One- or two-plate fixation of mandibular angle fractures?

• Published in: Journal of cranio-maxillo-facial surgery Vol. 25; no. 3; pp. 162 - 168
• Main Authors: Schierle, H.P., Schmelzeisen, R., Rahn, B., Pytlik, C.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Kidlington Elsevier Ltd 01.06.1997; Elsevier
• Subjects: Adult; Analysis of Variance; Biological and medical sciences; Bone Plates; Dentistry; Female; Fracture Fixation, Internal - methods; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics; Humans; Male; Mandibular Fractures - surgery; Maxillofacial surgery. Dental surgery. Orthodontics; Medical sciences; Middle Aged; Probability; Prospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Treatment Outcome; Human; Mandible; Stomatology; Stabilization; Diseases of the osteoarticular system; Fracture; Experimental study; Trauma; In vitro; Plate; Prospective; Fixation; Treatment; Angle; Surgery; Complication; Models; Technique; Maxillary disease
• ISSN: 1010-5182; 1878-4119
• DOI: 10.1016/S1010-5182(97)80009-1

Standard treatment of mandibular angle fractures with miniplates, according to the recommendations of Champy et al. (1976) , consists of fixation with one plate at the superior border of the mandible ventral to the external oblique line. In certain constellations, a second miniplate at the lower mandibular margin may provide additional stability. In contrast, extremely high complication rates following two-plate fixation of mandibular angle fractures were reported by Ellis and Walker (1994) . In a prospective randomized study, 31 consecutive patients were treated with 2.0 mm (mini) plates (Synthes Co., Switzerland). One group was treated with one plate, the other one with two plates. In none of the patients was intermaxillary immobilization used. Follow-up was performed 6 months postoperatively, consisting of clinical and radiographic examination. No significant differences ( P = 0.74 for infection, and P = 1.0 for occlusal and postoperative sensory disturbance) in postoperative short- or long-term complications were found between the two groups. The results are compared with our experimental investigations presented at the annual congress of the German Society of Oral and Maxillofacial Surgery 1995. Two-plate fixation may not offer advantages over single-plate fixation in general. However, individual fracture constellations may benefit from variation in plate(s) localization. Factors contributing to complications in mandibular angle fractures are discussed.