Open Treatment of Mandible Angle Fractures and the Role for Maxillomandibular Fixation

Abstract

BACKGROUND: Maxillomandibular fixation (MMF) remains a mainstay in the treatment algorithm of bony injuries involving the lower facial skeleton to help restore premorbid occlusion. PURPOSE: To compare postoperative open reduction and internal fixation outcomes in dentate patients with noncomminuted, isolated angle fractures of the mandible between patients that underwent postoperative MMF and those who did not. METHODS: Retrospective review of 224 patients treated for isolated, noncomminuted mandible angle fractures between January 1997 and December 2023. Patients were either kept in occlusion with intraoperative maxillomandibular (MMF) or with bimanual reduction. Patients either remained in MMF or not postoperatively. RESULTS: There was not a significant overall association of surgery group on complications (P=0.44). The odds of complications were lower for the intraoperative bimanual reduction group without MMF compared with patients that underwent intraoperative and postoperative MMF (odds ratio=0.48, P=0.26). CONCLUSION: This study describes similar surgical outcomes after open reduction and internal fixation of isolated, noncomminuted mandible angle fractures with or without postoperative MMF. This study helps show that in appropriately selected cases, postoperative MMF may not be necessary in this specific mandible fracture pattern