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Abstract
Introduction
The placement of a single miniplate is not sufficient to achieve rigid fixation in mandibular angle fractures. It often causes difficulties in reducing the intermaxillary fixation (IMF) period. Consequently, the placement of 2 miniplates is preferable. The intraoral approach in an open reduction and internal fixation (ORIF) of a mandibular angle fracture with 2 miniplates is often challenging. Accordingly, an alternative of transbuccal approach is performed. However, this method leaves a scar on the face and can result in facial nerve injury. This clinical study suggests a protocol that can maintain rigid fixation without a transbuccal approach in mandibular angle fractures.
Materials and Methods
The subjects were 7 patients who sustained fractures of the mandibular angle and treated at Department of Oral and maxillofacial surgery, Sacred Heart Hospital, Hallym University. ORIF under general anesthesia was done using the intraoral approach. One miniplate was inserted on external oblique ridge of the mandible, and the other was placed on lateral surface of the mandibular body with contra-angle drill and driver. A radiographic assessment and occlusal contact point examination was carried out before surgery, and 2, 4 and 6 weeks after surgery.
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References
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 | Fig. 1.Internal fixation on mandibular angle was performed using contra-angle drill laterally. A. Approach of contra-angle drill, B. Clinical view after internal fixation in case 6. |
 | Fig. 2.Radiograph of case 3. A. Preoperative panoramic view, B. Postoperative panoramic view after 6 weeks, C. Preoperative computed tomography (CT) view, D. Postoperative CT view. |
STable 1.
Summary of patient received ORIF by this protocol
Table 2.
Treatment results of patient received ORIF by this protocol
| Time of operation1 | IMF period2 | NCP-pre-op. | NCP-post-op.3 | NCP-6 weeks | Pre-op. complication | |
|---|---|---|---|---|---|---|
| Case 1 | 60 | 0 | 1 | 8 | 8 | Paresthesia |
| Case 2 | 90 | 3 | 1 | 7 | 7 | − |
| Case 3 | 60 | 7 | 3 | 4 | 4 | Paresthesia |
| Case 4 | 110 | 7 | 0 | 4 | 4 | Paresthesia |
| Case 5 | 80 | 0 | 0 | 4 | 4 | − |
| Case 6 | 80 | 0 | 2 | 10 | 10 | − |
| Case 7 | 80 | 0 | 2 | 8 | 8 | Infection |
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