eMedicine Specialties > Otolaryngology and Facial Plastic Surgery > Trauma

Mandibular Angle Fractures: Workup

Author: Jose E Barrera, MD, Clinical Faculty, Department of Otolaryngology-Head and Neck Surgery, Wilford Hall Medical Center
Coauthor(s): Stephen G Batuello, MD, Consulting Staff, Colorado ENT Specialists
Contributor Information and Disclosures

Updated: Nov 10, 2008

Workup

Imaging Studies

  • The single most informative radiologic study used in diagnosing mandibular fractures is the panoramic radiograph.
    • Panorex provides the ability to view the entire mandible in one radiograph.
    • Panorex requires an upright patient, and it lacks fine detail in the TMJ, symphysis, and dental/alveolar process regions.
  • Plain films, including lateral-oblique, occlusal, posteroanterior, and periapical views, may be helpful.
    • The lateral-oblique view helps in diagnosing ramus, angle, or posterior body fractures. The condyle, bicuspid, and symphysis regions often are unclear.
    • Mandibular occlusal views show discrepancies in the medial and lateral position of the body fractures.
    • Caldwell posteroanterior views demonstrate any medial or lateral displacement of ramus, angle, body, or symphysis fractures.
  • CT scanning may also be helpful.
    • CT scanning allows physicians to survey for facial fractures in other areas, including the frontal bone, naso-ethmoid-orbital complex, orbits, and the entire craniofacial horizontal and vertical buttress systems.
    • Reconstruction of the facial skeleton is often helpful to conceptualize the injury.
    • CT scanning is also ideal for condylar fractures, which are difficult to visualize.

More on Mandibular Angle Fractures

Overview: Mandibular Angle Fractures
Workup: Mandibular Angle Fractures
Treatment: Mandibular Angle Fractures
Follow-up: Mandibular Angle Fractures
Multimedia: Mandibular Angle Fractures
References
[ CLOSE WINDOW ]

References

  1. Cole P, Rottgers SA, Cameron H, et al. Improving the minimally invasive approach to mandible angle repair. J Craniofac Surg. Mar 2008;19(2):525-7. [Medline].

  2. Collins CP, Pirinjian-Leonard G, Tolas A, et al. A prospective randomized clinical trial comparing 2.0-mm locking plates to 2.0-mm standard plates in treatment of mandible fractures. J Oral Maxillofac Surg. Nov 2004;62(11):1392-5. [Medline].

  3. Alpert B, Engelstad M, Kushner GM. Invited review: small versus large plate fixation of mandibular fractures. J Craniomaxillofac Trauma. Fall 1999;5(3):33-9; discussion 40. [Medline].

  4. Barber HD, Woodbury SC, Silverstein KE. Mandibular Fractures. Oral and Maxillofacial Trauma. 1991;473-526.

  5. Dodson TB. Third molars may double the risk of an angle fracture of the mandible. Evid Based Dent. 2004;5(3):78. [Medline].

  6. Gardner KE, Aragon SB. The mandibular fracture. ENT Secrets. Hanley & Belfus; 1996:302-309.

  7. Katakura A, Shibahara T, Noma H, et al. Material analysis of AO plate fracture cases. J Oral Maxillofac Surg. Mar 2004;62(3):348-52. [Medline].

  8. King RE, Scianna JM, Petruzzelli GJ. Mandible fracture patterns: a suburban trauma center experience. Am J Otolaryngol. Sep-Oct 2004;25(5):301-7. [Medline].

  9. Kuriakose MA, Fardy M, Sirikumara M, et al. A comparative review of 266 mandibular fractures with internal fixation using rigid (AO/ASIF) plates or mini-plates. Br J Oral Maxillofac Surg. Aug 1996;34(4):315-21. [Medline].

  10. Lazow SK. The mandible fracture: a treatment protocol. J Craniomaxillofac Trauma. Summer 1996;2(2):24-30. [Medline].

  11. Luhr HG, Hausmann DF. [Results of compression osteosynthesis with intraoral approach in 922 mandibular fractures]. Fortschr Kiefer Gesichtschir. 1996;41:77-80. [Medline].

  12. Schilli W, Stoll P, Bahr W. Mandibular fractures. In: Manual of Internal Fixation. Springer-Verlag; 1981:65-80.

  13. Spiessl B. The stability principle. In: Internal Fixation of the Mandible: A Manual of AO/ASIF Principles. Springer-Verlag New York: 1989:30-45.

[ CLOSE WINDOW ]

Further Reading

[ CLOSE WINDOW ]

Keywords

jaw fractures, fractures, mandibular angle fractures, mandible angle fractures, facial fractures, mandibular fracture, craniofacial trauma, broken jaw, angle fracture, angle fracture of the mandible, wedge fracture, multifragmentary fracture, mandibular fracture

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

Jose E Barrera, MD, Clinical Faculty, Department of Otolaryngology-Head and Neck Surgery, Wilford Hall Medical Center
Jose E Barrera, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Academy of Sleep Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Stephen G Batuello, MD, Consulting Staff, Colorado ENT Specialists
Stephen G Batuello, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Physician Executives, American Medical Association, and Colorado Medical Society
Disclosure: Nothing to disclose.

Medical Editor

Hassan H Ramadan, MD, MSc, Professor and Vice-Chair, Department of Otolaryngology-Head and Neck Surgery, Professor, Department of Pediatrics, West Virginia University
Hassan H Ramadan, MD, MSc is a member of the following medical societies: American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, and American Rhinologic Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Stephen G Batuello, MD, Consulting Staff, Colorado ENT Specialists
Stephen G Batuello, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Physician Executives, American Medical Association, and Colorado Medical Society
Disclosure: Nothing to disclose.

CME Editor

Christopher L Slack, MD, Otolaryngology-Facial Plastic Surgery, Private Practice, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders
Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA, Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine
Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society
Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation unstricted gift unknown

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.