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# Mandible fracture

A [mandible](https://durgical.com/en/anatomy/mandible/) fracture is a break of the lower jaw, often in two places because the jaw forms a ring with its two joints; it is a common facial fracture.

Updated 2026-10-29

## Structures involved

Tap one to see what it is and open it in 3D.

- [Mandible](https://durgical.com/en/anatomy/mandible/)
- [TMJ capsule](https://durgical.com/en/anatomy/temporomandibular-joint/)
- [TMJ disc](https://durgical.com/en/anatomy/articular-disc-of-temporomandibular-joint/)
- [Inferior alveolar nerve](https://durgical.com/en/anatomy/inferior-alveolar-nerve/)
- [Mental foramen](https://durgical.com/en/anatomy/mental-foramen/)
- [Masseter](https://durgical.com/en/anatomy/superficial-part-of-masseter/)

## What it is

Break of the mandible (lower jaw), often at more than one site because the bone forms a ring with the two temporomandibular joints. It is one of the commonest facial fractures.

## Who gets it

Most frequent in young men. Interpersonal violence, road traffic accidents (including motorcycle crashes, common in Colombia), falls and sports are the main causes.

## Causes

- Assault and interpersonal violence
- Road traffic and motorcycle accidents
- Falls
- Sports injuries
- Pathological fractures (cysts, tumours, osteonecrosis, atrophic jaw)

## Risk factors

- Young male sex
- Alcohol use
- Not wearing a helmet
- Contact sports without a mouthguard
- Impacted third molars and an atrophic jaw in older adults

## Pathophysiology

Force applied to one point of the jaw ring often fractures the opposite side too, typically a body or angle fracture plus a contralateral condyle. The pull of the masticatory muscles displaces the fragments, causing malocclusion. Fractures through the tooth-bearing area are open to the mouth and can become infected.

## Classification

- By site: symphysis or parasymphysis, body, angle, ramus, condyle, coronoid, alveolar process
- Single or multiple; open or closed
- Favourable or unfavourable according to muscle pull
- Comminuted

## Symptoms and signs

- Pain and swelling of the jaw
- Malocclusion: the teeth no longer meet normally
- Trismus or pain opening the mouth
- Numbness of the lower lip and chin ([inferior alveolar nerve](https://durgical.com/en/anatomy/inferior-alveolar-nerve/))
- Step deformity, mobile segment or loose teeth
- Bleeding in the mouth, sublingual haematoma
- Deviation of the jaw on opening (condylar fracture)

## Red flags

- Airway compromise: bilateral parasymphyseal fracture ([tongue](https://durgical.com/en/anatomy/tongue/) falls back), bleeding, swelling of the floor of the mouth
- Associated head or cervical spine injury
- Signs of infection: fever, pus, increasing swelling
- Missing teeth that may have been aspirated

## Diagnosis

**Clinical**
Airway, breathing and circulation first, with cervical [spine](https://durgical.com/en/anatomy/region/spine/) protection. Then occlusion, step deformities, mobility, sublingual haematoma and lip sensation are examined.

**Tests**
No specific laboratory tests; preoperative tests as needed. [Chest](https://durgical.com/en/anatomy/region/chest/) X-ray if a tooth may have been inhaled.

**Imaging**
Panoramic radiograph (orthopantomogram) shows most fractures. CT of the face is preferred for condylar, comminuted or multiple facial fractures and in polytrauma.

## Differential diagnosis

- [Temporomandibular joint](https://durgical.com/en/anatomy/temporomandibular-joint/) dislocation
- Dental or alveolar fracture alone
- Soft tissue contusion
- Temporomandibular joint haemarthrosis
- Other facial fractures (zygomatic complex)

## Goal of treatment

Secure the airway, restore normal occlusion and jaw function, achieve bone healing and prevent infection and nerve damage.

## Treatment

**Acute**
Airway control, bleeding control and trauma assessment, with cervical spine protection.

**Medical**
Antibiotics for open (tooth-bearing) fractures, analgesia and chlorhexidine-class mouth rinses.

**Conservative**
Non-displaced fractures with normal occlusion, and many condylar fractures: soft diet and close follow-up, sometimes with short intermaxillary fixation and elastics.

**Surgical**
Open reduction and internal fixation with plates and screws for displaced fractures; closed reduction with intermaxillary fixation in selected cases.

**Rehabilitation**
Jaw opening exercises and physiotherapy after immobilisation to restore movement.

## Complications

- Malocclusion and malunion
- Infection and osteomyelitis
- Non-union
- Numbness of the lip and chin (inferior alveolar nerve injury)
- Temporomandibular joint ankylosis after condylar fractures, especially in children
- Tooth loss

## Prognosis

Most fractures heal well within about six weeks with correct reduction and fixation. Smoking, infection, poor oral hygiene and delayed treatment raise complication rates.

## Prevention

- Helmets for motorcycles and bicycles, seat belts
- Mouthguards in contact sports
- Violence prevention and reducing alcohol misuse

## Test yourself

Think of the answer, then tap the question to see it.

## Why are mandible fractures often found at two sites?

The mandible and its two joints form a ring, so a blow to one side often also breaks the opposite side, often the condyle.

## Which sign is the most sensitive clinical indicator of a mandible fracture?

Malocclusion: the patient's teeth no longer meet normally.

## Which nerve injury causes numbness of the lower lip after a mandible fracture?

Injury to the inferior alveolar nerve in its canal, which ends as the mental nerve.

## Which mandible fracture pattern can obstruct the airway?

Bilateral parasymphyseal fractures, which let the tongue fall back.

## What is the standard screening radiograph for mandible fractures?

The panoramic radiograph (orthopantomogram); CT is used for condylar or complex fractures.

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## Related conditions

- [Traumatic brain injury](https://durgical.com/en/conditions/traumatic-brain-injury/)
- [Spinal cord injury](https://durgical.com/en/conditions/spinal-cord-injury/)
- [Orbital floor (blowout) fracture](https://durgical.com/en/conditions/orbital-floor-fracture/)
- [Temporomandibular disorder](https://durgical.com/en/conditions/temporomandibular-disorder/)

Educational information, not medical advice. For any symptom, see a health professional.

Sources: [Mandible Fracture](https://www.ncbi.nlm.nih.gov/books/NBK507705/) (StatPearls (NCBI Bookshelf), 2023).

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Source: https://durgical.com/en/conditions/mandible-fracture/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/conditions/mandible-fracture/