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- Mandibular fracture > middle third fracture (anatomical factor)
- Minor mandibular fracture may be associated with head injury owing to the cranio-mandibular articulation
- Mandibular fracture may compromise the patency of the airway in particular with loss of consciousness----BILATERAL PARASYMPHYSIS FRACTURE
- Fracture of mandible occurred with frontal impact force as low as 425 lb (190 Kg) {Condylar fracture}
- Fracture of condyle regarded as a safety mechanism to the patient
- Frontal force of 800-900 lb (350-400 Kg) is required to cause symphysial fracture
- Mandible was more sensitive to lateral impact than frontal one---- ANGLE FRACTURE > CONDYLAR FRACTURE
PATHOLOGICAL : Fracture due to existing pathology
- GENERALISED SKELETAL DEFORMITY
- LOCALIED SKELETAL DEFORMITY
IMPACTED FRACTURE : A fracture in which one segment is firmly driven into another.
ATROPHIC : A spontaneous fracture resulting from atrophy of the bone, as in edentulous mandible
INDIRECT FRACTURE: A fracture at a point distant from the site of injury
COMPLICATED/COMPLEX – A fracture in which there is considerable injury to the adjacent soft tissue or adjacent parts; may be simple or compound
CLASSIFICATION BY ANATOMIC REGION
Dingman and Natvig
DIAGNOSIS OF MANDIBULAR FRACTURES
REDUCTION
- Closed reduction
- Open reduction
Indications
a) Nondisplaced favorable fractures
b) Grossly comminuted fractures
c) Significant loss of overlying soft tissue
d) Edentulous mandibular fractures
e) Mandibular fractures in children
f) Coronoid process fractures
g) Condylar fractures
Open reduction
- Displaced unfavourable fractures Multiple fractures of the facial bones
- Midface fractures and displaced bilateral condylar fracture
- Fractures of an edentulous mandible with severe displacement of fracture segment
- Edentulous maxilla opposing a mandibular fracture
- Delay of treatment and interposition of soft tissue between noncontacting displaced fractures fragments
- Malunion
- Conditions contraindicating Intermaxillary fixation
MCQS
1. If a fracture of jaw bone is communicated to external environment, it is called:
A. Comminuted fracture.
B. Compound fracture.
C. Green stick fracture.
D. Simple fracture.
Answer:B
COMPOUND FRACTURE
• A fracture in which an external wound involving the skin, mucosa, or periodontal membrane communicates with the break in the bone.
2. The most common site of fracture of the mandible is the;
A. Body
B. Angle
C. Symphysis
D. Condyle
Answer; B
