Pediatric Mandible Fractures Workup

Updated: Jul 24, 2018
  • Author: Abbas A Younes, MD, FACS; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Workup

Imaging Studies

See the list below:

  • Panorex

    • Panorex is the study of choice. The patient must be cooperative and motionless while the radiograph machine rotates. Patient movement may simulate a fracture. Most available equipment requires the patient to be able to sit upright; therefore, this examination may not be possible in critically ill patients or those with suspected cervical spine injuries. (Some facilities have special equipment for the supine patient.)

    • A series of plain radiograph views may provide similar information and often are easier to obtain in the acute trauma setting.

  • Plain radiography: Standard radiograph views that evaluate the mandible include the following:

    • Lateral oblique view - Provides the best view of the mandible from the condyle to the mental foramen

    • Posteroanterior (PA) view - Can visualize displacement of fractures of the ramus, angle, and body and fractures of the anterior mandible that may be obscured by the vertebral bodies

    • Towne occipitofrontal view - Demonstrates condylar fractures and displacement medially or laterally

    • Mandibular occlusal views - Demonstrate symphyseal displacement

    • Dental radiographs - May prove useful in alveolar fractures or dental root fractures

  • CT scanning

    • Thin-section (≤ 3 mm) CT scans through the mandible can be useful.

    • Direct coronal images and/or 3-dimensional or multiplanar reconstructions can help delineate relation of the temporomandibular joint (TMJ).