Fixation of Mandibular Fracture with Bioabsorbable Self-reinforced Poly(L/DL)-lactide(70/30%) Plate and Screw

ABSTRACT

Metal fixation device, titanium miniplate is commonly used in facial bone fixation. But metal fixation device requires secondary removal procedure because of such complications as bony atrophy, metallic corrosion, low carcinogenic risk, growth disturbance of craniofacial skeleton, and endocranial migration of device which may lead to pediatric craniofacial surgery. Bioabsorbable plates lose strength retention after a given period of time unlike metalic plates, are degraded and absorbed completely in human body. Because they yield no metalic complications nor risks, and require no secondary removal, their use has been recently increased in fixation of facial bone. Self-inforced(SR)-poly(L/DL) lactide(70/30%) plate is applied for the fixation of midfacial bone in adult. But its weak strength brings concern about the skeletal stability, and makes surgeons hesitate its application to mandibular fractures. SR-poly(L/DL) lactide are rarely used especially in mandibular fractures. The authors used Biosorb FX 2.0 plate in 58 patients of mandibular fractures by open reduction and internal fixation. The duration of intermaxillary fixation was 7 days in 12 patients of multiple fractures. Follow-up period was 4 to 16 months(mean; 12 months). Complications included 2 cases with malocclusion, 6 cases with sensory disturbance and no infection was reported. The malocclusion was solved by minimal occlusal grinding, and sensory disturbance was temporary. The authors applied bicortical fixation of two plate system(thickness 1.2mm) with long screws or large diameter screws to mandibular fractures and obtained sufficient skeletal stability. The risk of tissue reaction associated with possible postimplantative crystallization of SR-poly(L/DL) lactide(70/ 30%) could be reduced. They report their experiences with review of literature.