Mandibular fractures
Anatomical Classification
Condylar injuries
Condylar neck - 35%
Angle - 20%
Body - 20%
Parasymphysis - 13%
Symphysis - 11%
Coronoid - 1%
Clinical Features
1. Lacerations, bleeding
2. Swelling
3. Ecchymosis, sublingual haematoma indicated fracture of the lingual plate
4. Visible and palpable deformity of bone with tenderness
5. Abnormal mobility and crepitus of mandible
6. Malocclusion and step deformity of teeth
7. Para/anaesthesia of lower lip
8. Damaged teeth
9. Bleeding from the ear
Treatment Principles
1. Debridement
2. Reduction—open/closed
3. Fixation— internal/external
4. Immobilisation
5. Functional rehabilitation
Unilateral condyle
¨ Affected side:
- Pain in joint, worse on moving
- Tenderness and swelling
- Absent/ abnormal movement of head
- Deviation of mandible to affected side
- Gagging on molar teeth
¨ Opposite side:
- Open bite
- Limitation of lateral excursion
Bilateral condyle
- Pain
- Tenderness and swelling over both joints
- Gagging on posterior teeth—anterior open bite
- Restricted lateral movement
- Absence of condylar head movement