Mandibular / Panfacial Fractures

The mandible is a unique bone having a complex role in both aesthetics of the face and functional occlusion. Because of the prominent position of the lower jaw, mandible fractures are the most common fracture of the facial skeleton. In complex injuries, mandible fractures are frequently associated with other fractures of the face. When all the bones of the face are fractured it is called a panifacial fracture.

Preoperative

Mandibular Panfacial Fractures

Postoperative

Mandibular Panfacial Fractures

Evaluation

Fractures of the mandible should be classified according to the site of the fracture, degree of displacement, the presence of comminution and status of the dentition. Physical examination will typically reveal a malocclusion, pain at the fracture site, mucosal ecchymosis or laceration with bleeding between teeth at the fracture site. Plain radiographs can help further define the fractures of the mandible. In a patient with an isolated jaw injury, a Panorex is an ideal radiograph to visualize the fracture and condition of the teeth. In the multisystem injured patient, a computerized tomographic scan with three-dimensional reconstruction provides good visualization of the fractures.

Preoperative

Mandibular Panfacial Fractures

Sixty-six-year-old female sustaining complex comminuted fractures to all bones of the face

Postoperative

Mandibular Panfacial Fractures

Postoperative results after one stage repair

Treatment

Reduction and stabilization of the mandible fracture is the key to successful treatment. The method of management may vary based on the severity, location of the fracture and presence or absence of teeth. Mandible fractures are usually treated by closed reduction with the wiring of the teeth or open reduction with internal rigid fixation using plates. Nonoperative management of a mandible fracture with a soft diet is rarely indicated. The technique of closed reduction involves wiring of arch bars on the teeth and intermaxillary fixation for 4 to 6 weeks. Internal rigid fixation requires exposure of the fracture sites and stabilization with plates and/or screws. This technique can frequently avoid postoperative intermaxillary fixation (wiring teeth together) and the problems associated with this such as weight loss and joint stiffness.

Preoperative

Mandibular Panfacial Fractures

This patient sustained severe complex fractures of all facial bones with loss of right eye

Postoperative

Mandibular Panfacial Fractures

The postoperative result after one stage surgery

Accurate Reduction

Following the principles of accurate reduction with good stabilization can frequently avoid complications and help to restore the patient's primary occlusion and facial appearance.

Mandibular Panfacial Fractures

Skull with mandibular plates

Mandibular Panfacial Fractures

Rigid fixation of mandibular fractures shown on skull using titanium plates

Contact Us!

Thanks! Message sent.