Presentation
Syncope with headstrike.
Patient Data
There is a fracture of the left mandibular condyle. The temporomandibular joint is dislocated. No further fracture is identified. The maxillary sinuses are clear.
There is a significantly displaced and angulated fracture through the neck of the left condylar process of the mandible with the condylar head dislocated from the mandibular fossa and tilted almost 90 degrees medially. There is a non-displaced fracture that extends through the body of the mandible anteriorly between the lower right central and lower right lateral incisors. The fracture line passes inferolaterally with probable cortical breach demonstrated at the inferior margin of the body of the mandible. No other mandibular fracture identified. The right temporomandibular joint is enlocated. Elsewhere, no other fracture identified.
Case Discussion
As a closed ring, it is uncommon to injury (fracture and/or dislocation) the mandible in only one location. As such, when only one injury is identified, close scrutiny should be made to the rest of the ring to locate any other injuries.
In this case there is the obvious left condylar fracture-dislocation, with the right mental fracture only apparent on CT.
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