Mandible fractures, also referred to as jaw fractures, often occur because of the lack of support in the structure and the prominence it has on the face. Of course, like with any fracture, it is important to consider the level of emergency so that the best path of treatment can be taken. It is important especially with a jaw fracture that the airway is secure and not obscured for some reason.
Types Of Mandibular Fractures:
Closed or simple – This type of fracture does not break the skin, mucosa or the periodontal membrane.
Open or compound – An external wound occurs in this type of fracture such as that involving the skin, mucosa or periodontal membrane.
Greenstick – Situation where only one cortex is broken and the other is bent.
Atrophic – A fracture that occurs because of severe atrophy of the bone.
Multiple – Two or more lines of the fracture are present, but they do not communicate with one another.
Pathologic – A fracture that occurs from a mild injury that is linked with a preexisting bone disease.
Comminuted – The bone of the jaw is splintered or crushed in this type of fracture.
Complicated – This type of fracture occurs when there is considerable injury to the adjacent soft tissues or parts.
Treatments For Mandible Fractures
Medical treatment will first begin with the use of preoperative antibiotics to help fight any potential infections. The surgical approach to correcting a mandible fracture will be determined by Dr. Tahernia depending on the patient and the type of fracture.
Intraoral Approach – This method is often preferred over the extraoral approach because it has a lower risk for facial nerve damage and there is no external scar. This technique also is quicker to perform and can be done under a local anesthesia.
Submandibular Approach – In this approach, a small incision is made discretely in a crease of the skin that is about 2cm below the angle of the mandible. Dr. Tahernia will work his way through to the platysma muscle and then move further to reach the deep cervical fascia. Using a nerve stimulator, Dr. Tahernia can move to carry out the dissection of the pterygomasseteric sling.
Retromandibular Approach – Dr. Tahernia will place an incision about half of a centimeter below the earlobe that spans about 3.5 inches. The muscle is stripped from the surface of the mandible to give him access to the ramus and subcondylar region of the jaw.
Preauricular Approach – This approach is best used when it is necessary to get to the temporomandibular joint. An incision that spans about 2.5-3.5 cm is made in the preauricular folds. Once Dr. Tahernia has worked down to below the arch of the periosteal elevator, he can release the intervening tissue along the incision and retract the flap to expose the joint capsule. Depending on the type off fracture will determine if the capsule is opened.