Treatment of mandibular angle fractures - linea obliqua plate versus grid plate

To compare treatment outcomes, handling and long term results between two osseo-fixation systems for mandibular angle fractures - the external oblique ridge (external oblique) plate and the grid plate.

Sixty patients with mandibular angle fracture were analyzed regarding their operative treatment: 30 patients were treated with an external oblique plate and compared to 30 patients treated with a grid plate on the vestibular cortex. The follow up period was at least 1 year for both groups and the following complications were noted: infection, abnormality in fracture healing, nonunion, pain, hypoaesthesia and dysocclusion.

The overall average operation time (from intubation to extubation) was 102.1 min (± 44.1 min). Single sided fractures treated with the grid plate needed in average 81.07 min (± 37.9 min) of operation time while single sided fractures treated with the external oblique plate needed 89.3 min (± 42.2 min). In multiple mandibular fractures, no significant change in the operation time between either plating system was found (118.8 ± 35.2 min). After the follow up period fracture healing was considered clinically complete in all patients, but complications occurred significantly more often in the external oblique group (13.3%; N=8) than in the grid plate group (0%; N=0).

Isolated mandibular angle fractures can be more effectively treated using grid plates than using other osteosynthesis techniques. It is an easy to use alternative to conventional miniplate systems with good clinical outcome and fewer complications. An angulated burr and screwdriver has to be used to put on the plate laterally.