Rigid versus Nonrigid Fixation for Bilateral Mandibular Angle Fractures: A Retrospective Multicenter Review

Plast Reconstr Surg. 2024 Oct 1;154(4):737e-744e. doi: 10.1097/PRS.0000000000011103. Epub 2023 Sep 29.

Abstract

Background: Fractures involving the bilateral mandibular angle are an uncommon occurrence with limited evidence to inform the ideal fixation requirements for adequate treatment. The aim of this study was to evaluate the outcomes of managing bilateral mandibular angle fractures and determine whether rigid fixation on 1 side improves outcomes compared with bilateral nonrigid fixation.

Methods: Patients with isolated bilateral mandibular angle fractures treated surgically at the Royal Brisbane and Women's Hospital, Princess Alexandra Hospital, Gold Coast University Hospital, and Townsville University Hospital between January 1, 2010, and December 31, 2022, were identified retrospectively. Data collected included patient demographics, mechanism of injury, fixation scheme, postoperative occlusion, and the occurrence of postoperative complications and subsequent management.

Results: Eighty-four patients met the inclusion criteria. Fifty-two patients had nonrigid fixation applied to both fractures, and 32 had rigid fixation placed on at least 1 side. All cases proceeded to union. There was no statistically significant difference between the groups for occlusal outcomes, wound dehiscence, infection, or plate or screw loosening.

Conclusion: The authors' results suggest that bilateral nonrigid fixation can be used to treat bilateral mandibular angle fractures in the appropriate clinical context.

Clinical question/level of evidence: Therapeutic, III.

Publication types

  • Multicenter Study
  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bone Plates
  • Female
  • Fracture Fixation, Internal* / adverse effects
  • Fracture Fixation, Internal* / instrumentation
  • Fracture Fixation, Internal* / methods
  • Humans
  • Male
  • Mandibular Fractures* / diagnostic imaging
  • Mandibular Fractures* / surgery
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult