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Guardsman fracture

Case contributed by Craig Hacking
Diagnosis certain

Presentation

Fall onto chin

Patient Data

Age: 15-20 years
Gender: Male
ct

Bilateral fractures of the mandibular condylar head and neck are present. Both fractures are comminuted, with inferior displacement of the largest bony fragments. The articular fragments are anteriorly dislocated. Soft tissue swelling and locules of emphysema surround the fractures. A minimally displaced fracture is also seen in the tympanic part of the right temporal bone, in the anterior wall and floor of the bony external acoustic meatus. Blood density material is seen in the left external acoustic meatus. The ossicular chains are intact bilaterally. Deviated nasal septum. No orbital fracture is identified.

Conclusion

Bilateral comminuted fracture/dislocations of the mandibular condyles - Guardsman fractures

Fracture of the tympanic segment of the right temporal bone.

Case Discussion

Theses fractures are known as Guardsman or parade ground fractures as they classically occur in guards or soldiers that fall forwards onto the chin following syncope.

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