Original Article |

Repairing Angle of the Mandible Fractures With a Strut Plate

William Marshall Guy, MD; Nadia Mohyuddin, MD; Daniela Burchhardt, MD; Krista L. Olson, MD; Susan A. Eicher, MD; Anthony E. Brissett, MD
JAMA Otolaryngol Head Neck Surg. 2013;139(6):592-597. doi:10.1001/jamaoto.2013.3246.
Text Size: A A A
Published online

Importance Despite multiple fixation techniques, the optimal method of repairing mandibular angle fractures remains controversial.

Objective To evaluate the outcomes when using a 3-dimensional, curved strut plate in repair of angle of the mandible fractures.

Design Retrospective cohort study.

Setting Level I trauma center at an academic institution in Harris County, Texas.

Participants Patients with diagnostic codes involving angle of the mandible fractures that were repaired by the otolaryngology–head and neck surgery service from February 1, 2006, through February 28, 2011.

Exposure Open reduction internal fixation using either a 3-dimensional curved strut plate or any other type of repair technique for angle of the mandible fractures.

Main Outcomes and Measures Complication rates, postoperative complaints, and operative characteristics.

Results Ninety patients underwent qualifying procedures during the study period. A total of 68 fractures (76%) were repaired using the 3-dimensional curved strut plate and 22 (24%) were repaired using other methods. The revision surgery rate was 10% for the strut plate group (7 patients) and 14% for the non–strut plate group (3 patients), with no significant differences in rates of infection (3 [4%] vs 2 [9%]), dehiscence (4 [6%] vs 2 [9%]), malunion (1 [1%] vs 2 [9%]), nonunion (3 [4%] vs 0), hardware failure (1 [1%] vs 1 [5%]), malocclusion (2 [3%] vs 2 [9%]), and injury to the inferior alveolar nerve (1 [1%] vs 1 [5%]). The most common postoperative complaints were pain (13 [19%] vs 6 [27%]), followed by numbness (5 [7%] vs 2 [9%]), trismus (4 [6%] vs 3 [14%]), edema (3 [4%] vs 3 [14%]), and bite deformity (2 [3%] vs 2 [9%]), with a mean (range) follow-up time of 54.7 (2-355) days for the strut plate group vs 46.8 (8-308) days for the non–strut plate group.

Conclusions and Relevance The 3-dimensional curved strut plate is an effective treatment modality for angle fractures, with comparable infection rates, low incidence of alveolar nerve injury, and trends for decreased length of operation, complications, and infections compared with other techniques.

Figures in this Article

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours


Place holder to copy figure label and caption
Graphic Jump Location

Figure. Methods of repairing angle of the mandible fractures. A, Location of fractures; B, lateral view of the fractures; C, fracture reduction with arch bars; D, percutaneous approach to plating; E, anterior view of percutaneous approach to plating; F, postreduction with arch bars and plates. Illustration by Scott A. Weldon, MA, CMI. Published with permission from Baylor College of Medicine.




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles