Abstract
Introduction: Mandible is a complex bony structure and has a vital anatomical articulation with other maxillofacial components. Muscles retraction, cause displacements of the fragment. Masticatory forces on the mandibular angle cause displacement of the proximal and distal segment in the unfavourable direction which makes mouth opening restriction.
Objective: The main goal of the treatment is to achieve and restore function and facial appearance. As a clinician, acknowledging the management in an emergency setting and suitable treatment is mandatory to achieve a successful outcome.
Case report: A 24-year old male patient presented with a swelling on his right side of the face accompanied by pain and mouth opening restriction. The case history revealed the patient felt sleepy when he was driving and hit a tree in front of him, caused he hit the steering wheel then the patient was brought to the Emergency Department. On extraoral examination, the swelling was observed at the symphysis and right angle of the mandible and the step was palpated. The patient was diagnosed with a fracture of symphysis and angle of mandible bone.
Case management: The patient was treated by suturing the soft tissue laceration and interdental wiring at the emergency department, then open reduction internal fixation was done electively.
Conclusion: Treatment of unfavourable angle of mandible fracture should be done surgically with open reduction.

Key words: Mandible fracture, unfavourable, open reduction