Biomechanical analysis of mandibular angle fractures.

Background: Clinical evidence has suggested that minimal fixation can reduce complications of mandibular angle fractures, though no detailed biomechanical model has yet explored this unique and somewhat unexpected finding.

Methods: The current study uses finite element analysis to biomechanically evaluate different fixation schemes used to fixate mandibular angle fractures. Three fixation scenarios were considered: a single tension band at the superior mandibular border, a single bicortical angle compression plate at the inferior border and the tension band and bicortical plate used together.

Results: The dual plate model incurred the lowest von Mises stresses in the plates and the lowest principal strain in the callus. The tension band model observed the highest plate and screw von Mises stresses, but had fracture-site callus strain near to that of the dual plate model. The bicortical angle compression plate model observed the highest fracture-site callus strain.

Conclusion: The results from this study support the use of the single tension band configuration as a less invasive fixation approach to fractures of the mandibular angle. This is the first known study to explore and confirm clinical observations of angle fracture fixation outcomes with a detailed biomechanical modeling methodology.