Clinical results of two different three-dimensional plate types for the treatment of mandibular angle fractures: a retrospective analysis - Pfister, J.; Shazwani, F. N.; Muller, M.; Burkhard, J. P. (Oral Maxillofac Surg, 2024)
OBJECTIVES: The purpose of this study was to compare two different designs of three-dimensional osteosynthesis plates for their suitability in the treatment of mandibular angle fractures in terms of sufficient fracture healing and concomitant complications. MATERIALS AND METHODS: Retrospectively a total of 54 patients with 56 mandibular angle fractures were evaluated. Two different types of three-dimensional plates from the Medartis Trilock system were analyzed: (A) Square design plate (☐-plate) with a thickness of 1.0 mm, and (B) triangular-shaped 3D-plate ( big up tri, open-plate) with a thickness of 1.3 mm. Patient demographics, fracture mechanism and intraoperative details were recorded during an average follow-up period of 1 year. RESULTS: The utilization of big up tri, open-plates was observed to entail a considerably lengthier surgical time in contrast to ☐-plate systems (P = 0.037). The application of big up tri, open-plate showed a tendency of higher incidence of major complications than ☐-plate (P = 0.06), as evidenced by the occurrence of non-union in 2 out of 22 cases, resulting in higher surgical revision rate for big up tri, open-plate (P = 0.027). CONCLUSION: Sufficient treatment of mandibular angle fractures is feasible by using 1.0 mm thick, square shaped three-dimensional plate systems. The use of thicker three-dimensional osteosynthesis plates seems to significantly increase the operating time and complication rates, whereby the geometry of the plate seems to have an influence. CLINICAL RELEVANCE: The plate design could have an impact on treatment outcomes of mandibular angle fractures. TRIAL REGISTRATION NUMBER: Not applicable.
Keywords: journalArticle; *Bone Plates; *Fracture Fixation, Internal/instrumentation/methods; *Mandibular Fractures/surgery/diagnostic imaging; Adolescent; Adult; Aged; Female; Fracture Healing/physiology; Humans; Male; Mandibular angle fracture; Middle Aged; Operative Time; Plate design; Postoperative Complications/etiology; Retrospective Studies; Stress shielding; Three-dimensional plate types; Treatment Outcome; Young Adult; interests