Mandibular fracture

Mandibular fractures are relatively common especially among young men. Although traditionally the mandible and base of skull are thought to form a complete bony ring, interrupted only by the TMJs. This should mean that the mandible should fracture in two places (akin to the bony pelvis) making single fractures uncommon, but this in fact not the case, with ~40% of fractures being unifocal.

Aetiology and demographics will vary significantly depending on the population demographics and with where patients present. In the setting of a trauma centre in New Zealand, 90% of patients are male, with 64% between the ages of 15 and 29 2:

  • assault: 50%
  • motor vehicle accident (MVA): 10%
  • fall: 15%
  • sport: 15%
  • other: 10%

Presenting complaints will include 3:

Location
  • angle: 20-33% 1-3
  • body: 15-25%
  • condyle or neck: 15-36%  (see: TMJ trauma)
  • parasymphyseal: 14-15%
  • ramus: 5%
  • coronoid process: 1-3%
  • alveolar ridge: 2%

Unifocal fractures are common, accounting for approximately 40% of all mandibular fractures 1:

  • multifocal: 60% 1
  • unifocal: 40%
    • simple: 25%
    • comminuted: 10%
    • associated with condylar subluxation: 5%
Subtypes

Treatment be be conservative or involve formal reduction (which may be open or closed). Closed reduction may be supported with intermaxillary fixation or splints (ORIF).

Complications
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Article Information

rID: 5440
Synonyms or Alternate Spellings:
  • Mandibular fractures
  • Fractures of the mandible
  • Fractures involving the mandible

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    Figure 1: mandibular fracture locations
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    Case 1: coronoid process fracture
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    Case 2: mandible angle fracture
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    Left mandibular n...
    Case 3: left mandibular neck fracture
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    Mandibular fractu...
    Case 4: through body
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    Case 5: Guardsman fracture
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     Case 6: bilateral fracture
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    Case 7
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    Case 8: bilateral condylar fractures
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    Case 9: bilateral
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    Case 10
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    Case 11
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    Case 12: parasymphyseal
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