ADVANCES or changes in surgical endeavour are often slow to influence practice in the face of complacent acceptance of well-tried and routine procedures. It would seem that modern methods of open reduction and internal fixation of any fracture which presents difficulties of reduction or retention are not as generally appreciated and applied in relation to fractures of the jaw as they might be. The object of this paper is to draw attention to the rightful application of such methods and the advantages which they offer in selected cases. The majority of mandibular fractures with teeth standing on each side of the fracture line can be dealt with by dental splints, provided that trained dental and technical personnel with adequate laboratory facilities are constantly and readily available. There have, however, always been certain problem fractures where the multiplicity of fixation methods advocated is an indication that none of them is entirely satisfactory. Excluding fractures of the condylar region, and those gross injuries with extensive damage and loss of soft tissue, bone, and teeth such as are caused by explosive or gunshot wounds, the more common fractures where fixation is not generally satisfied by ordinary dental methods constitute two groups :--