Outcome of Open Reduction and Internal Fixation by Using One Titanium Plate and Archbar for the Management of Mandibular Fractures in Symphyseal and Parasymphyseal Region
DOI:
https://doi.org/10.37762/jgmds.12-4.753Keywords:
Mandible, symphysis, parasymphysis, Post-Operative ComplicationsAbstract
OBJECTIVES
To determine nerve injury, malocclusion, and non-union of ORIF using a single miniplate and arch bar in the treatment of mandibular fractures in the parasymphyseal and symphyseal regions.
METHODOLOGY
This descriptive cross-sectional study included 233 patients aged 13-65 years who presented within 48 hours of sustaining non-comminuted symphyseal or parasymphyseal mandibular fractures. Patients with bone pathologies, systemic diseases affecting healing, infected fractures, contraindications to general anesthesia, or who were unwilling to attend follow-up were excluded. ORIF was performed using a single titanium miniplate and Erich arch bar under general anesthesia. Outcomes were assessed at 4-week follow-up and included inferior alveolar nerve (IAN) injury, malocclusion, and non-union. Chi-square tests were used to evaluate associations between complications and clinical variables.
RESULTS
The mean age of the participants was 32.42 ± 5.75 years, with 66.95% of participants being male. Road traffic accidents were the leading cause (56.65%). IAN injury was the most frequent complication (30.04%). Malocclusion and non-union occurred in 2.58% and 1.72% of patients, respectively. No statistically significant associations were found between complications and age, gender, fracture type, or etiology.
CONCLUSION
Inferior alveolar nerve injury is the most common complication in mandibular symphyseal and parasymphyseal fractures managed with ORIF, warranting vigilant surgical technique and monitoring.
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Ramirez CA, Fattahi T, Portnoff JE, Shaikh R, Margolis J, Kraus JA, et al. Maxillofacial Trauma. In: Reti R, Findlay D, editors. Oral Board Review for Oral and Maxillofacial Surgery. Cham: Springer International Publishing; 2021. p. 179-200. https://doi.org/10.1007/978-3-030-48880-2_7 DOI: https://doi.org/10.1007/978-3-030-48880-2_7
Inchingolo F, Patano A, Inchingolo AM, Riccaldo L, Morolla R, Netti A, et al. Analysis of mandibular muscle variations following condylar fractures: a systematic review. J Clin Med. 2023;12(18):5925. https://doi.org/10.3390/jcm12185925. PMID: 37762866 DOI: https://doi.org/10.3390/jcm12185925
Maniaci A, Lentini M, Vaira L, Lavalle S, Ronsivalle S, Rubulotta FM, et al. The global burden of maxillofacial trauma in critical care: A narrative review of epidemiology, prevention, economics, and outcomes. Medicina. 2025;61(5):915. https://doi.org/10.3390/medicina61050915 DOI: https://doi.org/10.3390/medicina61050915
Dasukil S, Verma S, Jena AK, Mohapatra M. Frequency of concomitant injuries in maxillofacial trauma in a tertiary health care centre in India: a 5-year retrospective study. Chinese J Traumatol. 2024;28(3):216-219. https://doi.org/10.1016/j.cjtee.2024.03.008 DOI: https://doi.org/10.1016/j.cjtee.2024.03.008
Kademani D. Dental, Oral, and Maxillofacial Emergencies. In: Oral Medicine and Medically Complex Patients. 2025. p. 187-243. https://doi.org/10.1002/9781119984382.ch5 DOI: https://doi.org/10.1002/9781119984382.ch5
Diab J, Moore MH. Facial fractures in the elderly: epidemiology, clinical characteristics, and management. Eur J Plast Surg. 2021;44:577-86. https://doi.org/10.1007/s00238-021-1800-w DOI: https://doi.org/10.1007/s00238-021-01800-w
Polizzi A, Ronsivalle V, Lo Giudice A, Isola G, Bianchi A, Santonocito S, et al. Orthodontic approaches in the management of mandibular fractures: a scoping review. Children. 2023;10(3):605. https://doi.org/10.3390/children10030605 DOI: https://doi.org/10.3390/children10030605
Roccia F, Sobrero F, Raveggi E, Rabufetti A, Scolozzi P, Dubron K, et al. European multicenter prospective analysis of the use of maxillomandibular fixation for mandibular fractures treated with open reduction and internal fixation. J Stomatol Oral Maxillofac Surg. 2023;124(1):101376. https://doi.org/10.1016/j.jormas.2022.101376 DOI: https://doi.org/10.1016/j.jormas.2022.101376
Gadkaree SK, Derakhshan A, Nyabenda V, Ncogoza I, Tuyishimire G, Shaye DA. Wire osteosynthesis in the treatment of mandible fractures in low resource settings: a force study. Craniomaxillofac Trauma Reconstr. 2024;17(1):13-7. https://doi.org/10.1177/19433875221143605. PMID: 38371214 DOI: https://doi.org/10.1177/19433875221143605
Hamed S, Sweedan OA, Abou Eleneen HM. Screw retained band wiring versus miniplates for treatment of anterior mandibular fractures (randomized clinical trial). Alexandria Dent J. 2025;10:1-7. https://doi.org/10.21608/adjalexu.2025.344959.1582 DOI: https://doi.org/10.21608/adjalexu.2025.344959.1582
Vitkos EN, Papadopoulos KA, Dimasis P, Weissinger C, Kyrgidis A. One miniplate versus two miniplates in the fixation of mandibular angle fractures: an updated systematic review and meta-analysis. J Stomatol Oral Maxillofac Surg. 2022;123(6):e865-e873. https://doi.org/10.1016/j.jormas.2022.07.008 DOI: https://doi.org/10.1016/j.jormas.2022.07.008
Mahmoud NR, Habaka YF. Clinical efficacy of three plating systems in management of mandibular parasymphyseal fractures: a retrospective study. BMC Oral Health. 2024;24(1):1374. https://doi.org/10.186/s12903-024-05143-3 DOI: https://doi.org/10.1186/s12903-024-05143-3
Saman M, Kadakia S, Ducic Y. Post-operative maxillomandibular fixation after open reduction of mandible fractures. JAMA Facial Plast Surg. 2014;16(6):410-3. https://doi.org/10.1001/jamafacial.2014.543. PMID: 25504647 DOI: https://doi.org/10.1001/jamafacial.2014.543
Kopp RW, Crozier DL, Goyal P, Kellman RM, Suryadevara AC. Decade review of mandible fractures and arch bar impact on outcomes of non-subcondylar fractures. Laryngoscope. 2016;126(3):596-601. https://doi.org/10.1002/lary.25671. PMID: 26446363 DOI: https://doi.org/10.1002/lary.25671
Shaikh Q. Clinical outcomes in mandibular fracture at symphysis and parasymphysis region with miniplates under local anesthesia in systemically compromised patients. Ann Pak Inst Med Sci. 2014;10(3):140-4
Hussain S, Mohammad S, Khan R. Effectiveness of ORIF by using one titanium plate and arch bar for management of mandibular fractures in parasymphyseal region. Pak J Med Health Sci. 2010;4:61-4
Tariq A, Kanwal S, Javed A, Jadoon Z, Khan SA, Ahmed M. Frequency of inferior alveolar nerve damage after open reduction and internal fixation in mandibular fractures: frequency of inferior alveolar nerve damage. Pak J Health Sci. 2023:02-6. https://doi.org/10.54393/pjhs.v4i07.916 DOI: https://doi.org/10.54393/pjhs.v4i07.916
Alamgir A, Ullah A, Tariq A, Mahmud A, Jadoon M, Siraj F. Occurrence of inferior alveolar nerve damage after internal fixation and open reduction in patients visiting Ayub Medical College with mandibular fractures. Int J Health Sci. 7(S1):2739-45. https://doi.org/10.53730/ijhs.v7nS1.14561 DOI: https://doi.org/10.53730/ijhs.v7nS1.14561
Lone PA, Singh P, Kishore K, Goel M. Management of mandibular symphysis and parasymphysis fractures using a single mini plate with Erich arch bar: Our experience. JK Sci. 2017;19(2):119-23
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Copyright (c) 2025 Abdul Wali Khan , Khadija Syed , Salman Khan, Azmat Ali Safwan, Abdus Saboor, Ajmal Khan, Majida Rahim
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