Locking Versus Non-Locking Plate Fixation in the Management of Maxillofacial Fractures: A Prospective Comparative Study

Abstract

Introduction Various methods of fixation have been advocated for the treatment of maxillofacial fractures. A new type of plating system, initially developed by Raveh et al. is locking plate/screw system. This system has various advantages over conventional non locking plating system like better stability, ease of plate adaptation, early restoration of function, internal locking system which decreases the chance of screw loosening and infection. Objectives A comparative evaluation of locking plates system versus conventional miniplates in maxillofacial fractures. Method Twenty patients presenting with maxillofacial fractures were treated with locking plates and conventional non locking plates in two years from 2014 to 2016. Ten patients were treated with locking plate system in group A and 10 patients with conventional non locking plates in group B. Patients were evaluated on clinical and radiographic parameters during three months follow up. Results Postoperative outcomes for both groups were extremely favorable with a relatively small number of complications. There was no case of postoperative wound dehiscence, infection, damage to tooth roots, plate exposure and plate removal, malunion and any other complication in both the groups. Postoperative occlusion disturbance was seen in 20% cases in both group A as well as group B in mandible fractures. In maxillary fractures postoperative occlusion disturbance was seen in one case (20%) in group B. Conclusion This study concluded that despite the significant theoretical advantages of locking system seen in biomechanical studies, no statistical significant results were found between these two systems. The postoperative outcomes for both groups were almost similar with a relatively small number of complications.