a total of 90 patients with mandibular
parasymphysis fractures underwent treatment in two groups. Group A was treated with one
titanium miniplate along with Erich’s arch bar. In Group B, two titanium miniplates were placed
across the fracture site along with Erich’s arch bar. Then, the complications and duration of the
operation time were compared between two groups. The results were considered statistically
significant when the P < 0.05.
Results: No significant difference was observed between the groups regarding postoperative
complication rate. 1 month after surgery in Group A, number of patients with sensory
impairment (17%) was significantly lower than Group B (37%) (P = 0.029). Furthermore, the
operation time of Group A was significantly shorter than Group B (P < 0.001).
Conclusion: In the presence of arch bar, placing one miniplate instead of the routine technique of
placing two, do not increase complication rates. Furthermore, it reduces the operation time and
costs and results in a better neurosensory recovery outcome in short time.
Key Words: Mandibular fracture, open reduction, internal fixation