Mandibular fracture

Last revised by Anosh Rasool on 20 Apr 2024

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.

After the nasal bones, the mandible is considered the second most common site of facial fractures. Etiology and demographics will vary significantly depending on the population demographics and with where patients present. In the setting of a trauma center in New Zealand, 90% of patients are male, with 64% between the ages of 15 and 29 2:

  • assault: 50%

  • intimate partner violence

  • motor vehicle accident (MVA): 10%

  • fall: 15%

  • sport: 15%

  • other: 10%

Presenting complaints will include 3:

  • angle: 20-33% 1-3

  • body / horizontal branch: 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%

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

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