RT Book, Section
A1 Stark, Christopher L.
A2 Knoop, Kevin J.
A2 Stack, Lawrence B.
A2 Storrow, Alan B.
A2 Thurman, R. Jason
SR Print(0)
ID 1181488665
T1 Mandibular Fractures
T2 The Atlas of Emergency Medicine, 5e
YR 2021
FD 2021
PB McGraw-Hill
PP New York, NY
SN 9781260134940
LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1181488665
RD 2024/04/19
AB Blunt  trauma,  mandibular  pain,  and  malocclusion  are  typically  seen  in  patients  with  mandibular  fractures.  A  step-off  in  the  dental  line  or  ecchymosis  or  hematoma  to  the  floor  of  the  mouth  is  often  present.  Mandibular  fractures  may  be  open  to  the  oral  cavity,  as  manifested  by  gum  lacerations.  Dental  trauma  is  frequently  seen.  Other  clinical  features  include  inferior  alveolar  or  mental  nerve  paresthesia,  loose  or  missing  teeth,  dysphagia,  trismus,  or  ecchymosis  of  the  floor  of  the  mouth  (considered  pathognomonic).  Multiple  mandibular  fractures  are  present  in  more  than  50%  of  cases  because  of  the  ringlike  structure  of  the  mandible.  Mandibular  fractures  are  often  classified  as  “favorable”  or  “unfavorable.”  Fractures  displaced  by  masseter  muscle  contraction  are  unfavorable  and  inevitably  require  fixation,  whereas  fractures  that  are  not  displaced  by  masseter  contraction  are  favorable  and,  in  most  cases,  will  not  require  fixation.  Injuries  creating  unstable  mandibular  fractures  may  create  airway  obstruction  because  the  support  for  the  tongue  is  lost.  Mandibular  fractures  are  also  classified  based  on  the  anatomic  location  of  the  fracture.  Dislocation  of  the  mandibular  condyles  may  also  result  from  blunt  trauma  and  will  always  have  associated  malocclusion,  typified  by  an  inability  to  close  the  mouth.