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Mandibular angle fracture favorabilities and current management at a level 1 trauma center
David Jerkins, MD, Ali R. Abtahi, DO, R. Michael Johnson, MD, Reza Miremadi, MD, DDS, Jared M. Liston
Wright State University Boonshoft School of Medicine and Miami Valley Hospital, Division of Plastic
2016-02-14
Presenter: Jared M. Liston
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. The work on this project is that of the residents and student, with my guidance.
Director Name: R. Michael Johnson, MD
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Introduction: The mandibular angle is a common location of fracture with many treatment options. This study was performed to evaluate the current trends in fracture patterns and operative management of mandibular angle fractures at a Level 1 trauma center.
Materials and Methods: 295 patients with mandibular angle fractures were retrospectively analyzed. Maxillofacial CT scans determined whether the angle fractures were favorable, unfavorable, or neutral. Operative notes determined whether closed reduction or open reduction-internal fixation (ORIF) was used, the types of plates that were used in ORIF, whether mandibulomaxillary fixation (MMF) was used.
Results: Thirty seven patients (12.5%) with mandibular angle fractures were identified. Fifty-seven% of the angle fractures were favorable, 26.0% were unfavorable, and 17.0% were neutral. Of favorable fractures that were treated with ORIF, 46.2% were stabilized with lateral load bearing plates, 30.8% with a single Champy plate, and 23.0% with multiple Champy plates. In contrast, 100.0% of unfavorable fractures were reduced with single Champy plates. Eighty three% of favorable fractures received MMF, compared to 100.0% of unfavorable fractures.
Conclusions: Favorable fractures tended to be simple and seen in the setting of multiple other mandibular fractures, whereas unfavorable fractures were more frequently comminuted and often seen without other associated fracture. Current treatment patterns of mandibular angle fractures with a significant use of Champy plate fixation was described.
