MANDIBLE TRAUMA Flashcards
DOCUMENTATION
CLINICAL FEATURES
CLINICAL FEATURES
Ask About:
Malocclusion
Pain worsened by movement
Trismus
Widened or displaced mandible
Loss of smooth contours of the mandible
Tenderness
PHYSICAL EXAM
Complete exam of the face including:
Cranial Nerves
Visual acuity
Slit Lamp
Integrity of nearby structures
Inspect occlusion
Bimanual exam of mandible to assess mobility and tenderness
Palpate condyles preauricularily and with finger in EAC
Evaluate lingual and buccal mucosa
Teeth for mobility and
Mental nerve paresthesias
MANAGEMENT
AIRWAY / CIRCULATION
Assess for loss of airway due to loss of tongue support
OR
Critical hemorrhage
DISLOCATION
Reduction
IMAGING
Mandible or face CT with coronal or axial sections
Treatment may delayed for up to 2 weeks with appropriate antibiotics
Oral Chlorhexadine
+/- Barton’s Bandage
ANTIBIOTICS
Open fracture
Dental disruption
Amoxicillin/clavulanate 875 mg PO q 12 for 7 days.
penicillin allergy: Clindamycin 600-900 mg PO q 8 for 7 days.
Ampicillin/sulbactam 3,000 mg (3 g) IV q 6
penicillin allergy:
Clindamycin 900 mg IV q 8
URGENT CONSULTATION
Temporomandibular Joint Dislocation:
Anterior dislocation with an associated fracture
Failure of reduction
More than 2 prior temporomandibular joint dislocations
Superior or posterior dislocations
Mandibular Fractures:
Poor pain control
Impending airway compromise
Open fracture
Complex fracture
MONITOR COMPLICATIONS
Upper airway obstruction due to loss of tongue support
DDX
Intracranial Injury
Frontal Bone Fracture
Orbital Fracture
Globe Injury
Midfacial Fracture: LaFort I-III
Mandibular Fracture
Dental Injury
C-Spine injury
KEY FEATURES
Bilateral until proven otherwise
LOCATIONS
Dentoalveolar
Condyle
Coronoid
Ramus
Angle
Body
Parasymphysis
Symphysis
