A Guardsman’s fracture is where there is a fracture of the symphysis and both condyles. This is due to a fall with impact on the midpoint of the chin.
Management
Favourable fractures are held in alignment.
Unfavourable fracture are displaced by the muscles pulling them.
Mandibular fractures of the body or angle of the mandible can be managed conservatively, unless they are displaced, in which case reduction and internal fixation may be required.
Condylar fractures are usually managed conservatively, unless there is occlusion of normal movement due to dislocation of the condylar head.
If you want to test yourself then Norwich Image Interpretation Course has a great online facial x-ray quiz.
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About Tessa Davis
Tessa Davis is a Consultant in Paediatric Emergency Medicine at the Royal London Hospital and a Senior Lecturer at Queen Mary University of London.
Author: Tessa DavisTessa Davis is a Consultant in Paediatric Emergency Medicine at the Royal London Hospital and a Senior Lecturer at Queen Mary University of London.
Mandible x-rays
Tags: condylar process, coronoid, guardsman, mandible
Tessa Davis. Mandible x-rays, Don't Forget the Bubbles, 2016. Available at:
https://doi.org/10.31440/DFTB.10597
An orthopantomogram (OPG) is a good view to demonstrate most mandibular fractures.
Image from Image Interpretation
A PA mandible shows the displacement of fractures. It also demonstrates symphysis menti fractures which can be missed on the OPG.
Image from WikiRadiography
If an OPG cannot be obtained, a lateral view can be helpful. The body and ramus can be viewed along with the TMJ articulation.
Image from WikiRadiography
Know your anatomy
Image from WikiRadiography
Follow the line of the mandible.
Look at the condylar and coronoid process, rami and body, submental symphysis, and alveolar ridge for fractures
By Frank Gaillard, via Wikimedia Commons
By Coronation Dental Specialty Group [1] [CC BY 3.0 , via Wikimedia Commons
Management
If you want to test yourself then Norwich Image Interpretation Course has a great online facial x-ray quiz.
About Tessa Davis
View all posts by Tessa Davis | Website