Mandibular fractures
Mandibular fractures are among the commonest facial fractures seen in the emergency department. The mandible (lower jaw) develops from two hemimandibles that fuse in early childhood and articulates with the temporal bones at the temporomandibular joints (TMJs).
Its prominence and curved anatomy make it vulnerable to direct blunt force; fractures frequently occur at more than one site because forces are transmitted across the bone.
Clinical assessment, early airway management when required, appropriate imaging, and early liaison with oral and maxillofacial surgery (OMFS) are core ED tasks.
Clinical anatomy and common fracture sites
- Body (including dentoalveolar region, angle, symphysis/parasymphysis)
- Condylar head and neck (intracapsular and extracapsular)
- Coronoid process
- Ramus
Mechanism and fracture patterns
- Most commonly caused by direct lateral or anteroposterior blunt force (assault, fall, sporting injury, road‑traffic collision).
- A single impact often produces two or more fracture sites (for example, a body fracture with a contralateral condylar fracture).
- Impact to the chin commonly transmits force to the condyles and may injure nearby temporal bone structures and the external auditory canal.
How patients present
Presentation ranges from obvious deformity to subtle jaw pain or dental injury. Key history and symptoms to elicit: