Efficacy of 2.5mm stainless steel mini-plate versus stainless steel lag screw in anterior mandibular fractures- a comparative evaluation

Background: Anterior mandibular fractures are common entity in maxillofacial trauma with average incidence of 17%. The unique anatomy of mandible along with vector forces exerted by muscles separates the inferior border of mandible making these fractures problematic. Aim: To compare and evaluate use of 2.5mm stainless steel single lag screw with 2.5mm single miniplate (6-hole with gap) for non-communited anterior mandibular fractures Objective: 1. Evaluation of efficacy of lag screw as compared to miniplate, 2. Evaluation of intra-operative/post-operative complications, 3. Comparison of ease of placement of hardware, 4. Radiological evaluation of adequacy of fracture reduction Method: All patients were operated at an institute in Pune from 2012-2014. They were divided in two groups- Group S (2.5mm suitable length lag screw) and group P (2.5mm 6-hole with gap miniplate with 6 bicortical screws). Arch bar was spanned at upper border in both the groups. Standard pre-operative clinical and radiological evaluation-orthopantogram for supero-inferior and true occlusal for antero-posterior displacement was done. Post-operative assessment was done for correctness of implant position, adequacy of fracture reduction, and evidence of infection, relation of hardware to vital structures, occlusion, wound healing & vitality of teeth on 7th day, one month & 3 months interval. Results: Male predominance with mean age of 25 years was noted in sample group. Wound dehiscence of less than 3cms in two patients, infection in one patient were noticed in group P which were statistically insignificant. Mean time required for procedure in group S was 78.4min while in group P was 75.3 min. Inter-maxillary fixation post-surgery was required in two patients in group P. Seven patients in group S had reduction of fracture segment less than 0.5mm as compared to four in group P. Conclusion: Minimum difference was noted in time required for procedure and adequacy of reduction which were in favour of group S over group P.