Mandibular fracture
| Mandibular fracture | |
|---|---|
| Synonyms | mandible fracture, fracture of the jaw |
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| 3D computed tomographic image of a mandible fracture in two places. One is a displaced right angle fracture and the other is a left parasymphyseal fracture. | |
| Classification and external resources | |
| Specialty | emergency medicine |
| ICD-10 | S02.6 |
| MeSH | D008337 |
Mandibular fracture, also known as fracture of the jaw, is a break through the mandibular bone. In about 60% of cases the break occurs in two places. It may result in a decreased ability to fully open the mouth. Often the teeth will not feel properly aligned or there may be bleeding of the gums. Mandibular fractures occur most commonly among males in their 30s.
Mandibular fractures are typically the result of trauma. This can include a fall onto the chin or a hit from the side. Rarely they may be due to osteonecrosis or tumors in the bone. The most common area of fracture is at the condyle (36%), body (21%), angle (20%) and symphysis (14%). While a diagnosis can occasionally be made with plain X-ray, modern CT scans are more accurate.
Immediate surgery is not necessarily required. Occasionally people may go home and follow up for surgery in the next few days. A number of surgical techniques may be used including maxillomandibular fixation and open reduction internal fixation (ORIF). People are often put on antibiotics such as penicillin for a brief period of time. The evidence to support this practice; however, is poor.
By far, the two most common symptoms described are pain and the feeling that teeth no longer correctly meet (traumatic malocclusion, or disocclusion). The teeth are very sensitive to pressure (proprioception), so even a small change in the location of the teeth will generate this sensation. People will also be very sensitive to touching the area of the jaw that is broken, or in the case of condylar fracture the area just in front of the tragus of the ear.
Other symptoms may include loose teeth (teeth on either side of the fracture will feel loose because the fracture is mobile), numbness (because the inferior alveolar nerve runs along the jaw and can be compressed by a fracture) and trismus (difficulty opening the mouth).
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