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Published on: September 27, 2024
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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.
Summary
Biangular mandibular fractures are rare but carry significant risks of infection and neurological damage. Early surgical intervention is crucial for managing these complex facial injuries.
Area of Science:
- Oral and Maxillofacial Surgery
- Trauma Surgery
- Anatomy
Background:
- Bifocal mandibular fractures commonly involve the angle and condyle or symphysis.
- Limited data exists on biangular mandibular fractures, necessitating further investigation into their characteristics and management.
- Biangular fractures, affecting two angles of the mandible, are infrequent but present unique clinical challenges.
Purpose of the Study:
- To investigate the epidemiological and clinical characteristics of biangular mandibular fractures.
- To evaluate the outcomes of surgical management for biangular mandibular fractures.
- To identify predisposing factors and suggest an optimized treatment approach for biangular mandibular fractures.
Main Methods:
- Retrospective review of patients surgically treated for biangular mandibular fractures between January 2005 and December 2009.
- Assessment of third molar impaction using Pell and Gregory's and Shiller's classifications.
- Analysis of fracture etiology, injury patterns, surgical techniques, and postoperative complications.
Main Results:
- Seven cases (1.1%) of biangular fractures were identified among 640 mandibular fractures.
- The primary etiology was assault (85.7%), with direct impact as the mechanism in all cases.
- Inferior alveolar nerve injury occurred in 57.1%, impacted third molars in 71.4%, and neurological sequels in 42.9% of patients.
Conclusions:
- Biangular mandibular fractures are rare and associated with a high risk of infection and neurological sequelae.
- Mesioangular impacted third molars appear to be a predisposing factor for biangular fractures.
- Prompt surgical intervention is recommended to mitigate the risk of neurological complications.
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