eMedicine Specialties > Otolaryngology and Facial Plastic Surgery > Trauma

Mandibular Body 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 11, 2008

Workup

Imaging Studies

  • CT scanning and plain radiography, including panoramic, lateral-oblique, posteroanterior, occlusal, and periapical views, may be helpful. However, the single most informative radiologic study used in mandibular fracture diagnosis is panoramic radiography.
  • Panorex provides the ability to view the entire mandible in one radiograph. However, it requires an upright patient, and it lacks fine detail in the TMJ, symphysis, and dental/alveolar process regions.
  • Plain radiography may be helpful.
    • The lateral-oblique view helps diagnose ramus, angle, or posterior body fractures. The condyle, bicuspid, and symphysis regions are often unclear.
    • Mandibular occlusal views demonstrate discrepancies in the medial and lateral position of body fractures.
    • Caldwell posteroanterior views demonstrate any medial or lateral displacement of ramus, angle, body, or symphysis fractures.
  • CT scanning also may be helpful in assessment of facial fractures.
    • 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.
    • Reconstructions of the facial skeleton are often helpful in conceptualizing the injury.
    • CT scanning is also ideal for condylar fractures, which are difficult to visualize.

More on Mandibular Body Fractures

Overview: Mandibular Body Fractures
Workup: Mandibular Body Fractures
Treatment: Mandibular Body Fractures
Follow-up: Mandibular Body Fractures
Multimedia: Mandibular Body Fractures
References
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References

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

  2. 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].

  3. Ellis E 3rd, Price C. Treatment protocol for fractures of the atrophic mandible. J Oral Maxillofac Surg. Mar 2008;66(3):421-35. [Medline].

  4. 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].

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

  6. 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].

  7. Barber HD, Woodbury SC, Silverstein KE. Mandibular fractures. In: Oral and Maxillofacial Trauma. Philadelphia, Pa: WB Saunders Co; 1991:473-526.

  8. 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].

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

  10. 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].

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

  12. Schilli W, Stoll P, Bahr W. Mandibular fractures. In: Manual of Internal Fixation. New York, NY: Springer-Verlag; 1990:65-80.

  13. Spiessel B. The stability principle. In: Internal Fixation of the Mandible: A Manual of AO/ASIF Principle. New York, NY: Springer-Verlag; 1989:30-45.

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Further Reading

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Keywords

mandible, mandibular body fractures, mandible body fractures, mandible fractures, mandible fracture, jaw fracture, broken jaw, horizontal ramus fracture, mandibular fracture, mandibular surgery, jaw fracture

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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: eMedicine Salary Employment

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; Axis Three Corporation Ownership interest Consulting; Omni Biosciences Ownership interest Consulting; Sentegra Ownership interest Board membership; Syndicom Ownership interest Consulting; Oxlo  Consulting; Medvoy Ownership interest Management position

 
 
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