Management of Mandibular Angle Fractures Using One Miniplate Versus Two Miniplate  Fixation System

Authors

  • Shahrukh Zafar Department of Oral and Maxillofacial Surgery, Armed Forces Institute of Dentistry, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
  • Shahid Iqbal Khan Department of Oral and Maxillofacial Surgery, Armed Forces Institute of Dentistry, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
  • Muhammad Junaid Department of Oral and Maxillofacial Surgery, Armed Forces Institute of Dentistry, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
  • Syed Junaid Hussain Bukhari Department of Oral and Maxillofacial Surgery, Armed Forces Institute of Dentistry, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
  • Sana Somair Department of Oral and Maxillofacial Surgery, Armed Forces Institute of Dentistry, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
  • Ayesha Imran Department of Oral and Maxillofacial Surgery, Armed Forces Institute of Dentistry, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76iSUPPL-1.13632

Keywords:

Champy’s Technique, Internal Fixators, Mandibular Fractures, Maxillofacial Injuries, Open Fracture Reduction, Postoperative Complications

Abstract

Objective: To compare postoperative complication rates in patients with non-comminuted, favourable mandibular angle fractures treated using either single miniplate fixation (Champy’s technique) or a two-miniplate approach.

Study Design: Quasi-experimental study.

Place and Duration of Study: Department of Oral and Maxillofacial Surgery, Armed Forces Institute of Dentistry Rawalpindi, Pakistan from Dec 2024 to May 2025.

Methodology: Sixty patients with favourable mandibular angle fractures were non-randomly allocated by alternate assignment into two equal groups. Group-A underwent fixation with a single miniplate at the superior border, while Group-B received two miniplates at the superior and inferior borders. Postoperative complications, including wound infection, neurosensory disturbance, malocclusion, wound dehiscence, pseudoarthrosis, hardware failure, and scarring, were evaluated on Day 1 and Weeks 1, 2, and 4. Data were analysed using SPSS version 23. Chi-square test was applied to compare complication rates between the two groups, with significance set at p≤0.05.

Results: Wound infection occurred in 6.7% of patients in Group-A and 33.3% of patients in Group-B (p=0.010). Statistically significant differences were also noted in neurosensory dysfunction (0.0% vs. 16.7%, p=0.020), wound dehiscence (6.7% vs. 26.7%, p=0.038), hardware failure (6.7% vs. 26.7%, p=0.038), and scarring (3.3% vs. 23.3%, p=0.023), respectively. Malocclusion showed no significant difference (10.0% vs. 13.3%, p=0.688), and pseudoarthrosis was absent in both groups. Overall, 26.7% of Group-A and 73.3% of Group-B experienced at least one complication (p<0.001).

Conclusion: Single miniplate fixation resulted in fewer postoperative complications and is preferable for favourable mandibular angle fractures.

Downloads

Download data is not yet available.

Author Biography

  • Shahrukh Zafar, Department of Oral and Maxillofacial Surgery, Armed Forces Institute of Dentistry, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan

    Resident Oral and Maxillofacial Surgery

References

1. Yuen HW, Hohman MH, Mazzoni T. Mandible Fracture. [Updated 2023 Jul 31]. Stat Pearls [Internet]. Treasure Island (FL): Stat Pearls Publishing. 2024.

https://www.ncbi.nlm.nih.gov/books/NBK507705/

2. Cha S, Park G, Lee BS, Kwon YD, Choi BJ, Lee JW,et al. Retrospective clinical study of mandible fractures. Maxillofac Plast Reconstr Surg 2022; 44(1): 36.

https://doi.org/10.1186/s40902-022-00365-3

3. Ferrari R, Lanzer M, Wiedemeier D, Rücker M, Bredell M. Complication rate in mandibular angle fractures—one vs. two plates: a 12-year retrospective analysis. Oral Maxillofac Surg 2018; 22(4): 435-441. https://doi.org/10.1007/s10006-018-0728-4

4. Alam BF, Mohiuddin S, Hosein S, Hosein M. Patterns of Facial Fractures Associated with Socio-demographic and Causative Factors: A Multi-Center Analysis from Karachi. J Pak Dent Assoc 2019; 28(3): 103-107.

https://doi.org/10.25301/JPDA.283.103

5. Fox AJ, Kellman RM. Mandibular angle fractures: two-miniplate fixation and complications. Arch Facial Plast Surg 2003; 5(6): 464-469. https://doi.org/10.1001/archfaci.5.6.464

6. Vitkos EN, Papadopoulos KA, Dimasis P, Weissinger C, Kyrgidis A. One miniplate versus two miniplates in the fixation of mandibular angle fractures. An updated systematic review and meta-analysis. J Stomatol Oral Maxillofac Surg 2022; 123(6): e865-873. https://doi.org/10.1016/j.jormas.2022.07.008

7. Kerdoud O, Aloua R, Slimani F. Management of mandibular angle fractures through single and two mini-plate fixation systems: Retrospective study of 112 cases. Int J Surg Case Rep 2021; 80: 105690. https://doi.org/10.1016/j.ijscr.2021.105690

8. Falci SG, De Souza GM, Fernandes IA, Galvão EL, Al-Moraissi EA. Complications after different methods for fixation of mandibular angle fractures: network meta-analysis of randomized controlled trials. Int J Oral Maxillofac Surg 2021; 50(11): 1450-1463. https://doi.org/10.1016/j.ijom.2021.02.009

9. Sheen JR, Mabrouk A, Garla VV. Fracture healing overview. InStatPearls [internet] 2023 Apr 8. Stat Pearls Publishing. https://www.researchgate.net/publication/353681662_Fractur_Healing_Overview

10. Kostares E, Kostare G, Kostares M, Kantzanou M. Prevalence of surgical site infections after open reduction and internal fixation for mandibular fractures: a systematic review and meta-analysis. Sci Rep 2023; 13(1): 11174.

https://doi.org/10.1038/s41598-023-37652-6

11. Muhammed MR. Clinical Outcomes of Mandibular Angle Fractures Treated by Single-Versus Double Miniplates. Erbil Dental Journal 2024; 7(2): 185-190.

https://doi.org/10.15218/edj.2024.20

12. Olsen T, Sweitzer K, Arias-Camison R, Guedikian C, Bell D. 37. Impact Of Surgical Techniques and Patient Factors On Postoperative Outcomes in Mandibular Angle Fractures. Plast Reconstr Surg Glob Open 2025; 13(S1): 25-26.

https://journals.lww.com/prsgo/_layouts/15/oaks.journals/downloadpdf.aspx?an=01720096-202505001-00036

13. Tariq A, Kanwal S, Javed A, Jadoon Z, Khan SA, Ahmed M et al. Frequency of Inferior Alveolar Nerve Damage After Open Reduction and Internal Fixation in Mandibular Fractures: Frequency of Inferior Alveolar Nerve Damage. Pak J Med Health Sci 2023; 4(7): 02-06.

https://doi.org/10.54393/pjhs.v4i07.916

14. Rai A. Fractures of the Mandible. In Oral Maxillofac Surg Clin 2021 Feb 15 (pp. 1053-1084). Singapore: Springer Nature Singapore. https://doi.org/10.1007/978-981-15-1346-6_52

15. Oksa, M., Haapanen, A., Marttila, E., Furuholm, J., & Snäll, J. Postoperative wound dehiscence in mandibular fractures. Acta Odontol Scand 2023 81(7): 555–5561.

https://doi.org/10.1080/00016357.2023.2211156

16. Kong TH, Chung KJ, Kim YH. Analysis of the risk factors influencing complications in surgical treatment of mandibular fractures: A retrospective study. J Cranio-Maxillo-Fac Surgery 2022; 50(12): 929-933. https://doi.org/10.1016/j.jcms.2022.12.001

17. Capucha T, Shilo D, Abdalla-Aslan R, Blanc O, Ginini JG, Semel G, Emodi O et al. Is open reduction internal fixation using titanium plates in the mandible as successful as we think?. J Craniofac Surg 2022; 33(4): 1032-1036.

https://doi.org/10.1097/scs.0000000000008258

18. Albert DY, Muthusekhar M, Selvarasu KA. Miniplate removal post-open reduction internal fixation: A retrospective analysis. J Contemp Iss Bus Gov 2021; 27: 2944-2953.

http://dx.doi.org/10.47750/cibg.2021.27.02.302

19. Pal US, Ganguly R. Angle and Ramus Fractures. In Maxillofacial Trauma: A Clinical Guide 2021 (pp. 203-215). Singapore: Springer Singapore.

https://doi.org/10.1007/978-981-33-6338-0_13

20. Nazar IB, Boesoirie SF. Long-Term Outcome in Patients Treated for Maxillofacial Fractures. InProceedings of the 19th Otorhinolaryngology Head and Neck Surgery National Congress 2023 (Vol. 68, p. 49). Springer Nature.

https://doi.org/10.2991/978-94-6463-280-4_9

21. Mahmoud N, Ashour E. Comparative study between three different plating techniques in management of mandibular angular fractures. A Retrospective Study. Egypt Dent J 2021; 67(1): 167-180.

https://doi.org/10.21608/edj.2020.36904.1185

22. Pavithra SK, Vivek N, Saravanan C, Karthik R, Prashanthi G, Scott C. Comparison of Conventional Versus Right Angled Fixation Technique in Management of Mandibular Angle Fractures–A Prospective Randomized Clinical Study. J Oral Maxillofac Surg 2023; 81(8): 1001-1010.

https://doi.org/10.1016/j.joms.2023.04.005

23. Sakong Y, Kim YH, Chung KJ. Analysis of complication in mandibular angle fracture: Champy technique versus rigid fixation. J Craniofac Surg 2021; 32(8): 2732-2735.

https://doi.org/10.1097/scs.0000000000007688

24. Lander DP, Lee JJ, Kallogjeri D, Stwalley D, Olsen MA, Piccirillo JF, Spataro EA. The impact of treatment delay on malunion and nonunion after open reduction of mandible fractures. Facial Plast Surg Aesthet Med 2021; 23(6): 460-466.

https://doi.org/10.1089/fpsam.2020.0607

25. Chatterjee A, Gunashekhar S, Karthic R, Karthika S, Edsor E, Nair RU et al. Comparison of Single Versus Two Non-Compression Miniplates in the Management of Unfavourable Angle Fracture of the Mandible Orginal Research. J Pharm Bio allied Sci 2023 (Suppl 1): S486-S489.

https://doi.org/10.4103/jpbs.jpbs_555_22

Downloads

Published

30-01-2026

Issue

Section

Original Articles

Categories

How to Cite

1.
Zafar S, Shahid Iqbal Khan, Muhammad Junaid, Hussain Bukhari SJ, Somair S, Imran A. Management of Mandibular Angle Fractures Using One Miniplate Versus Two Miniplate  Fixation System. Pak Armed Forces Med J [Internet]. 2026 Jan. 30 [cited 2026 Feb. 6];76(SUPPL-1):S3-S8. Available from: https://www.pafmj.org/PAFMJ/article/view/13632