Background and objectives: The aim of this study is to report our experience with three cases of this rare complication, review the literature, and propose a special surgical management based in our experience.

Methods: We review the literature and report the surgical management of three patients referred to our department with a mandible fracture after IAN transposition.

Results: Only three cases of fracture after IAN transposition were found in the literature. One of them was first treated with MMF, and them needed to be operated for rigid fixation because lack of consolidation. The other two were treated directly with rigid fixation with uneventful follow up. Our patients were treated with open reduction and rigid fixation through intraoral approach. Locking plates 2.0 and 2.3 were set in the inferior border of the mandibular body. No implants were removed because any of them were implicated in the fracture. The postoperative follow up was uneventful.

Conclusions: Fracture after IAN transposition is a very uncommon complication and can be misdiagnosed. This situation has to be understood as load bearing situation since they arise in a atrophic mandibles with bone manipulation.

Key words: mandibular fracture; IAN transposition