0:00

You.

0:01

Let's start by looking at this unfortunate

0:03

soul on the 3D reconstructions.

0:07

So this portion of the mandible pretty much is the synthesis

0:12

here. And you can see the little mental nerve foramen on either side.

0:16

This is the portion of the body of the mandible.

0:19

And in this individual, as you can see,

0:21

there is a fracture at the junction between the body

0:25

of the mandible and the angle of the mandible,

0:28

the angle being this portion right here.

0:30

So this fracture is displaced, as you can see,

0:33

in the AP dimension, as well as when we look at it

0:37

from underneath, you can see the distal fracture fragment,

0:41

or the superior fracture fragment is lateral to the

0:43

medial fracture fragment. In this individual,

0:46

who has lots and lots of fractures,

0:47

you see this going across the maxilla and as

0:50

well as across at the bridge of the nose,

0:52

I mean at the base of the nose, actually did not show a fracture

0:57

involving the other side of the mandible.

0:59

So this is the exception to the rule that the mandible is a ring structure.

1:03

It may be that because of the other fractures

1:06

taking off the pressure of the ring,

1:08

those fractures being across the maxilla,

1:11

that this patient did not have bilateral fractures.

1:14

On the axial scans,

1:15

we can see that displacement laterally of

1:18

the more superior fracture fragment.

1:22

And we also see that the inferior alveolar canal,

1:26

which is demonstrated here on the affected side and here on

1:31

the left side, is involved with the fracture right through here.

1:36

So it's likely that this patient's nerve that is

1:39

innervating the distal portion of the mandible and the teeth

1:42

here is going to lead to some decreased sensation.

1:46

Important to note that the mandibular

1:49

condyle and the neck is not fractured,

1:51

therefore less risk of potential avascular necrosis.

1:55

And we will also comment about the plane of the

1:58

fracture with respect to the molar teeth.

2:01

In this case,

2:03

you can see that it's beyond the existing molar teeth.

2:06

This patient has had some extraction of the wisdom teeth,

2:10

if you will.

Case: Displaced Mandibular Fracture at the Angle

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