Fractures of the Mandible

Question 1

Clinical signs + symptoms of a mandibular fracture (8)

Answer 1

1. Pain
2. Occlusal derangement
3. Numbness of lower lip
4. Mobile teeth
5. Bleeding
6. AOB
7. Facial asymmetry
8. Deviation of mandible to opposite side/restricted movement

Question 2

Classification of mandibular fractures is based on what following criteria? (6)

Answer 2

1. Involvement of surrounding tissue
2. Number of fractures
3. Side of fracture
4. Site of the fracture
5. Direction of fracture line
6. Displacement of fracture

Question 3

Factors that can cause displacement of mandibular fractures (3)

Answer 3

Opposing occlusion
Magnitude of force
Mechanism of injury

Question 4

Radiographic assessment for mandibular fractures

Answer 4

OPT + PA mandible
Occlusal
CBCT

Question 5

E/O exam for mandibular fractures

Answer 5

TMJ - restricted, crepitus, pain
MOM - tender
Asymmetry
Mandible - pain, deviation
Lacerations/bleeding/bruising (chin, jaw/eyes)
Sensation to lower lip/chin

Question 6

I/O exam for mandibular fractures

Answer 6

Pain/bleeding/bruising/swelling
Lacerations
AOB
Occlusal derangement
Mobility
Step deformity (alveolar ridge)

Question 7

Tx for mandibular fracture

Answer 7

OMFs/A+E urgent referral
1. Control pain/infection - consider abx
2. Undisplaced - soft diet/analgesia/kuo

3. Displaced - IMF, ORIF

Question 8

Complications of fractures of mandible

Answer 8

Mobile teeth
Trismus
Persistent mental anaesthesia
Delay/mal union
Non union