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Vertical Favorability of Angle Fractures of the Mandible and Its Significance in ORIF: A Cadaveric Study

David Jerkins, MD Rachel Teng, MD Salim Mancho, DO
Wright State University Miami Valley Hospital
2016-02-14

Presenter: Rachel Teng

Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. The program director is responsible for making a statement within the confines of the box below specific to how much of the work on this project represents the original work of the resident. All authors/submitters of each abstract should discuss this with their respective program director for accurate submission of information as well as the program director's approval for inclusion of his/her electronic signature

Director Name: R. Michael Johnson

Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial

INTRO:
Mandibular angle fractures are among the most common jaw fractures. A large body of research has been dedicated to ascertain an optimal plating technique. Live human research is difficult to conduct and synthetic bones can only mimic mandibular microstructure. Therefore, there is still debate as to what the indications are for fixation technique based on fracture pattern. We attempt to elucidate the difference in forces when vertical favorable and unfavorable mandibular angle fractures are plated using a single superior oblique ridge plate.
METHODS:
Ten fresh cadaver mandibles were harvested. Mandibles were split through the symphysis and given a favorable or unfavorable fracture at 60 degrees and perpendicular to the ramus. Fractures were plated with a 4 hole 1.5mm champy plate bilaterally. Left and right sides were compared to control for bone variability. The load to failure and displacement to failure were tested via Instron machine.
RESULTS:
The average age of cadaver was 71. 8 were male and 2 were female. Load to clinical failure for favorable fractures was 344N +/- 261 versus 162N +/- 87 for the unfavorable fractures (p=0.1). There was no significant difference between the two groups in displacement to failure either with favorable averaging 2mm +/- 0.86 and unfavorable 1.82mm +/- 0.72 (p = 0.65)
CONCLUSION:
No statistically significant difference could be detected with our sample size between the two groups, though there is a trend to vertically favorable fractures having a higher load to failure. This may still be clinically significant but requires further testing.

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