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Mandibular angle fractures: two-miniplate fixation and complications
Albert J Fox1, Robert M Kellman
1Department of Otolaryngology and Communication Sciences, Upstate Medical University, Syracuse, NY 13210, USA.
Archives of Facial Plastic Surgery
|November 19, 2003
Summary
Two-miniplate fixation of mandibular angle fractures offers reliable outcomes with minimal complications. This technique demonstrated no malunion, nonunion, or osteomyelitis, with a low infection rate of 2.9%.
Area of Science:
- Oral and Maxillofacial Surgery
- Trauma Surgery
- Orthognathic Surgery
Background:
- Noncompression monocortical miniplate fixation is a standard for mandibular angle fractures.
- However, high complication rates are frequently reported for internal fixation of these fractures.
Purpose of the Study:
- To evaluate the outcomes and complication rates associated with two-miniplate fixation for mandibular angle fractures.
Main Methods:
- Retrospective analysis of 68 patients (70 fractures) treated with two-miniplate fixation at a level 1 trauma center.
- Data collected included trauma-to-treatment time, injury cause, associated fractures, and postoperative complications.
- Follow-up extended to 12 weeks, with radiographic assessment.
Main Results:
- No cases of malunion, nonunion, or osteomyelitis were observed.
- Overall complication rate was 17.6%, with infection in 2.9% of patients (treated with antibiotics).
- Occlusal disturbances (5.9%) and wound dehiscence (5.9%) were noted, often associated with multiple facial fractures.
Conclusions:
- Two-miniplate fixation provides reliable and effective rigid fixation for mandibular angle fractures.
- The complication and infection rates are comparable or superior to single-plate techniques.
- Further research is needed to establish the optimal approach for noncompression monocortical fixation of angle fractures.