Locking Versus Non-Locking Miniplates in the Treatment of Mandibular Fractures in Above 35 Years Age Patients

Objective: To compare the frequency of short term post-operative infection of locking plates versus non-locking plate in mandibular fractures in patients above 35 years of age. Methodology: A randomized controlled study was conducted at the Department of Oral and Maxillofacial Surgery, Pakistan Institute of Medical Sciences, Islamabad from January 2018 to January 2019, involving a 100 patients (50 patients in each group). On the basis of history, clinical features, orthopantomogram (OPG) and intraoperative findings, the diagnosis of mandibular fractures was established. Group A patients were treated with reduction and fixation of fracture with locking miniplates and miniscrews following champy’s principle of osteosynthesis. Whereas in group B patients, fractures were reduced and fixed with non-locking miniplates and miniscrews following champy’s principle of osteosynthesis. Results: Effect modifiers such as age, gender, and type of fracture were controlled by stratification. A post-stratification chi-square test was applied. The 1 patient that had infection in group A had an age range 50- 65 years (53 years) (P value: 0.197) while the 2 patients that had infection in group B were younger in age range of 35-50 years (36 years and 38 years) (P value: 0.322). The 1 patient who had infection in group A was female (P value: 0.043) while the 2 patients of group B who had infection were also females (P value: 0.027). In group A, only 1 patient had infection at the para-symphysis of mandible according to site (P value: 0.494). In group B, 1 patient had infection at para-symphysis of mandible and 1 at the body of the mandible site (P value: 0.599).  The results were not statistically significant in terms of infection by the end of 3rd week. Conclusion: The study concludes that insignificant post-operative infection rates while managing mandibular fractures either by locking plates or non-locking plates.