Herbert cannulated bone screw osteosynthesis in anterior mandibular fractures treatment: a comparative study with lag screw and mini-plate

Publication date: Available online 19 February 2018
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Yehia El-Mahallawy., Haytham Al-Mahalawy.
PurposeHerbert bone screw is a successful minimally invasive mean of fracture fixation that is used routinely in orthopedic surgery. The aim of this study was to evaluate the clinical and radiographic performance of Herbert bone screw in the treatment of anterior mandibular fractures and compare it with the commonly established treatment modalities; lag screw and 2.0-mm miniplates.Materials and methodsThis study implemented a randomized clinical trial and enrolled a sample of patients with anterior mandible fractures. The primary predictor variable was treatment group categorized as Herbert bone screw (HBS), lag screw (LS), or miniplate (MP) fixation of the fracture. The primary outcome variables were the presence of interfragmentary mobility and radiodensitometric appraisal of fracture healing progression. The secondary outcome was the postoperative clinical evaluation. Other variables collected were grouped into demographic, fracture location, and intra-operative clinical data. All of the recorded data were documented, tabulated, computed, and analyzed. Statistical significance was set at 5% level.ResultsTwenty-one patients were selected and randomly allocated into the three groups based on the fixation modality utilized. There were no significant differences in demographic data for the 3 groups. There were no statistically significant differences in clinical evaluation outcomes. However, there was a statistically significant difference in the gain of mean postoperative bone density between the HBS and MP groups (P=0.012), and between LS and MP groups (P=0.045), but not between HBS and LS groups.ConclusionHerbert cannulated bone screw osteosynthesis provides a successful and minimally invasive treatment modality for the management of anterior mandibular fractures.



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