Open reduction internal fixation (ORIF) is the recommended method for complex symphyseal fractures to assure adequate stability in the fracture site, thus preventing complications.
It is especially recommended in noncompliant patients.
|Non- or minimally displaced complex fractures in compliant patients with good dentition amenable to MMF.|
- Premorbid or unstable medical condition preventing general anesthetic
- Conditions making open reduction and internal fixation difficult
- Patient refusal of operative treatment
- Unavailability of plates and screws
Special consideration: MMF may be contraindicated in patients with psychiatric disorders, seizure disorders, and alcoholics.
|ORIF, two plates (basal triangle)|
|If control of the top of the basal triangle is required, the use of two plates provides this control.|
When application of two plates is simpler than a single load bearing reconstruction plate.
|ORIF, reconstruction plate (basal triangle)|
|Maximum stability under load bearing conditions.|
The reconstruction plate is considered the most predictable method of treatment.
|ORIF, reconstruction plate (comminuted fracture)|
|Standard method of treatment of a comminuted fracture.|
|Temporary stabilization of complex fractures simultaneously affecting several anatomic mandibular subunits.|
- Maintain fragment position without disrupting the blood supply
- Rapid application
|Basic surgical experience, no specialized skills|
|Some specialized surgical experience|
|Highly experienced and skilled surgeon|
|Basic equipment only|
|Simple surgical and imaging resources|
|Full specialized surgical and imaging resources|