Outcomes of double miniplate osteosynthesis in the immediate management of infected mandible fractures

Abstract

Introduction: A common complication of poorly managed mandible fractures is infection. There is a consensus amongst clinicians in treating infected mandible fractures in an immediate setting. The approach includes drainage of the purulent discharge, debridement of the fracture, removal of teeth in the fracture line and immediate fixation. Fixation can be load bearing or load sharing in nature. Although clinicians advocate for the use of a reconstruction load bearing plate, a double miniplate fixation could be an alternative. Aim: The aim is to assess the outcomes of double miniplate osteosynthesis in the immediate management of infected mandible fractures Material and method: A prospective cohort study was conducted. The sample size was 20 (n =20). Infections were treated with an incision and drainage and the fractures fixated with a double miniplate fixation system. Pain scores, fracture union, fracture stability and surgical times were measured. Follow–up visits included one week, six weeks and three months respectively. Results: Mandibular angle fractures were most commonly infected. The most common cause of infection were teeth in the line of fracture. The buccal fascial space was the most commonly involved fascial space in regard to spread of infection. Nineteen of the twenty cases attained fracture stability. However, complications commonly encountered were persistent infection and wound dehiscence. Conclusion: Although a limited number of clinical cases were treated, the results correspond with the current literature when an immediate miniplate fixation protocol is used in infected mandible fractures. However, complications encountered in the study included the persistence of infection and wound dehiscence.