Mandibular angle fractures- intra oral and extra oral approaches – A comparative study

Abstract

Aim: The aim of this study was to analyze outcomes of intra-oral and extra-oral approaches to mandibular angle fractures. Materials and Methods: a retrospective study was performed of patients who underwent open reduction and internal fixation of mandibular angle fractures. Inpatient and outpatient records were reviewed for pertinent data including age, gender, presence of other fractures, surgical approach, operative time, and post-operative complications. Results: The 40 patients with angle fracture, 60% were treated vis intra-oral approach and the rest 40% via extra-oral approach. The mean age of the patients were 30.87 years in the intra-oral group and 34.13 years in the extra-oral group. Main etiology of injury was RTA. The mean operating time for the intra-oral group was 95.63 minutes and 100.43 minutes for the extra-oral group. There was not much of difference in length of hospital stay for both the groups the mean being 2 days. Malocclusion was seen in 17.4% of extra-oral cases and 12.5% of intra-oral group. Re-surgery was performed in 12.5% of the extra-oral cases. Post-op infection was observed in 13% of intra-oral cases and 31.3% of extra-oral cases. Neurosensory disturbance occurred in 30% of extra-oral cases, and none in the intra-oral group, which is statistically significant. (p-0.017). Conclusion: Both methods of fixation for angle fractures are useful in the treatment. On the basis of our results we recommend using intra-oral approach while clinically favorable with single miniplate along superior border. Keywords: Mandbular angle fracture, Intraoral versus extra oral approach.