Open Reduction with Internal Fixation of Mandibular Angle Fractures: A Retrospective Study

The goal of this project was to report the complications associated with mandibular angle fractures and identify variables affecting their occurrence.

We retrospectively reviewed the charts of patients with a mandibular angle fracture treated at the Centre hospitalier universitaire de Québec between 2009 and 2013.

Seventy-eight patients (73 males) aged 15-59 years (mean 25.2 years) met our inclusion criteria. A wisdom tooth was present in 85.9% (n = 67) of the cases and it was removed 62.7% (n = 42) of the time. Thirty-four patients (43.6%) had other mandibular fractures. Most fractures were fixated with a sagittal split osteotomy plate (n = 32; 41.0%) or a 2.0-mm plate on the lateral aspect of the mandible (n = 20; 25.6%). The overall complication rate was 42.3% (n = 33); of these 37.2% were infections, 26.9% involved plate removal and 6.4% were associated with non-union. Older patients had more infections (p = 0.03) and more plates removed (p = 0.03). When a wisdom tooth was extracted, more infections (p = 0.04) and overall complications (p = 0.02) were observed.

This study confirms that, when treating a mandibular angle fracture in a healthy patient, it may be beneficial to leave a wisdom tooth in the line of fracture in place, if there is no indication to remove it.