An unusual case of sub-condylar bilateral fracture and bilateral post-traumatic temporomandibular ankylosis.
A case of bilateral sub-condylar fracture with wide stump dislocation associated with a central facial trauma, fracture-intrusion of the rhino-orbital-maxillary complex and a parasymphyseal mandibular fracture, is reported. After surgery and inter-maxillary fixation an unusual temporo-mandibular ankylosis developed. Maximum mouth opening, lateral and protrusive movements were severely limited. Surgical treatment of ankylosis was requested and performed. The originality of this case lies in the atypical lateral dislocation of condylar neck fractured stumps to the zygomatic arches and in the later appearance of ankylosis between the glenoid fossa, zygomatic arch, condylar neck stump, and the condylar process displaced anteromedially. The ankylosed blocks were resected, displaced condyles were also removed due to the strong adhesion with the ankylotic tissue and the lack of any anatomical continuity or connection with the glenoid fossa. Functional therapy allowed the resolution of the functional limitation.
Matteini
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Ospedale S. Andrea, II Facoltà di Medicina e Chirurgia, Università degli Studi La Sapienza, Rome, Italy. claudiomatteini@libero.it
Belli
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D000328:Adult; D000844:Ankylosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008335:Mandibular Condyle; D008337:Mandibular Fractures / Q000150:complications* / Q000601:surgery; D013705:Temporomandibular Joint Disorders / Q000209:etiology* / Q000601:surgery