Fractures of the mandible in motor vehicle accidents

Motor vehicle accidents are a common cause of fractures of the mandible and are the most common cause of serious and multiple fractures. The usual mechanism of injury is outlined. The common fractures that occur are through the anterior alveolar process, condylar necks, or edentulous areas of the body and symphysis. There is high incidence of other injuries associated with jaw fractures in these patients. Treatment of the mandibular fracture must wait until the patient's general condition is stabilized. Obstruction of the airway demands emergency treatment by keeping the tongue forward and repeated suction of blood and mucus from the mouth and nasopharynx. Emergency tracheostomy is rarely necessary because of mandibular fractures. The methods for immobilizing a fractured jaw are outlined. The majority of accident victims are young and therefore have teeth. When there are teeth that occlude immobilization of the mandible must include intermaxillary fixation by wiring the teeth into occlusion. Interosseus wiring is used to support unstable fragments. Intramedullary Kirschner wires are a simple and effective method for immobilizing fractures through the body and symphysis of edentulous patients.