Mandibular Fracture Lecture Notes

What is the definition of a fracture?

A break in the continuity of a bone.

Why is the mandible particularly prone to fractures?

Because it is a prominent, mobile bone in the lower third of the facial skeleton and absorbs significant forces during trauma.

List four normal functions of the mandible that can be disrupted by fracture.

Chewing, swallowing, speech, and maintenance of facial symmetry.

Name two unique features of the mandible that complicate fracture reduction.

1) Powerful muscular attachments, 2) Its ability to move in relation to the skull.

Which mandible region’s thin bony neck makes it vulnerable to fracture from chin impacts?

The condylar neck.

What two main blood supplies serve the mandible?

1) Endosteal supply from the inferior alveolar artery, 2) Periosteal supply via the periosteum.

Which cranial nerve branch innervates the mandible?

Mandibular division (V3) of the trigeminal nerve.

Kruger: Define a simple (closed) mandibular fracture.

Linear fracture without communication with the exterior or interior.

Kruger: What distinguishes a compound (open) fracture from a simple fracture?

It communicates with the exterior through skin or interior through mucosa/periodontium.

Kruger: What is a comminuted fracture?

Bone is splintered or crushed into multiple pieces, often from high-velocity impact.

Kruger: Describe a green-stick fracture and the age group in which it is common.

One cortex breaks while the other bends; common in children.

What is a pathological mandibular fracture?

Spontaneous fracture from mild trauma due to pre-existing bone pathology (e.g., cysts, tumors).

Dingman & Natvig: Which region lies between the canine and the angle?

Body of the mandible.

Rowe & Killey: What type of fracture does not involve the basal bone?

Dentoalveolar fracture.

Give two examples of horizontally favorable vs. unfavorable fractures.

Horizontally favorable: muscle pull brings fragments together; horizontally unfavorable: muscle pull distracts fragments apart (same logic applies vertically).

List four common causes (aetiology) of mandibular fractures.

Road traffic crashes, fights/altercations, falls, assaults (others: industrial accidents, sports, gunshot, excessive muscle contraction).

Name three cardinal clinical signs of a mandibular fracture.

Pain/tenderness, swelling, malocclusion (others include step deformity, trismus, parasthesia).

What intra-oral sign strongly suggests a mandibular fracture?

Sublingual hematoma.

Which imaging view provides a panoramic assessment of the mandible?

Panoramic radiograph (orthopantomogram).

Why might a chest X-ray be ordered after mandibular trauma?

To locate an avulsed tooth that is unaccounted for and might have been aspirated.

List the four broad steps in mandibular fracture management.

1) History taking, 2) Examination, 3) Investigation, 4) Treatment.

What diet is advised for green-stick fractures with no malocclusion?

Soft and fluid diet for 10–14 days (conservative therapy).

Define intermaxillary fixation (IMF).

Immobilization that wires the mandible to the maxilla, also called mandibulo-maxillary fixation.

Give two examples of semi-rigid immobilization devices.

Arch bars with wires