A 40-year-old male patient presented with a history of falling while intoxicated. On examination, his face appeared asymmetrical with diffuse swelling on the right side and a reduced, painful mouth opening. Radiological investigations including an orthopantomogram and CT scan revealed a horizontally unfavorable fracture of the right mandibular body region and a displaced fracture of the left low condylar neck region. The treatment plan involved open reduction internal fixation of the right body fracture and closed reduction of the left condylar fracture.

1. Case presentation
A presentation by Dr. Abhijeet
Kamble

2. CASE HISTORY
• A 40 Year old Male patient reported with an alleged history of
Fall under the influence of Alcohol on 2-06-2023 at round 9:30
p.m.
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3. GENERAL
EXAMINATION
GENERAL PHYSICAL
EXAMINATION
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4. Extra Oral EXAMINATION
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 Face apparently Asymmetrical
 Diffuse swelling evident over
lower half of the face on the Right
side.
 Sutures insitu wrt Right temporo-
parietal Region
 Mouth opening : Reduced and
painful
 Mandibular movements :
Restricted.
INSPECTION

5. EXTRA ORAL EXAMINATION
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 Tenderness present wrt Right
body region of the mandible and
left Preauricular Region of the
mandible.
 No step deformity noted due to
presence of swelling seen wrt the
right body region of the mandible.
PALPATION

6. INTRA ORAL EXAMINATION
1 OCCLUSION
DERANGED
STEP DEFORMITY
2
RESTRICTED
MOUTH OPENING
35 mm
3
6
MIDLINE SHIFT
Tenderness on
palpation – lower right
buccal sulcus region

7. INVESTIGATION
S
ORTHOPANTOMOGRAM
The OPG findings are suggestive of –
- Horizontally Unfavorable Fracture of
the Right Body Region of the
mandible,
- Displaced Fracture Left Low Condylar
Neck Region of the mandible.
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8. 3D CT
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NCCT FACE
NCCT FACE
Radiological Investigations

9. DIAGNOSIS
- Horizontally
Unfavorable Fracture
Right Body region of
the mandible.
- Displaced
Fracture Left
Low Condylar
Neck Region of
the mandible.
?
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Based Upon Clinical and Radiological Findings :
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10. Treatment Planning
MANAGEMENT
 Horizontally Favorable Fracture Right Body
Region of the Mandible.
 Open Reduction Internal Fixation.
- Unfavorable fracture
- Contralateral Condylar fracture requiring
early mobilization
- Displaced fracture which cant be managed
by closed reduction.
 Displaced Fracture Left Low Condylar Neck
Region of the mandible.
- Closed Reduction,
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11. THANK YOU