title: Lateral pterygoid plate fractures associated with mandible fractures.
abstract: OBJECTIVE
  Classically, pterygoid plate fractures have been associated with fractures of the mid-face and skull base. When isolated pterygoid plate fractures are identified on imaging that only extends to the level of the skull base, other related facial fractures may be missed. We sought to evaluate isolated lateral pterygoid plate fractures on computed tomography (CT) scans in conjunction with mandible fractures and to propose a mechanism of fracture unrelated to the classic dissociating mid-face Le Fort fractures.
  
  
  METHODS
  In this retrospective case series, 7 patients who sustained facial trauma from 2006 to 2012 were found to have isolated lateral pterygoid plate fractures. All patients had an ipsilateral subcondylar fracture, 2 had symphyseal fracture, 2 had body fracture, and 1 had coronoid fracture.
  
  
  CONCLUSIONS
  On the basis of these cases, isolated lateral pterygoid fractures noted on CT of the head may be suggestive of an unappreciated mandibular fracture. The suspected mechanism is due to force transduction through the medial and lateral pterygoid muscles when acute displacing force is placed on the mandible. In patients with identified isolated pterygoid plate factures, a dedicated CT of the mandible may be indicated to assess for associated mandibular fracture, even in patients whose clinical examinations have had negative results.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of California-Davis Medical Center, Sacramento.
authors.forename: Anh Q
authors.initials: AQ
authors.lastname: Truong
authors.affiliation: medical student at University of California School of Medicine, Sacramento3Department of Medical Education, University of California-Davis Medical Center, Sacramento.
authors.forename: Daniel C
authors.initials: DC
authors.lastname: O'Brien
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of California-Davis Medical Center, Sacramento.
authors.forename: E Bradley
authors.initials: EB
authors.lastname: Strong
authors.affiliation: Department of Radiology, University of California-Davis Medical Center, Sacramento.
authors.forename: Arthur
authors.initials: A
authors.lastname: Dublin
mesh_terms: D000328:Adult; D006801:Humans; D008297:Male; D008337:Mandibular Fractures / Q000000981:diagnostic imaging* / Q000601:surgery; D008875:Middle Aged; D056739:Pterygopalatine Fossa / Q000000981:diagnostic imaging* / Q000293:injuries* / Q000601:surgery; D012887:Skull Fractures / Q000000981:diagnostic imaging* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D055815:Young Adult