Complications of the use of trans-osseous wire osteosynthesis in the management of compound, unfavorable and non-comminuted mandibular angle fractures

Abstract

Objective: To analyze cases of compound, unfavorable and non-comminuted mandibular angle fractures treated by trans-osseous wiring, presenting postoperative complications, in a low resource center.

Materials and methods: This was a 13-year retrospective study of 1,324 fractures in 1,317 subjects. The predictor variables were age, gender, aetiology, time lag between injury and treatment, and concomitant mandibular and midfacial fractures. The outcome variable was the development of complication(s) after treatment. Descriptive and bivariate statistics were computed with EPI INFO 7 version software, and the P value was set at 0.05.

Results: The sample size was composed of 63/1317 (4.8%) of patients with complications. There were 48 males and 15 females with male: female ratio of 3.2:1. The age of the patients ranged from 21 to 62 years (mean 37.4± 5.6 years). The test of significance showed statistically significant association between complications of mandibular angle fractures and increasing age (P<0.002), male gender (P<0.001), road traffic accident (P<0.001), longer time lag between injury and treatment of fractures (P<0.000), and concomitant mandibular fractures (P<0.000). Deranged occlusion (n=19, 28.8%) and limited mouth opening <35mm (n=16, 24.2%) were the common complications. The complications were successfully treated during follow-up.

Conclusion: The use of trans-osseous wire osteosynthesis gave good results, and can still be useful in centres that are less well equipped and where access to rigid internal fixation with mini plates is either limited or unavailable. 

Funding: Self-funded

Keywords: Mandible, angle, fracture, trans-osseous wiring, complications