Genial Tubercle Avulsion in a Traumatic Mandibular Injury

Mandibular fractures represent a common consequence of high-energy facial trauma; however, avulsive fractures of the genial tubercle are exceedingly rare and sparsely documented in the literature. These injuries may be easily overlooked, particularly in polytrauma settings, despite their potential impact on airway function and mandibular stability. This report describes a unique case of combined midfacial and mandibular trauma, including an uncommon 2-cm avulsion fracture of the genial tubercle, following a motorcycle accident. A 22-year-old male presented to the emergency department after a motorcycle collision at approximately 50 km/hour. Initial evaluation revealed abrasions, intraoral lacerations, and mild left periorbital swelling. CT imaging demonstrated fractures of the anterior wall of the left maxillary sinus and the left orbital floor, a mandibular symphyseal fracture extending from #33 to #43, and a rare avulsive fracture of the genial tubercle associated with sublingual emphysema. Ophthalmologic, otolaryngologic, and neurosurgical examinations revealed no functional deficits or intracranial pathology. The patient received tetanus prophylaxis, systemic antibiotics, corticosteroids, and topical ophthalmic therapy. Surgical management included open reduction and internal fixation of the symphyseal fracture with two 2.0-mm four-hole plates under general anesthesia, preceded by stabilization with an Essig-type arch bar. Postoperative recovery was uneventful, and follow-up examinations confirmed satisfactory occlusion, stable fixation, and progressive healing. The Essig splint was removed six weeks after surgery. Long-term follow-up at three years confirmed radiographic stability of the genial tubercle fragment without secondary displacement or resorption, and the patient remained asymptomatic. This case highlights an exceptionally rare traumatic injury pattern involving an avulsive fracture of the genial tubercle. Early identification, appropriate imaging, and timely interdisciplinary assessment are essential for optimal management. This report adds to the limited literature on genial tubercle fractures and underscores the importance of maintaining clinical suspicion in anterior mandibular trauma.