A large review pooled results from studies of adults with isolated mandibular angle fractures, which are breaks in the back corner of the lower jaw. It compared fixing the break with a single non-compression miniplate versus using two miniplates. In total, 1,244 patients were included.
Overall complication rates were not clearly different between the two approaches. About 18% fewer patients had any complication with the single plate, but the range of possible effect included no difference, so this finding is uncertain.
Some specific problems were less common with a single plate. Hardware complications were about 31% lower, and wound dehiscence (the wound pulling open) was about 33% lower. Infection, bite problems (malocclusion), nerve sensation changes, and the need for repeat surgery did not differ significantly between groups.
The review suggests a single miniplate may be preferable for many mandibular angle fractures, especially when surgery is done entirely through the mouth and the break pattern is favorable. Two plates may still be considered for breaks that are mechanically unfavorable, but they carry more hardware-related problems. The authors did not report funding or conflicts of interest, and the review did not state how certain the evidence is.
Common questions
What is single miniplate fixation for a jaw fracture?
It is a surgery that uses one small non-compression plate and screws to hold a broken mandibular angle, the back corner of the lower jaw, in place while it heals. The analysis compared this with using two miniplates. Your surgeon can explain which approach fits your fracture.
Does one plate work as well as two?
In this pooled analysis of 1,244 adults, overall complication rates were not significantly different (RR 0.82, 95% CI 0.66 to 1.02, p = 0.07). Single-plate fixation was linked to lower hardware complications and wound dehiscence. The authors say single-plate fixation is not stated as superior for all fracture types.
What were the hardware and wound findings?
Single-plate fixation was linked to a lower risk of hardware complications (RR 0.69, 95% CI 0.51 to 0.95) and wound dehiscence (RR 0.67, 95% CI 0.45 to 0.99). These are associations from pooled data, not proof that one plate causes fewer problems. Ask your surgeon what this means for your case.
Were infection and bite problems different?
The analysis reported that infection, malocclusion (bite problems), neurosensory deficit (nerve or sensation changes), and reoperation rates were not significantly different between single and dual miniplate fixation. The study did not report separate numbers for these outcomes, so the comparison rests on the summary statement.
When might two plates still be used?
The authors note that dual-plate fixation may still be considered for mechanically unfavorable fractures, though it carries higher hardware-related morbidity. Single-plate fixation is not stated as superior for every fracture type. Decisions about your fracture should be made with your surgeon.
