Lag screw vs miniplate fixation in treatment of condylar neck fractures: A systematic review.

Abstract

Background: Fractures of the mandibular condyle region, particularly high condylar neck and condylar process fractures can lead to tremendous functional and aesthetic impairments and are challenging to treat. A conservative approach is the treatment of choice in non-displaced cases. However, fractures with signifi cant displacement pose considerable diffi culty as they require surgical intervention. Various techniques, including lag screws and miniplates, are currently available. This review aimed to assess the usage patterns and outcomes of lag screw and miniplate fi xation techniques in cases of mandibular condyle region fractures.

Material and methods: This review was conducted following the PRISMA guidelines. A comprehensive search of Science Direct, Springer Link and PubMed databases was performed, supplemented by a manual internet search. Keywords "lag screw", "miniplate", "condylar fracture", "high condylar neck fracture", "fi xation" were utilized. This review included human subject studies and in vitro studies published in the previous ten years.

Results: A total of eight studies were included in the qualitative analysis. Four studies assessed miniplate fi xation while the other four examined fi xation with lag screws. Five out of six in vivo studies assessed mouth opening, healing of the surgical site, occlusion during follow-up, and patient satisfaction. All studies showed satisfactory results in functional restoration. In-vitro studies indicated that either two lag screws or two parallel plain plates provide adequate fi xation for high condylar neck fractures.

Conclusion: Current clinical research biases lag screw usage more towards condylar process - high condylar neck fractures while miniplates are more commonly used in high condylar neck fractures. There is a severe lack of published studies regarding treatment outcomes of high condylar neck fractures.