Bilateral Mandibular Fractures

September 1, 2005
Richard Schell, MD
Richard Schell, MD

A 20-year-old man sustained a 2- to 3-cm soft-tissue laceration in the middle of the chin when he fell, face forward, onto pavement.

A 20-year-old man sustained a 2- to 3-cm soft-tissue laceration in the middle of the chin when he fell, face forward, onto pavement. He reported left preauricular pain with limited opening of his mouth and a change from his normal bite. Examination showed a mild anterior open bite and limited opening. A mandibular film series, consisting of anteroposterior, lateral right (A), left lateral oblique (B), and reverse Towne's (C) views, demonstrated a left subcondylar fracture. Because of the type of fall and resulting soft-tissue injuries, a panoramic radiograph was obtained (D). The film demonstrated a bilateral fracture.

A direct anterior blow often results in bilateral subcondylar fractures with midline soft-tissue damage and anterior open bite, as was found in this case. The lacerations were closed, and elastic intermaxillary fixation was carried out on the fractures. The patient subsequently had good occlusion and full range of motion.