Comparison of straight mini-plates vs. trapezoidal plates for internal fixation in condylar fractures: a systematic review

Introduction
The advancement of technology has introduced various fixation methods to ensure optimal bone healing in open treatment and internal fixation of maxillofacial fractures. Trapezoidal plates are specifically deve­loped for the condyle region to resist forces and stresses in 3 dimensions: bending, shearing, and torsion. OBJECTIVES: This systematic review aimed to evaluate the clinical outcomes of open treatment and internal fixation in the treatment of condylar fractures using trapezoidal plates, and compared with the usage of straight mini-plates.

Material and methods
A systematic search using PRISMA framework was conducted in five online databases(PubMed, Medline, Scopus, Embase, and Cochrane Library) in December 2022 to obtain relevant comparative stu­dies reporting trapezoidal and straight mini-plates in condylar fracture patients within the last 10 years. Inclusion criteria were adult patients, minimum follow-up duration of 3 months, and outcomes, including mouth opening, duration of operation, and any notable post-operative complications.

Results
A total of 8 studies with 224 patients were considered, which compared the efficacy of trapezoidal plates and straight mini-plates in the treatment of condylar fracture. All of them mentioned the superiority of trapezoidal plates, especially in terms of duration and ease of insertion; however, most studies also mentioned their results insignificance. Nevertheless, 5 studies found that complications still occur post-surgery, even with trapezoidal plates as the fixator.

Conclusions
Trapezoidal plates can serve as alternative fixator for the open treatment of condylar fractures. Considerations of degree of severity and operator factors are needed in the decision of using trapezoidal plates.