Fractures Of The Mandible

Fractures Of The Mandible

Management Of Mandibular Fracture

• Reduction
  • Open reduction
  • Closed reduction.
• Fixation.
• Immobilization.
• Prevention of infection and rehabilitation.

• After anesthesia is given, the dislocated fragments of the mandible are held between the fingers and thumbs on each side of the fractured line.
• The fragments are shaken up and down to disengage them or to break the fibrous union.
• When normal occlusion is achieved, the fragments are fixed in position.
• Various methods used for close reduction of mandibular fractures are:
  • Arch bar fiction
  • Bridle wire
  • The figure 8 wiring
  • Gilmer’s direct wiring
  • Eyelet wiring
  • Essig’s wiring
  • Stout’s continuous loop wiring
  • Risdon’s wiring.

Broken Jaw Symptoms

Bilateral Mandibular Fracture: Causes And Treatment

Reduction By Traction

• Open Reduction is a procedure by which we expose the fractured bone ends and bring them into alignment under direct vision.
• The fractured bone can be exposed by an intraoral or extraoral approach.
• The extraoral approach is preferred to avoid contamination.
• Depending on the areas to be accessed, various surgical approaches are used in open reduction.
• Symphysis, para symphysis, and the body of the mandible can be approached via intraoral incisions given in the labial mucosa. Extra-oral incisions can be used to approach these regions.
• Symphysis can be approached via an incision placed in the submental region of the skin crease. The body of the mandible can be approached by a sub-mandibular approach.

Condylar Fracture Of The Mandible

“Risk Factors For Developing Mandible Fractures”

Complications Of Untreated Mandibular Fractures

• The angle of the mandible should be approached via an intra-oral incision placed on the third molar region, which extends to the anterior border ramus. Externally, the angle of the mandible can be approached via Risdon’s incision.
• Ramus of the mandible can be approached via the retromandibular incision.
• The coronoid process can be approached via an intra-oral incision placed high on the anterior border of the ramus of the mandible.
• The Condyle of the mandible can be approached via various incisions, i.e., preauricular, retromandibular, and submandibular, etc.
• Aligned bone is held in position with the help of wire, screws, or bone plates as per requirement.

Fixation Of Mandibular Fracture

• In this phase, the fractured fragments are fixed in their normal anatomical relationship to prevent displacement and achieve proper approximation.
• If a closed reduction is done, the fractured fragments are fixed and immobilized in an anatomically reduced position through a wire that is placed around teeth, i.e., interdental wiring.
• Various wiring techniques are used, and each of them is used in various types of mandibular fractures.

“Comprehensive Overview Of Mandible Fracture Symptoms”

• Wiring techniques used are Bridle wire, Figure-of-8 wiring,
• Gilmer’s direct wiring, eyelet wiring, Essig’s wiring, Stout’s continuous loop wiring, and Risdon’s wiring.
• If an open reduction is done, the fixation can be:
• Non-rigid fiction: By use of transosseous wires or wire osteosynthesis
• Semi-rigid fixation: By use of monocortical mini plates or lag screws
• Rigid fixation: By use of dynamic compression plates, immobilization

Mandibular Fracture Surgery

“Is A Mandible Fracture Serious”

Symptoms Of A Comminuted Mandibular Fracture

• In this phase, the reduced and fused fragments of bone are immobilized for a certain period for healing to occur.
• A fixation device is given to stabilize the reduced fragments into their normal anatomical position till clinical bony union takes place.
• For mandibular fractures, the period of immobilization should be 4 to 6 weeks.
• If the mandibular condyle is fractured, then a period of immobilization is for 2 to 3 weeks.
• Prevention of infection and rehabilitation
• A proper antibiotic regimen should be given to the patient to prevent intraoperative and postoperative complications.
• If there is a presence of a gap between the bony ends, a proper bone graft should be given.
• After 4 to 6 weeks as the fracture is healed, and the jaw regains some of its strength, the patient should be encouraged to be on a normal diet and use the jaw as he/she used it before the trauma.