Miniplate osteosynthesis for mandibular angle fractures – A retrospective comparative study of 3 concepts in a temporal cohort

PurposePurpose of this retrospective study was to compare fixation of mandibular angle fractures by three different miniplating-concepts (single miniplate, double miniplate, TriLock mandibular angle plate) regarding osteosynthesis failure and hardware removal.MethodsIn this retrospective study a temporal cohort of 184 patients with 194 simple mandibular angle fractures, which had been treated by open reduction and internal fixation via miniplates at the University Clinic of Cranio-, Maxillofacial and Oral Surgery (General Hospital Vienna) in the period of 2005–2011, were included. Patients with pathologic fractures (e.g. tumour or osteonecrosis related) or comminuted fractures were not considered.Results9 of 194 (4.6%) fractures showed osteosynthesis failures. The osteosynthesis failure rates were 2.9% in the single miniplate group, 3.4% in the TriLock plate group, and 11.1% in the double miniplate group. In the double miniplate group 33.3% of the patients had undergone hardware removal, 21.4% in the single miniplate group, and 11.4% in the TriLock plate group.ConclusionA single 4-hole locking plate with a thickness of 1.25–1.3 mm guarantees for low osteosynthesis failure rates without postoperative maxillo-mandibular fixation and requires less hardware removal in simple mandibular angle fractures. Two miniplates, longer plates with more holes and thicker plates are prone to hardware removal.