Analyzing the Fitting of Novel Preformed Osteosynthesis Plates for the Reduction and Fixation of Mandibular Fractures

Abstract

Purpose: The known preformed osteosynthesis plates for the midface are helpful tools for a precise and fast fixation of repositioned fractures. The purpose of the current study is to analyze the precision of newly developed prototypes of preformed osteosynthesis plates for the mandible. Methods: Four newly designed preformed osteosynthesis plates, generated by a statistical shape model based on 115 CT scans, were virtually analyzed. The used plates were designed for symphyseal, parasymphyseal, angle, and condyle fractures. Each type of plate has three different sizes. For analysis, the shortest distance between the plate and the bone surface was measured, and the sum of the plate-to-bone distances over the whole surface was calculated. Results: A distance between plate and bone of less than 1.5 mm was defined as sufficient fitting. The plate for symphyseal fractures showed good fitting in 90% of the cases for size M, and in 84% for size L. For parasymphyseal fractures, size S fits in 80%, size M in 68%, and size L in 65% of the cases. Angle fractures with their specific plate show good fitting for size S in 53%, size M in 60%, and size L in 47%. The preformed plate for the condyle part fits for size S in 75%, for size M in 85%, and for size L in 74% of the cases. Conclusion: The newly developed mandible plates show sufficient clinical fitting to ensure adequate fracture reduction and fixation.

Optimal Plate Choice for High-Neck Mandibular Condyle Fracture: A Mechanistic Analysis of 16 Options

“…Clinical trials hold substantial significance in determining the optimal plate, especially considering the current high reoperation rates (up to 16%) attributed to plate fractures [31]. Nevertheless, it is important to note that new plate models continually emerge, some of which have not been investigated by the authors [34]. It should also be noted that the treatment of high-neck fractures is still a challenge for operators.…”

Quantitative Assessment of the Restoration of Original Anatomy after 3D Virtual Reduction of Long Bone Fractures

“…Conventional surgical simulation means brainstorming to establish surgical strategy, usually using 3D computed tomography (CT) images of broken bones, rather than 3D-image-based reduction of the fractures [ 23 , 24 ]. Because most of the current viewer systems are based on the picture archiving and communication system (PACS) used in most medical institutions, the function of editing or modeling 3D objects is not available and pre-surgical simulation with the virtual reduction of bone fractures (hereafter referred to as “3D-image-based reduction”) was not originally possible [ 25 , 26 , 27 , 28 , 29 , 30 ]. Thus, the accuracy and reliability of 3D image-based virtual reduction using quantitative assessment also could not be determined using that software.…”