Clinical research of endoscopy-assisted open reduction and internal fixation for the management of mandibular angle fractures

Abstract

Objective Management of mandibular angle fractures was often challenging.The report was to describe the application of endoscopy in the open reduction and rigid fixation by the transoral approach for the management of mandibular angle fracture when the Champy technique was not indicated.Methods A series of 34 patients with 37 sides of serious mandibular angle fractures was admitted for endoscopy-assisted surgery,of which 22 sides were unfavorable fractures with one fissure,13 sides were complicated fractures,and 2 side wascomminuted fracture.Monocortical fixation by the transoral approach was performed with one minipalte at the superior border of the mandible medial to the external oblique line and one miniplate at the inferior border with the aid of a percutaneous trocar.Results Adequate anatomic reduction and pretraumatic occlusion were achieved under the supervision of endoscope with intermaxillary fixation except one patient who achieved functional reduction.The physical examination and radiological imaging demonstrated no infection,nerve deficiency,malocculsion or other complications.Conclusion The endoscopy-assisted open reduction and two rigid fixation with miniplates by the transoral approach prove to be a reliable surgical method for the management of unfavorable,severely dislocated,or complicated mandibular angle fractures when the Champy technique is not indicated.The technique has the advantage of minimally invasive surgery. Key words: Mandibular angle; Fracture; Rigid internal fixation; Endoscopy