Mandibular Fractures

Basics

Description

  • Typically due to a direct force
  • The most common area fractured is the angle, followed by the condyle, molar, and mental regions
  • Because of its thickness, the mandibular symphysis is rarely fractured
  • Multiple fractures are seen in >50% of cases owing to the ring-like structure of the mandible
  • Bilateral mandibular fractures most commonly result from motor vehicle accidents (MVAs)
  • Open fractures are common, including lacerations of the gum overlying a fracture

Etiology

  • The mandible is the third most common facial fracture following nasal and zygomatic fractures
  • MVAs, personal violence, contact sports, or industrial accidents
  • Patients are often intoxicated and unable to give a clear history of events
  • Facial and head lacerations and facial fractures are the most commonly associated injuries

Pediatric Considerations
  • Mandibular fractures are uncommon in children <6 yr of age; when they do occur, they are often greenstick fractures and can be managed with soft diet alone
  • Inform parents that because any fracture of the mandible may damage permanent teeth, follow-up with a specialty consultant is advisable
  • Refer pediatric patients to a specialist with experience in children due to issues with growth plates and permanent teeth

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