Symptoms of Mandibular Jaw Fracture
The primary symptoms of mandibular jaw fracture include pain during masticatory movements, malocclusion (abnormal bite), facial asymmetry, and limited mouth opening, often accompanied by swelling and bruising at the fracture site. 1
Clinical Presentation
- Pain is typically exacerbated during jaw movement, particularly when chewing or speaking 2
- Malocclusion (abnormal bite) occurs as fracture displacement disrupts the normal dental alignment 1, 3
- Facial asymmetry may be visible, especially with displaced fractures 2
- Limited mouth opening (trismus) due to muscle spasm and pain 3
- Swelling and bruising at the fracture site 2
- Mobility of bone fragments may be detectable on palpation in some cases 3
Neurological Symptoms
- Anesthesia or paresthesia of the ipsilateral lower lip, chin, anterior tongue, and mandibular teeth may occur when fractures involve the mandibular canal and damage the inferior alveolar nerve 4
- These sensory disturbances can significantly impact quality of life and may persist if nerve damage is severe 4
Location-Specific Symptoms
- Condylar fractures: Pain in the temporomandibular joint area, deviation of the jaw to the affected side when opening the mouth, and limited jaw movement 1
- Angle fractures: Pain at the posterior mandible, often associated with third molars, malocclusion, and difficulty chewing 5
- Symphyseal/parasymphyseal fractures: Midline pain, step deformity, and potential airway compromise in severe cases 6
- Body fractures: Pain along the mandibular body, malocclusion, and mobility between fragments 6
Associated Findings
- Multiple fractures are common (67% of cases have paired fractures) due to the U-shaped configuration of the mandible 1
- Common patterns include mandibular angle/subcondylar fracture with contralateral parasymphyseal fracture 1
- "Flail mandible" refers to bilateral subcondylar fractures with symphyseal fracture 1
- 20-40% of patients with mandibular fractures have additional injuries 1
- Intracranial injuries occur in approximately 39% of mandibular fracture patients 1
- Cervical spine injuries are found in approximately 11% of patients with mandibular fractures 4, 1
Warning Signs Requiring Immediate Attention
- Airway obstruction may occur due to posterior displacement of the tongue following bilateral parasymphyseal fractures 6
- Excessive bleeding from the fracture site 7
- Severe malocclusion preventing mouth closure 3
- Signs of infection such as increasing pain, swelling, and fever 7
Clinical Pitfalls to Avoid
- Failing to recognize that mandibular fractures often occur in pairs due to the U-shaped configuration of the mandible 1
- Missing condylar fractures, which can be difficult to detect clinically but are common in motor vehicle accidents 6
- Overlooking associated cervical spine injuries, which are present in 6-19% of cases with significant maxillofacial trauma 4
- Failing to consider potential airway compromise in patients with bilateral mandibular fractures 6