21451 Closed treatment of mandibular fracture; with manipulation

Name of the Procedure:

Closed Treatment of Mandibular Fracture; with Manipulation
Common name(s): Closed reduction of broken jaw

Summary

This procedure involves the non-surgical realignment (manipulation) of a fractured mandible (lower jaw) to ensure proper healing. It is performed through external manipulation without making surgical incisions.

Purpose

The procedure aims to address broken or misaligned lower jawbones. The goal is to realign the jaw to facilitate natural healing, restore normal function (like chewing and speaking), and alleviate pain.

Indications

• Visible misalignment of the jaw.
• Difficulty in opening or moving the mouth.
• Pain, swelling, or bruising around the jaw area.
• Diagnosed mandibular fracture via X-ray or CT scan.
• Malocclusion (improper bite) due to jaw fracture.

Preparation

• Patient may need to fast for a few hours if sedation or anesthesia is used.
• Adjustments to medications may be required, particularly blood thinners.
• Pre-procedure evaluations such as physical exams and imaging studies (X-ray, CT scan).

Procedure Description

1. Patient is positioned comfortably and sedated or given local anesthesia to numb the area.
2. The healthcare provider uses external manipulation techniques to realign the fractured bone.
3. Once aligned, the jaw may be stabilized using a bandage, splint, or other supportive devices.
4. Imaging may be performed post-manipulation to confirm proper alignment.

Duration

The procedure typically takes about 30 minutes to 1 hour, depending on the complexity of the fracture.

Setting

This procedure is usually performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Oral and maxillofacial surgeons or trained dental professionals.
• Nurses or medical assistants.
• Anesthesiologists if general anesthesia or sedation is used.

Risks and Complications

• Infection.
• Improper alignment or re-fracture.
• Difficulty in jaw movement.
• Nerve damage leading to numbness or tingling.
• Complications from anesthesia.

Benefits

• Proper jaw alignment.
• Pain relief.
• Restoration of normal mouth function.
• Potential for faster healing compared to untreated fractures.

Recovery

• Soft or liquid diet to avoid stressing the jaw.
• Pain management with prescribed medications.
• Avoiding strenuous activities for a few weeks.
• Follow-up appointments for monitoring healing progress.
• Adherence to post-procedure care instructions for optimal recovery.

Alternatives

• Open reduction and internal fixation (surgical repair).
• Conservative management with immobilization without manipulation. Pros and cons: Surgical options might offer precise alignment but come with increased risks and recovery time. Conservative management might be less invasive but could lead to suboptimal healing if alignment is poor.

Patient Experience

• During the procedure: Minimal discomfort due to anesthesia; some pressure might be felt.
• After the procedure: Pain or discomfort, managed with medication; restricted jaw movement; requirement for a modified diet. Pain management and comfort measures: Prescriptive pain relief, cold packs to reduce swelling, and soft diet recommendations for comfort.