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Resident Manual of Trauma to the Face, Head, and Neck
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Chapter 5: Mandibular Trauma
Table 5.1. Descriptors Regarding the Severity and Displacement of
Mandibular Fractures
Fracture Terminology
Fracture Description
Compound or open fractures
Exposed to contaminated oral secretions
usually involving erupted teeth.
Simple or closed fractures
Not exposed to oral secretions; usually
nontooth-bearing bone.
Favorable fracture
Not distracted by muscle pull; requires less
fixation.
Unfavorable fracture
Distracted by muscle pull; may require greater
fixation to resist muscle pull.
Comminuted fracture
Crushed, fragmented, or splintered.
Complicated or complex fracture Associated with significant injury to the
adjacent soft tissues.
Multiple fractures
Two or more noncommunicating fractures on
the same bone.
Indirect fracture
Located at a point not in alignment with or
distant from the site of injury.
Impacted fracture
One fragment is driven firmly into the other
fragment.
Greenstick fracture
One bony cortex is broken, and the other cortex
is bent.
Pathologic fracture
Occurs through bone weakened by preexisting
disease.
Atrophic fracture
From bone atrophy by loss of supporting
alveolar bone in edentulous mandibles.
A. Condyle Fractures
Condyle fractures are considered the most common fracture of the
mandible. They are divided into the head, neck, and subcondylar regions
(Figures 5.1 and 5.2).
Lindahl, Spiessl and Schroll, Krenkel, and Neff proposed complex
condyle fracture classifications.
10,11,13–15
Ellis et al. classified condylar
fractures as condylar head fracture (intracapsular fracture located at
the border between the condylar head and neck), condylar neck
fracture (located below the condylar head but on or above the lowest
point of the sigmoid notch), and condylar base fracture (the fracture
line isolated below the lowest point of the sigmoid notch).
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