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Comparison of Intraoral External Oblique Ridge Fixation and Transbuccal Lateral Cortical Plate Fixation for Mandibular Angle Fracture-A Randomized Control Trial

Muhammad Asim, Muhammad Muddassar, Imran Salem Qureshi, Mirza Abdul Rauf, Zahoor Ahmed Rana and Kamal Khan Hoti

Background/objectives: Mandibular fractures account for almost half of all the fractures occurring in the maxillofacial region. Among mandibular fractures, angle fracture has a highest rate of post-operative complications (0-32%). This study compared the fixation of mandibular angle fracture with intra-oral external oblique ridge fixation versus transbuccal lateral cortical plate fixation using a single miniplate. Post-operative complications especially infection was noted and compared.

Methods: A randomized controlled trial was done to compare the outcome of the two procedures. A total of 120 mandibular angle fracture patients were randomly allocated into Group A and Group B, 60 in each group. Group A underwent ORIF with intraoral approach and Group B underwent open reduction Internal fixation (ORIF) with transbuccal lateral cortical plate fixation for mandibular angle fractures. Patients of both groups were reviewed on 1st week, 1st month and third month for clinical signs of infection.

Results: In group A, 10 (16.66%) patients suffered from infection and in group B, 4 (6.66%) of patients reported with infection at the last follow up visit that is at the end 3 months. No statistically significant p value after application of ‘Chi square test’ was noted for infection at the end of the third month review.

Conclusion: Mandibular angle fractures can be effectively treated with transbuccal lateral cortical plate fixation as ease of plate adaptation, placement of plate in mid neutral area and less chance of infection.