Question:

A 28-year-old male presents status-post assault. He states he was struck in the face and jaw several times. He presents with blood in his mouth and with multiple loose teeth. Attached are images of his CT scan. What are his findings?

Answer:

This patient sustained bilateral mandibular fractures that are comminuted, displaced, and communicating with the oral cavity. The CT scan shows a vertical fracture on the right side of the mandible symphysis with mild anterior displacement of the right-side fragment. The second fracture is visualized in the left mandible at the angle with mild inferior displacement of the right-side fragment. There is significant soft tissue swelling in the region of fracture.

OMFS was consulted who placed an Erich Arch Bar over the maxillary and mandibular teeth, as shown in the Panorex.

The patient was taken to the OR by OMFS for an open reduction internal fixation of the right mandibular parasymphysis fracture, the left mandibular angle fracture, and extraction of teeth #1, #16, and #17. The patient was with left V3 hypoesthesia, as expected. He has been following a normal post-operative course. ■