Rigid internal fixation with plates and screws is now standard for the treatment of fractures, osteotomies and reconstruction of the craniomaxillofacial skeleton. The latest innovations are selfdrilling, self-tapping screws and locking miniplates. These screws offer the prospect of less instrumentation and faster application. Preclinical testing has shown them to be substantially more retentive in cancellous bone, a significant advance in cancellous block bone grafting. Locking 2.0 miniplates utilize double threaded screws which both lock to the bone and the plate creating a mini-internal fixator. This results in a more rigid construct with less distortion of the fracture or osteotomy, screws which do not loosen and less interference with bone circulation since the plate is not pressed tightly against the bone. Locking miniplates are designed for midface application in the repair of fractures, osteotomies and defects. Three configurations in a variety of shapes and lengths are available for mandibular surgery. The thinner and medium varieties are useful in transoral plating of fractures utilizing the Champy technique. The heavier, longer variety are used in unilateral edentulous fractures in the symphysis and parasymphysis as well as an aid to tumor resection and reconstruction with both free and vascularized grafts. They are not designed to replace the heavier 2.4 locking reconstruction plates designed for complex fractures or extensive reconstructions.
by The Keio Journal of Medicine