Evaluation of treatment outcomes in double mandibular fracture management with mixed versus non-rigid fixation – A randomized controlled trial.

Mandibular fractures are among the most common fractures of the facial skeleton, and the complex

anatomy of the mandible makes it susceptible to fractures at multiple sites, which can be on the same side or opposite. Over the past 40 years, mandibular

fractures have been treated using a technique called open reduction and internal fixation, which for a single fracture, can involve either a single miniplate

for non-rigid fixation or stronger reconstruction plates for rigid fixation. However, treating double mandibular fractures is challenging because the segment

in between two fractures lack support on either side resulting in rotational movement. Previous studies recommend different approaches for the management

of double mandibular fractures. Some suggest that a non-rigid fixation scheme can be used for both fractures, few suggest rigid fixation at least at one

fracture site and others recommend rigid fixation for both fractures. Despite the common occurrence of double mandibular fractures (22% to 52%), there is

limited knowledge regarding standardized, evidence-based, best fixation strategies. To address this gap, the present randomized controlled trial (RCT) will

compare the outcomes of non-rigid fixation alone and a combination of rigid and non-rigid internal fixation. This study aims to provide clearer guidelines

for the management of double mandibular fractures, ensuring better treatment outcomes and functional rehabilitation.