One miniplate compared with two in the fixation of isolated fractures of the mandibular angle

The purpose of this study was to compare one miniplate with two in the management of isolated fractures of the mandibular angle as regards wound healing, failure of hardware, scarring, weakness of the facial nerve, and overall morbidity, by making a systematic review with a meta-analysis. I made a comprehensive electronic search with no date or language restrictions in October 2014. The inclusion criteria were studies in humans, including randomised or quasirandomised controlled trials (RCT), controlled clinical trials (CCT), and retrospective studies that compared the morbidity after treatment of such fractures with one and two miniplates. Ten publications were included: three RCT, three CCT, and four retrospective studies. Three studies showed a low, and seven a moderate, risk of bias. There was a significant difference between one and two miniplates in the incidence of wound healing, failure of hardware, weakness of the facial nerve, and overall complications (p=0.04, p =0.05, p=0.002, and p=0.05, respectively). The result of the meta-analysis showed that one miniplate placed on the external oblique ridge provided a significant reduction in the incidence of wound infection and dehiscence, failure of hardware, and overall complications, compared with two miniplates, one placed on the external oblique ridge and one placed on to the ventral surface of mandible to fix the fracture.