Comparison of a single noncompression miniplate versus 2 noncompression miniplates in the treatment of mandibular angle fractures: a prospective, randomized clinical trial

The aim of this study is to compare the postoperative complications after fixation of mandibular angle fractures with 2 noncompression miniplates, in which a single plate is fixed onto the superior border of the mandible and the other plate to the lateral aspect of the mandible, with the standard technique of a single noncompression miniplate fixed onto the superior border of the mandible.

We randomly divided 54 patients with unilateral mandibular angle fractures into 2 groups, with 27 in each group. Randomization was done with lots in closed envelopes. Group I patients were treated with a single noncompression miniplate fixed at the superior border as suggested by Champy et al through an intraoral approach. Group II patients were treated with 2 noncompression miniplates in which 1 plate was fixed in a manner similar to that in group I and the other plate was fixed to the lateral aspect of the angle of the mandible with combined intraoral and transcutaneous access through a trocar and cannula. The patients were assessed for malocclusion, infection, wound dehiscence, and plate exposure. The data were analyzed statistically with the chi(2) test, and statistical analysis was performed with SPSS statistical software for Windows, version 8.0 (SPSS, Chicago, IL).

Group I comprised 21 men and 6 women with a mean age of 32.4 years (range, 18-43 years). Group II comprised 23 men and 4 women with a mean age of 29.6 years (range, 21-49 years). No patients complained of malocclusion in either group. Wound dehiscence occurred in 3 patients (11.1%) in group I and 2 patients (7.4%) in group II, which was not statistically significant (chi(2) = 0.0, P > .99). Infection occurred in 1 patient (3.7%) in group I and 2 patients (7.4%) in group II, which was not statistically significant (chi(2) = 0.0, P > .99). One patient from both the groups required plate removal. Scar developed at the transcutaneous incision site in 5 patients (18.5%) in group II.

The use of 2 noncompression miniplates for treating noncomminuted fractures of the mandibular angle does not seem to have any advantage over the use of a single plate.