Clinical results of two different three-dimensional plate types for the treatment of mandibular angle fractures: a retrospective analysis

Oral Maxillofac Surg. 2024 Dec;28(4):1501-1507. doi: 10.1007/s10006-024-01275-6. Epub 2024 Jun 26.

Abstract

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 (△-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 △-plates was observed to entail a considerably lengthier surgical time in contrast to ☐-plate systems (P = 0.037). The application of △-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 △-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: Mandibular angle fracture; Plate design; Stress shielding; Three-dimensional plate types.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bone Plates*
  • Female
  • Fracture Fixation, Internal* / instrumentation
  • Fracture Fixation, Internal* / methods
  • Fracture Healing / physiology
  • Humans
  • Male
  • Mandibular Fractures* / diagnostic imaging
  • Mandibular Fractures* / surgery
  • Middle Aged
  • Operative Time
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult