Update on ladder plates for mandibular angle fractures

Luke Soliman, Victor King, Melvyn S. Yeoh, Albert S. Woo

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations


Purpose of reviewFractures of the mandibular angle are surgically challenging with high rates of postoperative complications. Among established fixation techniques for these injuries, Champy's tension band approach with miniplate fixation has held prominence. Rigid fixation, using two plates, also remains commonly used. More recently, geometric ladder plates, which confer greater three-dimensional stability have been developed to overcome the shortcomings of conventional fixation approaches. Herein, we aim to summarize the recent evidence surrounding the use of ladder plates and offer our own opinion for optimal treatment of these fractures.Recent findingsIn high-powered studies, the rates of hardware failure, malocclusion, and malunion are lower among cohorts managed with ladder plates relative to miniplate groups. Rates of infection and paresthesia remain similar. Ladder plates have also been shown to decrease operative time in preliminary study.SummaryLadder plates show superiority to miniplate approaches across several outcomes. However, the relatively larger strut plate constructs may not be necessary for minor, uncomplicated fractures. It is our belief that reasonable outcomes may be achieved with either approach depending on surgeon experience and comfort with the given fixation technique.

Original languageEnglish
Pages (from-to)209-214
Number of pages6
JournalCurrent Opinion in Otolaryngology and Head and Neck Surgery
Issue number4
StatePublished - Aug 1 2023

Bibliographical note

Publisher Copyright:
© 2023 Lippincott Williams and Wilkins. All rights reserved.


  • angle
  • ladder plate
  • mandible fracture
  • miniplate
  • strut plate

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology


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