Interfragmentary Gap Discrepancy after Intraoral one-plate fixation in Mandibular angle fracture

Abstract

Purpose: Mandibular angle fractures (MAF) recorded many complications following various treatment techniques. Inter-fragmentary gap, strain and movement appear to be responsible for most of the complications with predilection towards the inter-fragmentary gap. This study aimed to calculate and assess the resulted post-treatment inter-fragmentary gap using cone beam computed tomography (CBCT) and its effect on the healing outcome and complications after mini plate fixation at Champy’s osteosynthesis line in MAFs. Patients and methods Twenty-five patients with MAF were subjected to intra-oral open reduction and fixation through semi-rigid min plate fixation near the superior border of the mandible at Champy’s osteosynthesis line. The linear inter-fragmentary gap in the mesio-distal plane and the bucco-lingual splay were measured at the inferior border of the mandible after fixation of the fractured bony segments in the final properly aligned position, immediately postoperative, on a CBCT. The healing process was clinically followed for 3 months postoperatively to record any complications. Results Uneventful healing was reported in the expected normal duration. At the inferior border of the mandible, the mean mesio-distal inter-fragmentary gap recorded a low value of 0.3 mm. In the bucco-lingual plane, inter-fragmentary lingual splay gap at the inferior border recorded a higher value yet with no clinical effect on healing;1.8 mm. Conclusion Semi-rigid Champy’s mini plate is dependable in MAF treatment with predictable acceptable mixed primary and secondary healing outcomes despite the resulted radiographic yet clinically insignificant inter-fragmentary gap and lingual splay at the mandibular inferior border