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Fixation of mandibular angle fractures with a 2.0-mm 3-dimensional curved angle strut plate
Claude Guimond1, James V Johnson, Jose M Marchena
1Department of Oral and Maxillofacial Surgery, University of Texas Health Science Center at Houston, Houston, TX 77030, USA.
Purpose:
The aim of this study was to evaluate our experience and complication rate with the use of a 3-dimensional 2.0-mm curved angle strut plate for mandibular angle fracture fixation.
Patients And Methods:
This was a retrospective evaluation of 37 patients with noncomminuted mandibular angle fractures fixated with a transorally placed curved 2.0-mm strut plate. Postoperative intermaxillary fixation was used in 5 patients for a mean period of 22 days. A nonchewing diet was prescribed for 6 weeks. Records were reviewed for demographic information, medical history, fracture characteristics, operative management, and complications.
Results:
Two patients developed infections requiring plate removal and reapplication of fixation. Both of these patients had a molar in the fracture line that was left in place during the first operation. One patient developed a mucosal wound dehiscence without consequence. After a mean follow-up period of 10 weeks, 39.4% of patients with a postinjury/pretreatment inferior alveolar nerve deficit reported a return to normal sensation. All patients who developed a sensory deficit as a result of surgery reported full recovery of sensation. A persistent sensory deficit appeared to be related to fracture displacement.
Conclusion:
Fixation of noncomminuted mandibular angle fractures with a 2.0-mm curved angle strut plate was predictable. This plate is low in profile, strong yet malleable, facilitating reduction and stabilization at both the superior and inferior borders. Development of a postoperative infection appeared to be related to failure of removal of a molar in the fracture line. The infection rate of 5.4% found in this study compares favorably with that seen with reconstruction plates. Use of this plate did not appear to cause a permanent sensory deficit in this study.
