Archives of Craniofacial Surgery (대한두개안면성형외과학회지)

Korean Cleft Palate-Craniofacial Association (대한두개안면성형외과학회)
권호 표지
DOI QR코드

DOI QR Code

Usability testing of a novel interlocking three-dimensional miniplate for mandibular angle fractures

  • Prasetyanugraheni Kreshanti (Faculty of Medicine, Universitas Indonesia) ;
  • Aria Kekalih (Department of Community Medicine, Faculty of Medicine, Universitas Indonesia) ;
  • Ahmad Jabir Rahyussalim (Department of Orthopaedics and Traumatology, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia) ;
  • Sugeng Supriadi (Research Center for Biomedical Engineering, Faculty of Engineering, Universitas Indonesia, Kampus UI) ;
  • Bambang Pontjo Priosoeryanto (Division of Veterinary Pathology, School of Veterinary Medicine and Biomedical Sciences, IPB University) ;
  • Deni Noviana (Division of Surgery and Radiology, School of Veterinary Medicine and Biomedical Sciences, IPB University) ;
  • Mendy Hatibie Oley (Division of Plastic Reconstructive and Aesthetic Surgery, Department of Surgery, Faculty of Medicine, Sam Ratulangi University) ;
  • Chaula Luthfia Sukasah (Division of Plastic Reconstructive and Aesthetic Surgery, Department of Surgery, Faculty of Medicine, Universitas Indonesia)
  • Received : 2024.05.26
  • Accepted : 2024.08.19
  • Published : 2024.08.20
Download PDF
⟨ Previous Next ⟩

Abstract

Background: We developed a novel interlocking three-dimensional (3D) miniplate design with an adjustable configuration. As this device is new, surgeons must become familiar with its application. This study evaluated the usability and learning curves associated with the novel interlocking 3D miniplate for mandibular fracture fixation. Methods: The study participants, nine plastic surgeons, were asked to apply an interlocking 3D miniplate and a standard miniplate to polyurethane mandible models. The participants had completed the Basic Craniomaxillofacial Osteosynthesis course during residency and had operated on craniomaxillofacial fractures within the past 5 years. They were instructed to place the interlocking 3D miniplate three times and the standard miniplate once. We assessed the time required for implant placement, the comfort level of the surgeons, and the biomechanical stability of the plates. Biomechanical testing was conducted by subjecting the mandible to forces ranging from 10 to 90 N and the displacement was measured. Results: The results indicate increasing comfort with each attempt at placing the interlocking 3D miniplate, with a significant difference between the first and third attempts. Additionally, a reduction in application time was noted with repeated attempts, suggesting improved efficiency. Biomechanical tests showed comparable stability between the tested plates. Conclusion: Multiple attempts at applying the interlocking 3D miniplate resulted in increased comfort and reduced application time. These findings indicate that, despite its novelty, the interlocking 3D miniplate is relatively straightforward to apply and has a short learning curve. However, surgeons must have specific qualifications to ensure proper training and minimize errors during placement.

Keywords

Acknowledgement

This was supported by the PUTI Doctoral Program at Universitas Indonesia (Grant No. NKB-592/UN2.RST/HKP.05.00/2020).

References

  1. Bouloux GF, Chen S, Threadgill JM. Small and large titanium plates are equally effective for treating mandible fractures. J Oral Maxillofac Surg 2012;70:1613-21. 
  2. Choi BH, Suh CH. Technique for applying 2 miniplates for treatment of mandibular angle fractures. J Oral Maxillofac Surg 2001;59:353-4. 
  3. Choi BH, Yoo JH, Kim KN, Kang HS. Stability testing of a two miniplate fixation technique for mandibular angle fractures: an in vitro study. J Craniomaxillofac Surg 1995;23:123-5. 
  4. Siddiqui A, Markose G, Moos KF, McMahon J, Ayoub AF. One miniplate versus two in the management of mandibular angle fractures: a prospective randomised study. Br J Oral Maxillofac Surg 2007;45:223-5. 
  5. Levy FE, Smith RW, Odland RM, Marentette LJ. Monocortical miniplate fixation of mandibular angle fractures. Arch Otolaryngol Head Neck Surg 1991;117:149-54. 
  6. Ellis E 3rd, Walker LR. Treatment of mandibular angle fractures using one noncompression miniplate. J Oral Maxillofac Surg 1996;54:864-71. 
  7. Singh A, Arunkumar KV. Standard 3D titanium miniplate versus locking 3D miniplate in fracture of mandible: a prospective comparative study. J Maxillofac Oral Surg 2016;15:164-72. 
  8. Assael L, Ueeck B. Body and angle fractures of the mandible. In: Ehrenfeld M, Manson PN, Prein J, editors. Principles of internal fixation of the craniomaxillofacial skeleton. Theme; 2012. p. 147-57. 
  9. Kreshanti P, Supriadi S, Kekalih A, Rahyussalim AJ, Priosoeryanto BP, Noviana D, et al. Novel design of interlocking 3-dimensional miniplate in mandibular angle fractures: an in vitro study. J Craniofac Surg 2024;35:1591-6. 
  10. Marcus HJ, Bennett A, Chari A, Day T, Hirst A, Hughes-Hallett A, et al. IDEAL-D framework for device innovation: a consensus statement on the preclinical stage. Ann Surg 2022;275:73-9. 
  11. Nielsen J, Landauer TK. A mathematical model of the finding of usability problems. Paper presented at: INTERCHI93: Conference on Human Factors in Computing. 1993 Apr 24-29; Amsterdam, The Netherlands. 
  12. Steffen C, Sellenschloh K, Willsch M, Soares AP, Morlock MM, Heiland M, et al. Patient-specific miniplates versus patient-specific reconstruction plate: a biomechanical comparison with 3D-printed plates in mandibular reconstruction. J Mech Behav Biomed Mater 2023;140:105742. 
  13. Carvalho P, Saavedra M, Ballester RY, Luz J. Biomechanical evaluation of the sheep mandible as a model for studying fixation methods. Int J Morphol 2018;36:926-30. 
  14. Gerlach KL, Schwarz A. Bite forces in patients after treatment of mandibular angle fractures with miniplate osteosynthesis according to Champy. Int J Oral Maxillofac Surg 2002;31:345-8. 
  15. Esen A, Dolanmaz D, Tuz HH. Biomechanical evaluation of malleable noncompression miniplates in mandibular angle fractures: an experimental study. Br J Oral Maxillofac Surg 2012;50:e65-8. 
  16. Tate GS, Ellis E 3rd, Throckmorton G. Bite forces in patients treated for mandibular angle fractures: implications for fixation recommendations. J Oral Maxillofac Surg 1994;52:734-6. 
  17. Smith V, Warty R, Nair A, Krishnan S, Sursas JA, da Silva Costa F, et al. Defining the clinician's role in early health technology assessment during medical device innovation: a systematic review. BMC Health Serv Res 2019;19:514. 
  18. Hopper AN, Jamison MH, Lewis WG. Learning curves in surgical practice. Postgrad Med J 2007;83:777-9. 
  19. Eversbusch A, Grantcharov TP. Learning curves and impact of psychomotor training on performance in simulated colonoscopy: a randomized trial using a virtual reality endoscopy trainer. Surg Endosc 2004;18:1514-8. 
  20. Simsek T, Erdogan MM, Ugur L, Kazaz H, Tezcan E, Seyhan S. New design titanium miniplate in mandibular angle fracture treatment: a biomechanical study. J Braz Soc Mech Sci Eng 2021;43:21-4. 
  21. Yamaji T, Ando K, Wolf S, Augat P, Claes L. The effect of micromovement on callus formation. J Orthop Sci 2001;6:571-5.