Resident Manual of Trauma to the Face, Head and Neck

Chapter 5: Mandibular Trauma

Table 5.1. Descriptors Regarding the Severity and Displacement of Mandibular Fractures Fracture Terminology Fracture Description Compound or open fractures Exposed to contaminated oral secretions usually involving erupted teeth. Simple or closed fractures Not exposed to oral secretions; usually nontooth-bearing bone. Favorable fracture Not distracted by muscle pull; requires less fixation. Unfavorable fracture Distracted by muscle pull; may require greater fixation to resist muscle pull. Comminuted fracture Crushed, fragmented, or splintered. Complicated or complex fracture Associated with significant injury to the adjacent soft tissues. Multiple fractures Two or more noncommunicating fractures on the same bone. Indirect fracture Located at a point not in alignment with or distant from the site of injury. Impacted fracture One fragment is driven firmly into the other fragment. Greenstick fracture One bony cortex is broken, and the other cortex is bent. Pathologic fracture Occurs through bone weakened by preexisting disease. Atrophic fracture From bone atrophy by loss of supporting alveolar bone in edentulous mandibles. A. Condyle Fractures Condyle fractures are considered the most common fracture of the mandible. They are divided into the head, neck, and subcondylar regions (Figures 5.1 and 5.2). Lindahl, Spiessl and Schroll, Krenkel, and Neff proposed complex condyle fracture classifications. 10,11,13–15 Ellis et al. classified condylar fractures as condylar head fracture (intracapsular fracture located at the border between the condylar head and neck), condylar neck fracture (located below the condylar head but on or above the lowest point of the sigmoid notch), and condylar base fracture (the fracture line isolated below the lowest point of the sigmoid notch). 16

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Resident Manual of Trauma to the Face, Head, and Neck