From the Guidelines
The management of a jaw fracture should prioritize stabilization, pain management, and prevention of complications, with surgical intervention being the usual treatment for most cases, as indicated by the principles outlined in general fracture management 1. When considering the management of a jaw fracture, several factors come into play, including the type and severity of the fracture, the patient's overall health, and the potential for complications.
- The diagnosis of a jaw fracture is typically based on a history of trauma and focal pain on palpation, confirmed with radiographic studies.
- For simple, non-displaced fractures, conservative treatment may be appropriate, but this approach is less common for jaw fractures compared to other types of fractures.
- More complex or displaced fractures, which are the majority of jaw fractures, require surgical intervention with open reduction and internal fixation (ORIF) to restore proper alignment and function.
- Post-surgical care includes meticulous oral hygiene, a soft or liquid diet for 4-6 weeks, avoidance of tobacco products, and regular follow-up appointments to monitor healing.
- Intermaxillary fixation may be necessary in some cases to ensure proper healing and alignment of the jaw. Given the potential for significant morbidity and impact on quality of life associated with improperly managed jaw fractures, surgical intervention with ORIF is generally recommended for most jaw fractures to ensure optimal outcomes in terms of morbidity, mortality, and quality of life.
From the Research
Management of Jaw Fractures
The management of jaw fractures is a complex process that requires careful consideration of various factors, including the type and location of the fracture, the patient's overall health, and the potential risks and complications associated with different treatment options.
- The use of prophylactic antibiotics in the surgical treatment of maxillofacial fractures has been shown to reduce the risk of infection, particularly in cases involving mandibular fractures 2.
- A study published in 2022 found that biplanar fixation techniques may be more effective than traditional Champy techniques in reducing strain magnitudes in the miniplates, bone, and fracture zone, and may also promote more rapid bone healing 3.
- The diagnosis and management of osteonecrosis of the jaw (ONJ), a potential complication of jaw fractures, requires a multidisciplinary approach and may involve the use of antibiotics, surgery, and other treatments 4.
Treatment Options
The treatment of jaw fractures may involve a range of options, including:
- Surgical fixation using plates, screws, and other hardware
- The use of tape muzzles, circumferential wiring, and other forms of immobilization
- Acrylic splints and other types of dental appliances
- Percutaneous skeletal fixation and intramedullary pinning
- Bone plating and partial mandibulectomy
Risk Factors and Complications
Certain factors may increase the risk of complications or poor outcomes in patients with jaw fractures, including:
- The presence of underlying medical conditions, such as diabetes or osteoporosis
- The use of certain medications, such as bisphosphonates or glucocorticoids
- Poor oral hygiene or dental health
- The presence of other injuries or trauma, such as cervical spine injuries 5
- The type and location of the fracture, with some types (such as ramus-condyle unit fractures) being associated with a higher risk of complications 5