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Clinical Challenges in Otolaryngology
February 2005

Mandibular Angle Fractures and Noncompression Plating Techniques

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Copyright 2005 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2005

Arch Otolaryngol Head Neck Surg. 2005;131(2):166-168. doi:10.1001/archotol.131.2.166

Hypothesis: Noncompression plating techniques of internal fixation of mandibular angle fractures are effective and safe.

Fractures of the mandibular angle are a common occurrence in the emergency departments of any inner-city hospital. In the year 2002, more than 100 mandible fractures were repaired at San Francisco General Hospital, about one third of which involved the angle of the mandible. The angle of the mandible has some unique properties. Fractures in this area are less surgically accessible than parasymphyseal or body fractures via a transoral approach. The cross-section of the bone in this area is less than that in more anterior locations, creating less surface contact area to allow stabilization. In addition, fractures in the angle are often posterior to occluding molar teeth, and, therefore, slight differences in reduction can be tolerated with regard to dental occlusion. Nevertheless, the force generated by the muscles of mastication can reach 60 DN or more at the angle, and any fracture fixation technique must be strong enough to counteract this force. figure

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