eMedicine Specialties > Otolaryngology and Facial Plastic Surgery > Trauma

Mandibular Angle Fractures: Follow-up

Author: Jose E Barrera, MD, Clinical Faculty, Department of Otolaryngology-Head and Neck Surgery, Wilford Hall Medical Center
Coauthor(s): Stephen G Batuello, MD, Consulting Staff, Colorado ENT Specialists
Contributor Information and Disclosures

Updated: Nov 10, 2008

Outcome and Prognosis

Both closed and open reductions of mandibular fractures cause favorable results for bony union. In a study of 922 mandibular body and angle fractures that were repaired using an intraoral approach without IMF, solid bony union was achieved in more than 99% of patients.

Future and Controversies

Controversy exists regarding open versus closed reduction for angle fractures. Traditionally, MMF has been the mainstay of treatment. Plating techniques have revolutionized open reduction as a treatment modality.

Advantages of closed reduction include proven efficacy, low complication rate, and short operating time. This technique may be performed as an office procedure. Disadvantages include long fixation (ie, 3-6 wk), poor nutrition associated with MMF, risk of TMJ ankylosis, and airway problems.

Advantages of ORIF include earlier mobilization and nearly exact bone-fragment reapproximation. Disadvantages include increased treatment cost and need for operating room time.

Another controversy involves disposition of teeth located in the fracture line. In the postantibiotic era, infection of involved teeth is less troublesome. Many teeth may be retained, and they can be useful in reduction and stabilization of fractured segments. Extract teeth if they prevent proper reduction and fracture stability or if they have significant periodontal disease or caries.

 


More on Mandibular Angle Fractures

Overview: Mandibular Angle Fractures
Workup: Mandibular Angle Fractures
Treatment: Mandibular Angle Fractures
Follow-up: Mandibular Angle Fractures
Multimedia: Mandibular Angle Fractures
References
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References

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  3. Alpert B, Engelstad M, Kushner GM. Invited review: small versus large plate fixation of mandibular fractures. J Craniomaxillofac Trauma. Fall 1999;5(3):33-9; discussion 40. [Medline].

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  11. Luhr HG, Hausmann DF. [Results of compression osteosynthesis with intraoral approach in 922 mandibular fractures]. Fortschr Kiefer Gesichtschir. 1996;41:77-80. [Medline].

  12. Schilli W, Stoll P, Bahr W. Mandibular fractures. In: Manual of Internal Fixation. Springer-Verlag; 1981:65-80.

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Further Reading

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Keywords

jaw fractures, fractures, mandibular angle fractures, mandible angle fractures, facial fractures, mandibular fracture, craniofacial trauma, broken jaw, angle fracture, angle fracture of the mandible, wedge fracture, multifragmentary fracture, mandibular fracture

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Contributor Information and Disclosures

Author

Jose E Barrera, MD, Clinical Faculty, Department of Otolaryngology-Head and Neck Surgery, Wilford Hall Medical Center
Jose E Barrera, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Academy of Sleep Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Stephen G Batuello, MD, Consulting Staff, Colorado ENT Specialists
Stephen G Batuello, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Physician Executives, American Medical Association, and Colorado Medical Society
Disclosure: Nothing to disclose.

Medical Editor

Hassan H Ramadan, MD, MSc, Professor and Vice-Chair, Department of Otolaryngology-Head and Neck Surgery, Professor, Department of Pediatrics, West Virginia University
Hassan H Ramadan, MD, MSc is a member of the following medical societies: American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, and American Rhinologic Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Stephen G Batuello, MD, Consulting Staff, Colorado ENT Specialists
Stephen G Batuello, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Physician Executives, American Medical Association, and Colorado Medical Society
Disclosure: Nothing to disclose.

CME Editor

Christopher L Slack, MD, Otolaryngology-Facial Plastic Surgery, Private Practice, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders
Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA, Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine
Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society
Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation unstricted gift unknown

 
 
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