Miniplate osteosynthesis for mandibular angle fractures--A retrospective comparative study of 3 concepts in a temporal cohort.

Abstract

Purpose of this retrospective study was to compare fixation of mandibular angle fractures by three different miniplating-concepts (single miniplate, double miniplate, TriLock mandibular angle plate) regarding osteosynthesis failure and hardware removal. In this retrospective study a temporal cohort of 184 patients with 194 simple mandibular angle fractures, which had been treated by open reduction and internal fixation via miniplates at the University Clinic of Cranio-, Maxillofacial and Oral Surgery (General Hospital Vienna) in the period of 2005-2011, were included. Patients with pathologic fractures (e.g. tumour or osteonecrosis related) or comminuted fractures were not considered. 9 of 194 (4.6%) fractures showed osteosynthesis failures. The osteosynthesis failure rates were 2.9% in the single miniplate group, 3.4% in the TriLock plate group, and 11.1% in the double miniplate group. In the double miniplate group 33.3% of the patients had undergone hardware removal, 21.4% in the single miniplate group, and 11.4% in the TriLock plate group. A single 4-hole locking plate with a thickness of 1.25-1.3 mm guarantees for low osteosynthesis failure rates without postoperative maxillo-mandibular fixation and requires less hardware removal in simple mandibular angle fractures. Two miniplates, longer plates with more holes and thicker plates are prone to hardware removal.