Evolution and Recent Advances in Fixation in Maxillofacial Surgery

Maxillofacial injuries are common and often require coordinated management between different surgical specialties. They can result from various causes such as road traffic accidents, interpersonal violence, falls, sports injuries, and missile injuries. Fracture management aims for uneventful healing to restore form, function, and aesthetics while addressing complications like malunion, soft tissue breakdown, and infection. Treatment methods have evolved from wiring and splinting to advanced techniques like rigid fixation, compression plates, and customized plating systems using materials such as stainless steel, titanium, and resorbable plates. Traditionally made of stainless steel, modern plates now utilize biocompatible titanium alloys, offering enhanced strength and reduced risk of adverse reactions. Pre-contoured designs match bone anatomy, minimizing intraoperative adjustments, while low-profile plates reduce soft tissue irritation and improve aesthetics. Locking plate systems provide more stable fixation, particularly beneficial in challenging cases with poor bone quality. Biodegradable plates eliminate the need for removal surgeries, gradually degrading within the body.