To compare the outcomes of intra-oral and extra-oral approaches to mandibular angle fractures

Abstract

Aims and objective: The aim of this study was to comparethe outcomes of intra-oral and extra-oral approaches to mandibular angle fractures.Material and methods: A Retrospective study was conducted in the Department of Maxillofacial surgery, Narayan Medical College and Hospital ,sasaram, Bihar, India, for 1 year .Total 100 Patients with angle fracture that required open reduction and internal fixation were include in this study. All the Patients were reviewed for age, gender, presence of other fractures, type of surgical approach, number of plates, OT time, which was calculated from the beginning of the incision till the closure. Length of admission and complications such as malocclusion, non- union, re-operation, post-op infection, neurosensory deficit, facial nerve injury, implant retrieval, scarring and wound dehiscence were also studied. Results: There were a total of 100 patients with mandibular angle fracture who underwent open reduction and internal fixation, 50(50%) of them were treated intra-orally and the remaining 50 (50%) of them extra orally. Male patients formed the majority of mandibular angle fractures (90%) in extra-oral group and 96% in intra-oral approaches (p=0.77). the mean age of patients in intra-oral group was 32.18 years and 35.85 years in the other group with a standard deviation of 12.58 and 13.77 respectively. The mean operating room time for intra-oral approach was 96.55 minutes when compared to 102.74 minutes for extra-oral approach with a p value of 0.61. Malocclusion was seen in 14% of extra-oral cases and 20% of intra-oralapproach patients, with a p value of 0.85. Non union was not seen in any of the cases. Re-surgery was performed in 12% of the extra-oral cases and none in the intra-oral group. (p value-0.27). Post-op infection was observed in 12% of intra-oral cases and 28% of extra-oral cases with a p value of 0.35. Conclusion: we conclude the use of intraoral approach while clinically favorable with single miniplate along the superior border.

Keywords: Mandbular angle fracture, Intra oral approach, extra oral approach