Infection after rigid internal fixation of mandibular fractures: a clinical and radiologic study

Of 214 patients with mandibular fractures treated following the AO/ASIF principle of rigid fixation, 13 patients (6.1%) developed postoperative infection. The yearly percentage decreased remarkably during the study period. When rigid fixation became a routine method, the infection rate was as low as the corresponding figure for cases treated with nonstable techniques and maxillomandibular fixation (MMF). All but one of the infected fractures were in the angular region of the mandible. Teeth had been extracted from the fracture line in 9 of the 10 dentulous patients. It was concluded that erroneous techniques had been used in almost all infected cases, because compression could not be achieved when there was an irregular fracture line, an atrophic edentulous mandible, or inadequate stability due to removal of a tooth in the line of fracture. In five patients, successful reoperation was performed using a reconstruction plate. Detailed radiologic examination was useful in assessment of infection and in follow-up.