One miniplate compared with two in the fixation of isolated fractures of the mandibular angle. 2015

E A Al-Moraissi
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Thamar University, Yemen. Electronic address: dr_essamalmoraissi@yahoo.com.

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.

UI MeSH Term Description Entries
D008334 Mandible The largest and strongest bone of the FACE constituting the lower jaw. It supports the lower teeth. Mylohyoid Groove,Mylohyoid Ridge,Groove, Mylohyoid,Grooves, Mylohyoid,Mandibles,Mylohyoid Grooves,Mylohyoid Ridges,Ridge, Mylohyoid,Ridges, Mylohyoid
D008337 Mandibular Fractures Fractures of the lower jaw. Fracture, Mandibular,Fractures, Mandibular,Mandibular Fracture
D001860 Bone Plates Implantable fracture fixation devices attached to bone fragments with screws to bridge the fracture gap and shield the fracture site from stress as bone heals. (UMDNS, 1999) Bone Plate,Plate, Bone,Plates, Bone
D005593 Fracture Fixation, Internal The use of internal devices (metal plates, nails, rods, etc.) to hold the position of a fracture in proper alignment. Osteosynthesis, Fracture,Fixation, Internal Fracture,Fixations, Internal Fracture,Fracture Fixations, Internal,Fracture Osteosyntheses,Fracture Osteosynthesis,Internal Fracture Fixation,Internal Fracture Fixations,Osteosyntheses, Fracture
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000069590 Round Ligaments Cord-like fibrous tissue structure that connects two articular extremities of bones, ligaments and /or cartilages. Round Ligament,Chorda Obliqua,Ligamentum Teres,Oblique Cord,Round Ligament of Elbow,Chorda Obliquas,Elbow Round Ligament,Elbow Round Ligaments,Ligament, Round,Ligaments, Round,Ligamentum Tere,Oblique Cords
D012306 Risk The probability that an event will occur. It encompasses a variety of measures of the probability of a generally unfavorable outcome. Relative Risk,Relative Risks,Risk, Relative,Risks,Risks, Relative
D013529 Surgical Wound Dehiscence Pathologic process consisting of a partial or complete disruption of the layers of a surgical wound. Dehiscence, Surgical Wound,Wound Dehiscence, Surgical
D013530 Surgical Wound Infection Infection occurring at the site of a surgical incision. Postoperative Wound Infection,Infection, Postoperative Wound,Infection, Surgical Wound,Surgical Site Infection,Wound Infection, Postoperative,Wound Infection, Surgical,Infection, Surgical Site,Infections, Postoperative Wound,Infections, Surgical Site,Infections, Surgical Wound,Postoperative Wound Infections,Surgical Site Infections,Surgical Wound Infections,Wound Infections, Postoperative,Wound Infections, Surgical
D014945 Wound Healing Restoration of integrity to traumatized tissue. Healing, Wound,Healings, Wound,Wound Healings

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