Biodegradable Plates in Craniofacial Trauma: Preliminary Experiences

Objectives: To evaluate technical aspects and therapeutic results of miniplate osteosynthesis with Leibinger Delta System® in patients treated for craniofacial fractures in Al-Adan Hospital in Kuwait during 2004-5. Methods: Clinical records, x-rays and clinical photographs of 12 operated patients were reviewed. Results: We operated on 3 females and 9 males, aged between 5 and 44 years. Two children were treated for mandibular body fractures, 3 children for orbital floor blow-out fractures. All adult patients were treated for frontal bone, frontobasal, or frontonasal complex fractures. One patent also had a maxillary fracture of Le Fort II - III type. During operations we encountered following problems: In two patients with severely comminuted fractures we had to switch to smaller Titanium miniplates to be able to fix all small fragments. In one of pediatric mandibular fractures, miniplates were not rigid enough to prevent dislocation of fragments after removal of the arch-bar and intermaxillary fixation. Visibility of transparent plates and screws in operation field is poor. All patients healed without infectious complications or symptoms of intolerance. Fixation of non-load bearing fragments was stable. All patients failed to attend scheduled follow-up visits after the surgical wounds had healed and edemas subsided. Conclusion: Delta System® resorbable plates proved to be suitable especially for cranial osteosynthesis, easy to handle and very well tolerated. Their usefulness in cases of severe comminution is limited by their rather large size. They are not sufficiently rigid to reliably stabilize mandibular fractures, even in children.