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Biangular fractures of the mandible
1Department of maxillofacial surgery, centre François-Xavier-Michelet, groupe hospitalier Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
Introduction:
Bifocal fractures of the mandible often associate the angle and condyle or symphysis. Little data is available on biangular fractures. The authors had for aim to study their characteristics and to suggest an adapted management.
Material And Methods:
We retrospectively reviewed the records of patients operated on for a biangular fracture from January 2005 to December 2009. The impact of a third molar was evaluated using Pell and Gregory's and Shiller's classifications.
Results:
Six hundred and forty patients underwent surgery for a mandibular fracture, seven of whom (1.1%) for biangular fractures. The patients' mean age was 27.6 years. Patients were predominantly men (85.7%). Assaults or brawls were the most frequent etiology (85.7%). The mechanism was direct impact in every case. The inferior alveolar nerve was injured in 57.1% of cases. There was an impacted third molar in 71.4% of cases. Most of the time, a single miniplate was sufficient for each angle. Two cases of postoperative infection were noted. The mean follow-up was 52.2months. The occlusion was restored in every case. Three patients presented with neurological sequels in the V3 area.
Discussion:
Biangular fractures are rare and present a high risk of infection and neurological sequels. The presence of a mesioangular impacted third molar seems to be a predisposing factor. The risk of neurological sequels requires performing surgery rapidly.
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