Mandibular angle fractures treated with a single miniplate without postoperative maxillomandibular fixation: A retrospective evaluation of 50 patients

Background and Objectives The ideal line of osteosynthesis in mandibular angle fractures indicates that a plate might be placed either along or just below the external oblique ridge. Some authors believe that using one miniplate at this line at the mandibular angle region provides sufficient strength to stabilize the fracture but others imply a second plate is required. Such controversies exist in the use of maxillomandibular fixation (MMF). The intention of the present study was to compare efficiency and complications of using one miniplate with and without MMF in mandibular angle fractures. Methods and Materials Forty patients with facial trauma with mandibular angle fractures including displaced and unfavorable fractures were categorized into two groups of 20 persons. In all patients, one miniplate was placed on the external oblique ridge. In the first group, patients had light maxillomandibular elastic bands just after surgery but no rigid MMF. In the second group, patients had rigid MMF for 2 weeks after surgery. Patients were followed to evaluate complications and treatment efficiency. Conclusions Our study showed that use of a single miniplate in the external oblique ridge is a functionally stable treatment for all types of angle fractures (including displaced and unfavorable fractures) except comminuted and long oblique fractures, which were not included in our study. Use of postoperative MMF did not improve the results.

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Letter to the Editor: “A randomised controlled trial comparing fixation of mandibular angle fractures with a single miniplate placed either transbuccally and intra-orally, or intra-orally alone” by Sugar et al/ Int. J. Oral Maxillofac. Surg. 2009; 38: 241–245

International Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.ijom.2009.10.018 ◽

2010 ◽

Vol 39 (4) ◽

pp. 418-419

Author(s):

Panayiotis A. Kyzas

Keyword(s):

Randomised Controlled Trial ◽

Controlled Trial ◽

Mandibular Angle ◽

Letter To The Editor ◽

Angle Fractures ◽

Randomised Controlled ◽

Single Miniplate

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Manual Reduction to Assist Intraoperative Maxillomandibular Fixation May Suffice for Mandibular Angle Fractures Treated with Open Reduction and Internal Fixation

Journal of Evidence Based Dental Practice ◽

10.1016/j.jebdp.2009.05.013 ◽

2009 ◽

Vol 9 (4) ◽

pp. 236-237

Author(s):

Corwin Zigler ◽

Vivek Shetty

Keyword(s):

Internal Fixation ◽

Open Reduction ◽

Mandibular Angle ◽

Maxillomandibular Fixation ◽

Manual Reduction ◽

Angle Fractures

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A randomised controlled trial comparing fixation of mandibular angle fractures with a single miniplate placed either transbuccally and intra-orally, or intra-orally alone

International Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.ijom.2008.11.001 ◽

2009 ◽

Vol 38 (3) ◽

pp. 241-245 ◽

Cited By ~ 32

Author(s):

A.W. Sugar ◽

A.J. Gibbons ◽

D.W. Patton ◽

K.C. Silvester ◽

S.C. Hodder ◽

...

Keyword(s):

Randomised Controlled Trial ◽

Controlled Trial ◽

Mandibular Angle ◽

Angle Fractures ◽

Randomised Controlled ◽

Single Miniplate

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Use of 3-D Plate in Displaced Angle Fracture of Mandible

Craniomaxillofacial Trauma & Reconstruction ◽

10.1055/s-0032-1332211 ◽

2013 ◽

Vol 6 (1) ◽

pp. 25-29 ◽

Cited By ~ 9

Author(s):

Uma Shanker Pal ◽

R.K. Singh ◽

Satish Dhasmana ◽

Somdipto Das ◽

Sanjib K. Das

Keyword(s):

General Anesthesia ◽

Three Dimensional ◽

Wound Dehiscence ◽

Mandibular Angle ◽

Angle Fracture ◽

Angle Fractures ◽

Therapeutic Study ◽

And Function ◽

Single Miniplate

Introduction Mandibular angle fractures can be treated by various methods, but even the most popular methods may not be able to give satisfactory results, as the pterygomasseteric sling and masticatory forces can result in displaced angle fracture. These displaced fragments cannot be satisfactorily retained by single miniplate fixation. The aim of this study is to assess treatment of displaced angle fracture with 3-D miniplate fixation. This study can also be considered as a therapeutic study with level V evidence. Materials and Methods This study was designed to assess the feasibility of 3-D matrix miniplate fixation in displaced angle fractures. Eighteen patients with displaced angle fractures were included in this study. Matrix miniplate fixation was done transorally under general anesthesia. Results All these cases were treated successfully, and common complications like infection (5.5% of patients), wound dehiscence (11%), paresthesia (16.7%), and malocclusion (11%) were observed in our study. Conclusions Three-dimensional miniplate fixation in displaced angle fractures provides better stability and function.

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