Charalambous et al reported a clinical prediction rule for deciding if an X-ray is necessary to detect mandibular fracture. The authors are from Manchester Royal Infirmary.

Patient selection: mandibular trauma


Predictors of high-risk for mandibular fracture - any of the following:

(1) malocclusion

(2) trismus

(3) pain with mouth closed

(4) presence of broken teeth

(5) step deformity (on palpation)


If none of the predictors are present, then the risk of mandibular fracture is low and no X-ray is required.


Performance: sensitivity 100% for fracture, with specificity 39%

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