Managing mandible fractures requires more than textbook knowledge. It requires sound clinical judgment, careful evaluation, and an understanding of how treatment decisions impact outcomes. In this episode of the Everyday Oral Surgery Podcast, Dr. Grant Stucki welcomes back Dr. Andrew Jenzer, oral and maxillofacial surgeon, to continue their trauma series with an in-depth discussion on facial fractures. Dr. Jenzer breaks down the fundamentals that guide clinical decision-making, starting with how bone healing is influenced by fixation and mobility, and why minimizing movement is key to predictable outcomes. He walks through essential fracture terminology, zones of tension and compression, and the physical exam findings that should never be missed, including the importance of identifying a patient’s pre-injury occlusion. The conversation also explores imaging strategies, timing considerations, and how to approach treatment planning, from observation to closed reduction, or open reduction with internal fixation. Along the way, Dr. Jenzer shares practical insights, common pitfalls, and real-world considerations that go beyond textbook learning. This episode connects core principles to real-world surgical practice and offers a clear framework for approaching mandible fractures with confidence! Key Points From This Episode: Primary and secondary bone healing and how fixation affects outcomes.Why minimizing mobility improves fracture healing success.Mandible fracture terms: simple, compound, comminuted, green stick, and pathologic.Muscle-related fracture terms: favorable, unfavorable, horizontal, and vertical.Zones of tension and compression and their clinical relevance.Physical exam findings: loss of function, malocclusion, and nerve changes.The importance of identifying the patient’s pre-injury occlusion.Imaging and clinical considerations for a thorough evaluation.When to escalate patients to the ER for full trauma evaluation.Three treatment paths: observe, closed reduction, or open reduction with internal fixation (ORIF).How patient factors and compliance shape treatment decisions.Closed reduction and Maxillomandibular fixation (MMF) options: arch bars, intermaxillary fixation (IMF) screws, Minne Ties, bridal wire, manual stabilization, and hybrid systems.Navigating trade-offs between efficiency, stability, and patient comfort.The advantages of ORIF for stability and faster recovery.Evaluation and management of condylar fractures, including surgical indications.Why coronoid fractures rarely require treatment.Ramus and angle fractures: approach and fixation options.Champy technique benefits, limitations, and the role of patient compliance.Ladder plates as a stronger, more reliable alternative to the Champy technique.How to approach decision-making for teeth in the line of fracture.Dr. Jenzer’s step-by-step approach to fracture exposure, reduction, and fixation.Navigating complications of healing mandible fractures, including malunion, nonunion, and infection.Links Mentioned in Today’s Episode: Dr. Andrew Jenzer — https://surgery.duke.edu/profile/andrew-clark-jenzer Dr. Andrew Jenzer Email Address — andrew.jenzer@gmail.com Everyday Oral Surgery Website — https://www.everydayoralsurgery.com/ Everyday Oral Surgery on Instagram — https://www.instagram.com/everydayoralsurgery/ Everyday Oral Surgery on Facebook — https://www.facebook.com/EverydayOralSurgery/ Dr. Grant Stucki