Mandible Fracture Workup

Updated: Oct 22, 2016
  • Author: Thomas Widell, MD; Chief Editor: Trevor John Mills, MD, MPH  more...
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Workup

Laboratory Studies

Laboratory studies for fracture of the mandible include the following:

  • 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.
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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. [5]

Computed tomography

In selected patients with nondiagnostic radiographs in whom mandibular fracture is strongly suspected, CT scan may be necessary to diagnose condylar fracture. Also, CT scan of the brain should be considered to rule out intracranial injury. [2, 3, 4]

Multidetector CT is used to determine the most appropriate treatment management, fixation method, and surgical approach; to assess the adequacy of the reduction; and to evaluate the potential complications in the postoperative period. [22]

Magnetic resonance imaging

MRI is helpful in evaluating soft tissue injury, such as hematomas and complications of trauma. [9]

 

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