Presentation
Alleged assault.
Patient Data
There is a right-sided spiral fracture through the condylar process of the mandible. On the left there is a transverse, undisplaced fracture through the condyle of the mandible.
The temporomandibular joint shows normal anatomical alignment on the left. On the right there is a degree of subluxation is present.
A fracture through the neck of the right mandibular condyle is displaced. An undisplaced fracture through the base of the left mandibular condyle extends to the coronoid process. The temporomandibular joints remains congruent.
Post-operative OPG. Plate and screw fixation of right spiral displaced condylar fracture. Transverse left mandibular fracture is unchanged.
Case Discussion
The mandible, like the bony pelvis, is considered a closed ring (with the other side of the ring being the base of skull) and if one fracture is seen a careful search for a second fracture or temporomandibular joint injury should be performed. Although it should be noted that multifocal fractures occur in 60% of cases (i.e. 40% of cases are unifocal).