Impacted Mandibular Fracture: A Report of a Rare Case

Representing unusual fracture patterns is extremely important to understand. A 27-year-old male patient with a known history of a road traffic accident with sustained injury reported to the Department of Oral and Maxillofacial Surgery in Saveetha Dental College with pain in the left and right lower jaw region of three days duration. The patient provided a history of frontal impact in the symphysis region after a fall from a two-wheel vehicle. Clinical examination revealed a laceration of 2 cm in the chin region with bilateral pre-auricular swelling and trismus with an anterior open bite. The computed tomography scan revealed a bilateral dicapitular condyle fracture with an oblique impacted fracture of the symphysis with a displaced inferior border and left lingual cortical displacement. Apart from this, an incomplete fracture was evidenced, extending along the inferior border to the right body of the mandible. The fracture site was exposed through the laceration. The impacted mandibular fracture segments were mobilized and fixation was done using a 2 mm five-hole plate at the lower border across the sagittally split segment after placement of maxillomandibular fixation with an arch bar at the alveolar border as a part of tension banding. The oblique lingual fracture was reduced and fixed with a 2 x 14 mm bicortical screw. The primary objective of the current case report is to elucidate an unusual fracture of the mandible and discuss the management of such impacted mandibular fractures.