TRADITIONAL METHODS VS RIGID INTERNAL-FIXATION OF MANDIBLE FRACTURES

Objective: To compare traditional methods tie, intermaxillary fixation with interosseous wiring or external fixation) with newer techniques tie, plating, use of lag screws) of open reduction and fixation of mandible fractures. Design: Retrospective analysis of data from medical records. Setting: Academic urban medical center. Patients: Nonrandomized sample of 356 patients admitted to the hospital for treatment of mandible fractures from 1987 through 1991; 155 patients treated with open reduction and fixation were studied. Interventions: Sixty-nine patients were treated with interosseous wire fixation or external fixation, 86 patients with rigid internal fixation. Main Outcome Measures: Presence of infection, nerve impairment, nonunion, malunion, operative time, and follow-up. Results: No significant difference was noted between the two groups for sex, treating service, delay in presentation, antibiotic coverage, mechanism of injury, or type of fracture. The incidence of infection, nerve injury, and unavailablity for follow-up were greater in patients treated by the newer techniques. Overall expense and operative time were greater in the group treated with plates and lag screws. Conclusions: We advocate traditional techniques for patients with mandible fractures requiring open reduction and fixation.