Management of Mandibular Angle Fractures Using One Miniplate or Two Miniplate Fixation System: A Systematic Review and Meta-Analysis. 2019

Patiguli Wusiman, and Keremu Abasi, and Dilinuer Maimaitishawuti, and Adili Moming
Resident, Department of Oral and Maxillofacial Surgery, Stomatological Medical Center, First Affiliated Hospital of Xinjiang Medical University, Ürümqi, People's Republic of China.

OBJECTIVE The management of mandibular angle fractures is controversial. The present study proposed to determine the superiority between the 1 miniplate and 2 miniplate fixation system and evaluated the best option for patients. METHODS A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, examining Medline-Ovid, Embase, and PubMed databases for relevant reports in English without date restrictions in October 2018. The inclusion criteria were studies of humans, including randomized controlled trials, controlled clinical trials, and retrospective studies, with the aim of comparing the 2 techniques. The incidence of postoperative complications and operative times were evaluated, and the relative risk and corresponding 95% confidence intervals were assessed to measure the effect size. Subgroup analyses of the different fracture regions and different miniplate sizes were performed. Publication bias was measured using a funnel plot. RESULTS Thirteen reports were enrolled for analysis. The results showed that the 1 miniplate fixation system reduced the overall complication rate compared with the 2 miniplate fixation system (P = .02). The incidence of wound dehiscence, hardware failure, scarring, and paresthesia showed statistically significant differences in favor of the 1 miniplate system (P < .05). The subgroup analyses indicated that 1 miniplate with isolated fractures caused a lower incidence rate of wound dehiscence, scarring, and hardware failure compared with the 2 miniplate fixation technique (P < .05). CONCLUSIONS The results of the present study suggest that the 1 miniplate system is superior to 2 miniplates with a reduction in postoperative complication rates for the management of mandibular angle fractures.

UI MeSH Term Description Entries
D008337 Mandibular Fractures Fractures of the lower jaw. Fracture, Mandibular,Fractures, Mandibular,Mandibular Fracture
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
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
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective

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