The Mandibular Fracture Score is a numeric scoring system which gives an objective and standardized assessment for the severity of a mandibular fracture. The score was developed at the University of Munster in Germany.
Parameters used for score:
(1) preoperative
(1a) anatomic location
(1b) amount of displacement
(1c) complex fractures
(1d) systemic factors
(2) intraoperative
(2a) difficult positioning and reduction
(2b) undefined occlusion
(2c) difficult soft tissue coverage
|
Parameter |
Finding |
Points |
|---|---|---|
|
anatomic location |
symphysis |
0 |
|
|
premolar region |
1 |
|
|
molar region |
2 |
|
|
angle |
3 |
|
|
ramus |
3 |
|
amount of displacement |
none |
0 |
|
|
minor |
1 |
|
|
marked |
2 |
|
complex fractures |
none |
0 |
|
|
minor |
1 |
|
|
marked |
2 |
|
systemic factors |
none |
0 |
|
|
one or more present |
2 |
|
difficult repositioning and reduction |
none |
0 |
|
|
minor |
1 |
|
|
marked |
2 |
|
undefined occlusion |
none |
0 |
|
|
minor |
1 |
|
|
marked |
2 |
|
difficult soft tissue coverage |
none |
0 |
|
|
minor |
1 |
|
|
marked |
2 |
Systemic factors:
(1) history of seizure disorders
(2) psychiatric diagnoses
(3) abnormal calcium metabolism
(4) poor oral hygiene
(5) immunodeficiency
(6) severe malnutrition
(7) significant metabolic or endocrine abnormality
mandibular fracture score =
= SUM(points for the 7 parameters)
Multiple fractures:
(1) Each fracture is scored individually.
(2) My assumption in the implementation is that the points for systemic factors is added to each score.
(3) Each of these scores is then added together to give a cumulative score.
Interpretation:
• minimal score for a single fracture: 0
• maximum score for a single fracture: 15
• The higher the score, the more severe the fracture.
Complications seen after fracture:
(1) malocclusion
(2) infection
(3) disturbed wound healing
(4) fifth nerve dysfunction
(5) temporomandibular joint complications
From Figure 3, the estimated rate of complications:
|
Score |
Rate of Complications |
|---|---|
|
0 to 4 |
2 out of 15 (about 1 in7 = 14%) |
|
5 to 9 |
4 out of 28 (about 1 in 7 = 14%) |
|
10 to 14 |
13 out of 27 (about 1 in 2 = 50%) |
|
>= 15 |
2 out of 3 (66%) |
Purpose: To use the mandibular fracture score to objectively evaluate the severity of a mandibular fracture.
Specialty: Otolaryngology, Emergency Medicine, Surgery, general
Objective: severity, prognosis, stage
ICD-10: S02.6,
