HEAD, EYE, EAR, NOSE, AND THROATEMERGENCIES■ Airway compromise may result from soft-tissue swelling and lack of tongue
support from a flail mandible (bilateral mandibular body fractures).
■ OMFS or ENT consult for disposition
■ All open fractures (blood in mouth) require a consult and antibiotics.
■ If discharged, remember to give pain meds, soft diet, and appropriate
follow-up with OMFS/ENT.
■ Tetanus if needed
COMPLICATIONS
■ Airway compromise
■ Malocclusion
■ Mental nerve damage (anesthesia of the lower lip)
■ Infection/osteomyelitis secondary to an open fracture
Mandibular Dislocation
■ Patients usually give a history of wide mouth opening (such as with yawn-
ing or laughing) as the cause of their dislocation.
■ The mandible is displaced forward and superiorly with the condyle ante-
rior to the articular eminence, resulting in a protruding chin.
■ Dislocation may be unilateral or bilateral.
AFIGURE 14.11. (A) Panorex X-ray of mandible body fracture. (B) Open mandible fracture.
(Courtesy of Edward S. Amrhein, DDS as printed in Knoop KJ, Stack LB, Storrow AB.Atlas of
Emergency Medicine, 2nd ed. New York: McGraw-Hill, 2002:17 and 18.)
B