The comparative strength of laryngeal fracture fixation

Purpose: To assess the fixation strength provided by miniplate fixation, wire-tube batten fixation, and wire fixation alone in repair of thyroid cartilage. Materials and Methods: Segments 2.5-cm wide x 1-cm long were cut from three fresh, frozen, human cadaveric larynges from an 83-year-old man, a 58-year-old woman, and an unknown cadaver. A vertical fracture was induced and repaired with one of three randomly assigned fixation techniques (n = 10 in each fixation group). The repaired cartilage was placed in an Instron Universal Testing Device (Boston, MA) and subjected to a three-point bending test. Load to failure was recorded on an analogue graph. Results: All reconstruction techniques significantly differed from each other, with miniplate fixation providing a stronger repair than wire tube batten (P < .05), wire tube batten providing a stronger repair than wire alone (P < .01), and miniplate providing a stronger repair than wire alone (P < .001). Conclusion: In experimentally induced fractures of the human larynx, miniplate fixation consistently yielded the strongest repair. Although both miniplate and wire batten produced excellent anatomic reaction, we feel that miniplate fixation was easier to perform. Copyright (C) 1998 by W.B. Saunders Company.