Biomechanical evaluation of fixation devices for mandibular angle fractures

The treatment of mandibular angle fractures is plagued with the highest postsurgical complication rate of all mandibular fractures. Multiple plating systems are available. In this study four plating variations were compared in a biomechanical in vitro study. All plating systems were noncompressive Synthes titanium plates. The 3.0 mm reconstruction plate with 6 holes, the 2 mm universal fracture plate with 6 and 8 holes and tension bands and the 6 hole universal fracture plate without tension band were compared. Measurements of gaps at the osteotomy sites showed no significant difference for the plating systems. However the vertical (inferior/superior) displacements were significantly higher for the six-hole plate without tension. The horizontal (bucca/lingual) displacement for the six-hole plate without tension had also highest displacement value. The addition of a tension band was effective to reduce these displacement values. Quantitative computed tomography scans were used to demonstrate a minimal difference in bone quality.