Treatment methods for fractures of the mandibular angle

Treatment modalities for mandibular angle fractures.

Fixation of mandibular fractures with 2.0-mm miniplates: review of 191 cases.

Comparison of a Single Noncompression Miniplate Versus 2 Noncompression Miniplates in the Treatment of Mandibular Angle Fractures: A Prospective, Randomized Clinical Trial

BackgroundNoncompression monocortical miniplate fixation of the mandibular angle is an accepted and reliable method for providing rigid internal fixation. High complication rates have been reported...

Mandibular angle fractures: two-miniplate fixation and complications.

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 Germany 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.

C. Pytlik

Papers

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