Open reduction and internal fixation of combined angle and body/symphysis fractures of the mandible: How much fixation is enough?

Purpose: To assess the internal fixation requirements for combined mandibular angle and contralateral body or symphysis fractures of the mandible. Patients and Methods: Two sample groups of patients treated for combined angle and body/symphysis fractures were compared for the development of major complications, defined as a need for another surgical intervention. The groups were divided based on whether they were treated with rigid or nonrigid fixation of the body or symphysis fracture. Results: Nine hundred seventy-six patients were treated in the rigid group, and 149 were treated in the nonrigid group. There was a 4.9% major complication rate in those in the rigid fixation group versus 15.4% in the nonrigid fixation group (P <.001). Conclusion: The fixation requirements of patients treated with double fractures of the mandible are different than when treating isolated fractures of the mandible. Double fractures require that at least one of the fractures undergoes rigid fixation to decrease the incidence of complications.