Treatment methods for fractures of the mandibular angle

Fractures of the mandibular angle are plagued with the highest rate of complication of all mandibular fractures. Over the past 10 years, various forms of treatment for these fractures were performed on an indigent inner city population. Treatment included: 1) closed reduction or intraoral open reduction and non-rigid fixation; 2) extraoral open reduction and internal fixation with an AO/ASIF reconstruction bone plate; 3) intraoral open reduction and internal fixation using a solitary lag screw; 4) intraoral open reduction and internal fixation using two 2.0 mm mini-dynamic compression plates; 5) intraoral open reduction and internal fixation using two 2.4 mm mandibular dynamic compression plates; 6) intraoral open reduction and internal fixation using two non-compression miniplates; 7) intraoral open reduction and internal fixation using a single non-compression miniplate; and 8) intraoral open reduction and internal fixation using a single malleable non-compression miniplate. This paper reviews the results of those modes of treatment when used for the same patient population at one hospital. Results of treatment show that, in this patient population, the use of either an extraoral open reduction and internal fixation with the AO/ASIF reconstruction plate or intraoral open reduction and internal fixation, using a single miniplate, are associated with the fewest complications.