Herbert Cannulated Bone Screw Osteosynthesis in Anterior Mandibular Fracture Treatment: A Comparative Study With Lag Screw and Miniplate.

Purpose: The Herbert bone screw (HBS) is a successful and minimally invasive method of fracture fixation that is used routinely in orthopedic surgery. The aim of this study was to evaluate the clinical and radiographic performances of the HBS in the treatment of anterior mandibular fractures and compare it with the common and established treatment modalities, the lag screw (LS) and the 2.0-mm miniplate (MP).

Materials And Methods: This study implemented a randomized clinical trial and enrolled a sample of patients with anterior mandibular fractures. The primary predictor variable was treatment group categorized as HBS, LS, or MP fixation of the fracture. 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 intraoperative clinical data. All recorded data were documented, tabulated, computed, and analyzed. Statistical significance was set at the 5% level.

Results: Twenty-one patients were selected and randomly allocated to 1 of 3 groups based on the fixation modality used. There were no relevant differences in demographic data for the 3 groups. There were no statistically relevant 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 = .012) and between the LS and MP groups (P = .045), but not between the HBS and LS groups.

Conclusion: Cannulated HBS osteosynthesis provides a successful and minimally invasive treatment modality for the management of anterior mandibular fractures.