Mandibular fractures

What are mandible or mandibular fractures?

Mandible fractures are fractures of the lower jaw where your bottom teeth sit. These can include the dentate (tooth-bearing) portion of the mandible or outside of this at areas such as the condyle which forms part of the temporomandibular joint (TMJ) or jaw joint. These may commonly occur due to interpersonal violence, sporting injuries and falls, particularly during a loss of consciousness where patients have failed to put their hands out in time to break the fall.

What are the possible treatment strategies?

Some fractures are not displaced and all that is required is a soft diet and time to allow the bones to “knit” back together. In most cases however, the occlusion (way of biting) will be disturbed due to steps in the mandible where the fracture has occurred. The fracture therefore needs to be reduced (brough back into alignment) and fixed together. This is most commonly via an open reduction and internal fixation (ORIF) placing titanium miniplates across the fracture lines once reduced.

How long does surgery take?

Surgery may take anything from 30 minutes to a couple of hours depending upon the number of fractures and severity of displacement. This is always under general anaesthesia (asleep) and meticulous attention to detail ensures that the time is well spent in achieving the optimum result to return your bite to its pre-injury pattern, returning you to function as early as possible.

Will I have any scars?

Generally speaking, fractures of the mandible are fixed from inside the mouth, such that there are no external scars required. In some cases however, the fractures are either very high up the mandible and/or very displaced (pulled apart). In these instances, the approach may need to be from the outside, but care will be taken to keep the incisions as small as possible, as well as ensuring they are hidden within skin tension lines.

What will my recovery be like?

Recovery will take around 6 weeks, during which time you should have a soft diet, the consistency of mushy peas, mashed potato and overcooked pasta! It is important to allow time for the fracture to heal, as the titanium plates only hold the fracture in the right position and you have to ensure that the areas are kept clean and undisturbed. Contact sports should ideally be avoided for a few months following the surgery.