Mandible Fracture in Emergency Medicine Workup
- Author: Thomas Widell, MD; Chief Editor: Rick Kulkarni, MD more...
Laboratory Studies
- Direct laboratory studies toward workup of a trauma patient. If this is an isolated injury, laboratory studies may not be required.
- If fracture is an isolated injury, obtain preoperative labs if surgery is planned.
Imaging Studies
Radiographs
Best plain film to assess the mandible is a panorama view (ie, Panorex), which shows the mandible in its entirety in a single view. Panoramic view is not always available, as it requires a special radiographic machine. If panorama view is not available or patient is unable to sit for film, obtain routine mandible films.
Routine views include bilateral lateral oblique projections to look at the angle, body, and to a lesser extent, symphysis, and Townes view to look at the condyles.
Submental view can be helpful in evaluating the symphysis.
Obtain chest films of patients with unaccounted missing teeth to rule out aspiration.
Cervical spine radiographs may be indicated with severe facial injuries or in patients with a consistent mechanism and neck pain.[2]
Computed tomography
In selected patients with nondiagnostic radiographs in whom mandibular fracture is suspected strongly, CT scan may be necessary to diagnose condylar fracture.
CT scans often are used to better evaluate fracture prior to surgical repair.
Consider CT scan of the brain to rule out intracranial injury.
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