December 1997

Mandibular Fracture and Associated Cervical Spine Fracture, a Rare and Predictable InjuryProtocol for Cervical Spine Evaluation and Review of 1382 Cases

Author Affiliations

From the Department of Otolaryngology—Head and Neck Surgery, Emory University School of Medicine, Atlanta, Ga.

Arch Otolaryngol Head Neck Surg. 1997;123(12):1304-1307. doi:10.1001/archotol.1997.01900120054008

Objectives:  To assess the relationship and incidence of cervical spine injuries in patients with mandibular fractures and to recommend an organized approach to cervical spine evaluation in these patients.

Design:  A retrospective review of medical records of all patients with mandibular fractures at a level I trauma hospital from 1984 through 1993. Patient demographics, injury, mechanism of injury, associated symptoms, physical presentation, and adjuvant radiographic evaluations were recorded.

Setting:  Level I,1000-bed, urban trauma center in Atlanta, Ga.

Results:  A total of 1382 patients with mandibular fractures were examined during the 10-year period of review. Cervical spine radiographs were obtained on 501 (36.3%) of these patients. From these radiographs, only 8 cervical spine fractures were found. All of the patients with cervical spine injuries (n=8) had other associated maxillofacial injuries (n=4), were involved in a motor vehicle accident (n=7), or sustained gunshot wounds (n=1).

Conclusions:  Judicious use of cervical spine radiographs in the appropriate setting of mandibular trauma is beneficial. However, clinical criteria should dictate rational use of radiographs, since the association between cervical spine injuries and mandibular trauma is rare and predictable.Arch Otolaryngol Head Neck Surg. 1997;123:1304-1307