Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents following blunt force trauma to the lower face. Reports localized pain at the mandibular angle, exacerbated by jaw movement and mastication. Patient notes malocclusion, trismus, and subjective numbness of the lower lip/chin. No history of loss of consciousness or airway compromise.
Clinical Examination Findings
Extraoral: Significant swelling and ecchymosis noted at the left/right mandibular angle. Tenderness on palpation with palpable step-off deformity. Intraoral: Malocclusion present with premature contact. Gingival laceration noted at the retromolar trigone. Positive for lingual nerve paresthesia. Bimanual manipulation reveals abnormal mobility of the mandibular segment.
Treatment Protocol
Immediate management includes stabilization of the mandible with a Barton bandage or maxillomandibular fixation (MMF). Patient referred for urgent CT maxillofacial imaging. Surgical plan: Open reduction and internal fixation (ORIF) via intraoral approach using titanium mini-plates. Prophylactic antibiotics and analgesics prescribed.