The Andy Gump Frcture of the Mandible

Airway Compromise in Mandibular Fracture

“…9 Fracture of the lingual cortex of mandibular symphysis region might cause vascular injury and it caused continuous hemorrhage into the floor of mouth. And then, flail mandible which is the bilateral condylar fracture and symphysis fracture, 10 so called Andy Gump fracture which is the bilateral body fractures of the elderly edentulous atrophic mandible, 11 and genial tubercle fracture type 2, 5,12 mechanically cause genioglossal and geniohyoid muscle retrusion, and it induced tongue and hyoid retrodisplacement into the pharynx. Case 1 showed genial tubercle fracture type 2.…”

“…All cases were communicated mandibular fracture included symphysis and para-symphysis region. Complex fracture of the mandibular symphysis region might cause airway compromise due to hemorrhage into the floor of mouth (eg, sublingual and submental arteries injury) 8,9 and the tongue and hyoid retrodisplacement into the pharynx, 5,[10][11][12] and mandibular fracture in patient taking a DOAC or warfarin might encourage pharyngeal airway obstruction. 6 Early endotracheal intubation was recommended even patient showed no dyspnea, to prevent pharyngeal airway obstruction because pharyngeal airway might cause airway obstruction at a few hours after injury.…”

Mandibular Fracture in a Patient Taking a Direct Oral Anticoagulant

“…7 fracture of the lingual cortex of the mandibular symphysis region might cause vascular injury and continuous hemorrhage into the floor of mouth. Also, (1) flail mandible, which is the bilateral condylar fracture and symphysis fracture, [8][9][10] (2) so-called ''Andy Gump fracture,'' which are bilateral body fractures of the elderly edentulous atrophic mandible, 11 and (3) genial tubercle fracture type 2 12 mechanically cause genioglossal and geniohyoid muscle retrusion, and induce tongue and hyoid retrodisplacement into the pharynx. 8 In this case, although the patient showed no dyspnea, the authors decided to perform endotracheal intubation before CT evaluation because (1) this mandibular fracture was caused by a high-velocity impact, (2) the patient was on a DOAC, and (3) the sublingual region showed a dark purple and slight swelling.…”

“…To conclude, the maxillofacial surgeon must know that (1) fractures of the mandibular symphysis region might cause airway compromise due to hemorrhage into the floor of the mouth (eg, sublingual and submental artery injury) 6 and mechanical reasons (eg, tongue and hyoid retrodisplacement into the pharynx), [8][9][10][11][12] and (2) mandibular fractures in patients on DOACs might cause pharyngeal airway obstruction. Early intubation is recommended to prevent pharyngeal airway obstruction.…”

“…A fracture of the lingual cortex of the mandibular symphysis region might cause vascular injury and continuous hemorrhage into the floor of mouth. Also, (1) flail mandible, which is the bilateral condylar fracture and symphysis fracture, 8–10 (2) so-called “Andy Gump fracture,” which are bilateral body fractures of the elderly edentulous atrophic mandible, 11 and (3) genial tubercle fracture type 2 12 mechanically cause genioglossal and geniohyoid muscle retrusion, and induce tongue and hyoid retrodisplacement into the pharynx 8 …”