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Overview

What is a broken jaw (mandibular fracture)?

A broken jaw (mandibular fracture) is the second most common facial fracture in sports

because of the anterior location on the skull. The mandible is the jawbone. Because the

mandible is exposed and not covered by most protective devices, it is susceptible to injury.

Symptoms

What are the signs and symptoms of a broken jaw?

The mandible usually fractures in more than one place and occurs on opposite sides of the

midline of the jaw. These fractures can either be displaced (more severe with bone ends

separated and moved apart) or nondisplaced (bone ends aligned).

The signs and symptoms of a displaced broken jaw include:

Gross deformity

Malocclusion (teeth do not align when jaw is closed)

Oral bleeding

Paresthesia or anesthesia of lower lip andchin

Changes in speech

Swelling

Bruising to the floor of the mouth

Mucous membrane tears

The signs and symptoms of a nondisplaced broken jaw include:

Oral bleeding oozing between the teeth

Point tenderness over the fracture site

Pain on opening and closing the jaw

Swelling

Discoloration

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Causes

Who gets a broken jaw?

A broken jaw is most often caused by a blow to the lower jaw from sports equipment (hockeystick, bat). Because of the length of a hockey stick and/or bat, it does not take as much force

from the opponent swinging the equipment to create enough force to fracture the jawbone.

Mountain biking is another sport with a high incidence of facial fractures. This type of injury

occurs when the athlete goes over the handlebars and falls directly onto the lower jaw or chin

hitting a hard surface.

Fighting sports in which direct blows are delivered as part of the sport (boxing, mixed martial

arts) also have a high incidence of jawbone fractures.

Treatment

What is the immediate treatment for a broken jaw?

If a broken jaw is suspected, emergency services should immediately be called. Initial

treatment should be focused on maintaining an open airway with the athlete in a sitting

position with the athletes hands supporting the lower jaw. This position will allow the blood

to flow forward and out of the mouth rather than back into the throat.

Because the amount of force required to fracture the mandible is significant, care must be

taken to evaluate the athlete for possible concussion and/or brain injury also.

To determine if the athlete has any signs and symptoms ofconcussion, check for the

following:

Dizziness

Headache

Confusion Nausea

Ringing in the ears

Inability to answer simple questions

If any of the above symptoms are present, assume that the athlete may also have a

concussion. An unconscious athlete or an athlete with a suspected concussion should be

placed on their side with head tilt and jaw support after the mouth has been cleared of any

broken or dislodged teeth.

The jaw can be immobilized using an ace bandage or roller gauze but care must be taken to

ensure that the jaw is not displaced posteriorly which may compromise the airway. Thebandages can be wrapped under the chin and over the top of the head.

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A crushed ice pack can be applied to the area to reduce the amount of swelling. However,

care must be taken that the weight of the ice pack does not displace the fracture.

More Information: Read aboutsports injury treatment using the P.R.I.C.E. principle-

Protection, Rest, Icing, Compression, Elevation.

Is surgery needed to repair a broken jaw?

If the athlete has sustained a nondisplaced jawbone fracture, the healing can be managed

conservatively with analgesia and rest. To allow the fracture to heal properly, the athlete

should only eat soft foods for up to four weeks or as long as recommended by the treating

physician.

Most displaced jawbone fractures will require closed reduction and internal fixation for four

to six weeks. While the athletes jaw is wired shut, the athlete should be consuming high -

protein, high-carbohydrate liquid diets. It is normal for an athlete to lose between 5% and

10% of his/her body weight during this time. If there is concern about the amount of weightlost, the athlete should consult with a nutritionist.

When is it safe to return to sports after a broken jaw?

Light activities such as stationary cycling, walking, and light resistance exercises can be

performed during the time of fixation to maintain muscle tone. Care should be taken not to

increase the heart rate to a level where increased oxygen is needed for the muscles because

the athlete is only able to breathe through his/her nose and not able to breathe through his/her

mouth to increase the oxygen uptake. It is recommended that the athlete should not return to

contact or collision sports until one to two months after the jaw is unwired.

If you suspect that you have a broken jaw (mandibular fracture), it is critical to seek the

urgent consultation of a local sports injuries doctor for appropriate care. To locate a top

doctor or physical therapist in your area, please visit ourFind a Sports Medicine Doctor or

Physical Therapist Near You section.

Related Articles

Broken Nose (Nasal Fracture)

Subdural Hematoma

Orbital Blowout FractureTraumatic Brain Injury (TBI)

References

Anderson, M.K., Hall, S.J., & Martin, M. (2009). Foundations of Athletic Training:

Prevention, Assessment, and Management. (3rd Ed). Lippincott Williams & Wilkins:

Philadelphia, PA

Bahr, R., & Maehlum S. (2004). Clinical Guide to Sports Injuries. Human Kinetics:

Champaign, IL.

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Assessment & management of facial trauma injuries

Facial trauma can present some of the most challenging injuries that prehospital care

providers are called on to manage. Although most injuries to the face arent life-threatening,

some may compromise the patients airway or result in significant hemorrhage requiring the

providers immediate attention.

Facial trauma may also be associated with other injuries that place the patients life in

jeopardy. Finally, these injuries may be disfiguring, which may distract the novice provider

from recognizing and addressing more serious conditions.

Mechanisms of InjuryAlthough injuries to the face are mostly the result of blunt trauma, they may also result from

penetrating trauma. The most common causes of blunt trauma to the face are motor vehicle

crashes and assaults. During a crash, an occupant may strike their face on hard surfaces inside

the vehicle, such as the steering wheel, dashboard or windshield, or on the roadway if theyreejected from the vehicle.

Assaults, another common cause of injuries, occur when the face is punched by a fist or

struck by an object. A minority of these injuries result from stab, gunshot or shotgun wounds.

Assessment: Primary SurveyThe primary survey is a rapid assessment of vital functions to identify life-threatening

conditions. The typical approach for performing the primary survey is through the standard

ABCsairway, breathing and circulationdisability and exposure (A-B-C-D-E).

Airway & breathing: The primary survey begins with an assessment of airway patency. Whenthe provider first sees the patient, numerous clues may point toward an inadequate airway.

When lying in a supine position, an unconscious patient is at risk for airway obstruction from

the tongue as it relaxes and falls back to block the airway. Noisy breathing, namely gurgling

or high-pitched noises, indicates partial airway obstruction. The airway may be compromise