Emergency War Surgery NATO Handbook: Part IV: Regional Wounds and Injuries: Chapter XXIII: Maxillofacial Wounds and Injuries

Regional Fractures: Fractures of the Mandible

United States Department of Defense

Next to the nasal bone, the mandible is the most commonly fractured facial bone. Its weakest and most frequently fractured area is the neck of the condyle. Forces delivered to one side of the mandible often produce fractures of the opposite side, either at the condylar neck or at the angle, and forces directed to the chin often produce fractures at the condylar neck and parasymphyseal regions. Such fractures may, in fact, occur bilaterally and it should be remembered that nearly half of all mandibular fractures resulting from blunt trauma are multiple in nature.

Examination will reveal one or more of the following findings: restriction of the normal movements of the jaws, abnormal mobility of the jaws, crepitation upon manipulation, an open injury extending into the mouth, irregularities in alignment of the teeth, and abnormal occlusion. Swelling and bruises of the soft palate, fauces, and lateral wall of the pharynx are occasionally seen in severe fractures of the ascending ramus.

Primary treatment of mandibular fractures is dictated by a number of considerations, among which are the nature, location, and severity of the fracture and the condition of the existing dentition. Some of these fractures may be managed by dietary control only, others by closed techniques utilizing simple intermaxillary fixation, and some by open reduction and internal fixation. There is no indication for immediate bone grafting in the primary repair of mandibular fractures in the combat hospital.  

Approved for public release; Distribution is unlimited.

The listing of any non-Federal product in this CD is not an endorsement of the product itself, but simply an acknowledgement of the source. 

Operational Medicine 2001

Health Care in Military Settings

This web version is provided by The Brookside Associates Medical Education Division.  It contains original contents from the official US Navy NAVMED P-5139, but has been reformatted for web access and includes advertising and links that were not present in the original version. This web version has not been approved by the Department of the Navy or the Department of Defense. The presence of any advertising on these pages does not constitute an endorsement of that product or service by either the US Department of Defense or the Brookside Associates. The Brookside Associates is a private organization, not affiliated with the United States Department of Defense.

Contact Us  ·  ·  Other Brookside Products