Mandible fractures are the most common indication for surgical repair of facial fractures, and their management continues to evolve with modern plating systems and imaging.

In this episode of Plastics in Practice, we break down the key anatomy, causes, diagnostic pearls, and surgical strategies you need to know for the boards and the operating room.

We start with the anatomy of the mandible — from condyle to symphysis — and review the opposing muscle forces that make fracture management so challenging . Then we dive into epidemiology: in the U.S., interpersonal violence dominates, while motor vehicle collisions are more common worldwide .

From there, we walk through preoperative evaluation and imaging, emphasizing the role of CT over panoramic radiographs for detecting posterior fractures. We also cover timing of repair, antibiotic prophylaxis, and surgical principles: restoring occlusion, rigid vs. functional fixation, and key approaches to angle, symphysis, bilateral, condylar, comminuted, and edentulous fractures.

• Mandible fractures occur most often in men 25–34, usually from assaults or MVCs.

• CT is the gold standard for imaging.

• Early repair is ideal, but delays >72h don’t significantly raise infection risk.

• Antibiotics are recommended, but evidence for type/duration remains weak.

• Surgical principle: restore occlusion + stable fixation, tailored to fracture site.

  
  

📚 References:Morrow BT, Samson TD, Schubert W, Mackay DR. Evidence-Based Medicine: Mandible Fractures. Plast Reconstr Surg. 2014;134(6):1381–1390. doi:10.1097/PRS.0000000000000717

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