A Unique Case of Neck Strangulation in Agricultural Field Leading to Bilateral Angle Fractures: Diagnosis and...

The angle of the mandible acts as a transitional zone between dentate and edentulous areas. It is a distinct anatomical subcomponent, suspended within robust masticatory muscles. Angle fractures are predominantly caused by low-kinetic-energy etiological factors like assaults and falls, while they are less associated with high kinetic energies. Bilateral angle fracture resulting from the subsequent accidental strangulation in the agricultural field stands as a singularly unique event necessitating immediate action.

We present a rare event where the patient had a bizarre machinery mishap while farming in the agricultural field. A 16-year-old female presented with persistent pain, restricted mouth opening, and malocclusion following a farming accident where her scarf became entangled in a thresher, causing sudden neck strangulation. Radiographic imaging, including cone beam computed tomography (CBCT), confirmed bilateral angle fractures extending to the developing third molars. The patient underwent intraoral open reduction and internal fixation using miniplates along Champy's osteosynthetic lines.

Postoperatively, the patient experienced significant pain relief, restored occlusion, and an uneventful recovery. The mechanism of injury was attributed to force transmission through the suprahyoid musculature, deviating from conventional mandibular angle fracture etiologies.

This case underscores the importance of considering strangulation injuries as potential causes of mandibular fractures and highlights the role of meticulous clinical and radiographic assessment in ensuring comprehensive management. Given the rarity of such cases, further research is needed to understand the biomechanics of force transmission in maxillofacial trauma.