Mandible fracture treated with Champy (miniplate)?

From the Guidelines

A Champy plate is the recommended fixation method for mandible fractures, as it provides stable fixation while following the natural stress lines of the mandible, allowing for less invasive surgery, faster healing, and reduced risk of complications. For a typical mandibular fracture:

• Use 2.0 mm Champy plates and screws
• Place plates along the superior border of the mandible
• Use at least 2 screws on each side of the fracture line
• Ensure proper occlusion before final tightening of screws The procedure involves making an intraoral incision to expose the fracture, reducing the fracture and establishing proper occlusion, contouring the plate to fit the mandibular anatomy, securing the plate with screws, and checking occlusion again before closing the incision 1. Postoperative care includes a soft diet for 4-6 weeks, oral antibiotics for 5-7 days, and regular follow-up to monitor healing and occlusion. The use of Champy plates is supported by the fact that mandibular fractures are classified according to the degree of comminution, location, and the presence of displaced fragments, and the mandible is a U-shaped bone forming an incomplete ring that articulates with the calvaria via the temporomandibular joints, making stable fixation crucial for proper healing 1. Key considerations in the treatment of mandible fractures include the high incidence of secondary fractures, with approximately 67% of cases involving two separate fractures, highlighting the importance of proper fixation techniques to prevent further complications 1.

From the Research

Mandible Fracture Treatment with Champy Miniplate

• The use of Champy miniplates for the treatment of mandible fractures has been widely accepted due to their advantages, including being small, flexible, and easily adaptable 2.
• The Champy technique involves placing a single miniplate on the superior border of the mandible, which has become a preferred method of treatment among surgeons 3.
• Studies have shown that the use of Champy miniplates can reduce morbidity and complication rates compared to other fixation techniques, such as transosseous wire fixation 4.
• The placement of miniplates according to Champy's principles can minimize morbidity and is considered an effective treatment option for mandibular fractures 4.

Advantages and Outcomes

• The use of Champy miniplates has been shown to result in primary bone healing in 100% of cases, with a low incidence of complications such as soft tissue infection, nonunion, and malunion 5.
• A study found that the incidence of complications was not significantly different between patients who returned to a normal diet at 2,4, or 6 weeks after open reduction and internal fixation (ORIF) of mandibular fractures, suggesting that strict adherence to a softened diet may not be necessary 6.
• The Champy technique has been compared to other fixation techniques, such as the use of resorbable plates, and has been found to be a viable option for the treatment of mandible fractures 5.

Surgical Techniques and Trends

• The current trends in the management of simple, noncomminuted mandibular angle fractures involve the use of a single miniplate on the superior border, with or without arch bars, which is the preferred technique among 51% of surgeons surveyed 3.
• The use of intraoperative maxillomandibular fixation (MMF) as an adjunct to internal fixation has become controversial, with some surgeons considering it not mandatory in certain circumstances 3.
• The placement of screws in a neutral position, rather than an eccentric position, is favored by 51% of surgeons surveyed, resulting in compression 3.