[Results of compression osteosynthesis with intraoral approach in 922 mandibular fractures]

A series of 922 fractures of the mandibular body (median-paramedian, horizontal ramus and mandibular angle) was treated within a 10 years period from January 1984 to December 1993 by an uniform treatment method. It consisted of compression plating with bicortical screw anchorage and intraoral approach, thus avoiding any outer scar and facial nerve damage. Postoperatively intermaxillary fixation was not used in any of these cases. A solid bony union was achieved in more than 99% of the cases. Major complications as osteomyelitis and non union were observed in 8 cases (0.86%). Minor complications of soft tissue infections without interference of fracture healing as haematomas, soft tissue abscesses and suture dehiscence were observed in 6.1%. A separate analysis of 352 mandibular angle fractures, which are regarded as particularly problematic, showed a frequency of severe complications (osteomyelitis and nonunion) of 0.85%. This is comparable with the frequency of complications of 0.86% within the total series. In this largest series of compression plating via intraoral approach, which has ever been published, the technique again has proved its significance as a standard procedure for the treatment of mandibular fractures.