FRACTURES AND DISLOCATION OF THE JAW
Fractures and dislocation of the jaw occur frequently among members of the
military population, particularly in combat. Immediate treatment involves lifesaving
techniques to maintain breathing, control hemorrhage and shock, and observation for
possible brain damage. Immediate treatment should also include immobilization of the
head and neck to prevent damage to the spinal cord until the possibility of injury to the
cervical spine has been ruled out at a definitive care facility. Among the more common
traumatic facial injuries are fractures of the mandible and maxilla. Displaced bone
segments from fractures of the maxilla and bilateral subcondylar or parasymphysis
fracture of the mandible may result in airway problems. These fractures are often
associated with soft tissue injury or loss, bone loss, and comminuted or impacted
fragments of bone. Jaw fractures and associated injuries should be referred to the
dental officer (usually an oral surgeon) for treatment. A diagnosis is usually established
following a thorough examination that includes visual inspection, palpation, and
COMMON SIGNS AND SYMPTOMS
Most patients with jaw fractures have a history of trauma and complain of pain.
In addition, many patients have abnormal mobility of the fractured jaw and trismus
(muscle spasm). Some common signs and symptoms of mandibular fractures include:
malocclusion, laceration over the fracture site, ecchymosis (bleeding into the skin or
mucosa) in the floor of the mouth, step defect, paresthesia (numbness or abnormal
sensation), lack of condylar movement on opening, lateral deviation on opening, and the
inability to open the mouth. Fractures of the maxilla and other bones of the mid-face
have the following common signs and symptoms--distortion of facial symmetry, open
bite because of displacement of the maxilla, ecchymosis, and paresthesia.
CLASSIFICATION OF FRACTURES
Fractures may be classified by their severity and tissue involvement. Figure 3-1
has examples of some types of fractures.
a. Simple Fracture. A simple fracture is a break in the bone that does not
produce an open wound in the skin. A simple fracture can be complete (complete
severance of the bone) or incomplete. Tissue adjacent to the fracture may or may not
suffer considerable injury.
A greenstick fracture is one in which one side of the bone is broken and the
other side is bent.