These are the most common mandibular fractures (B, Fig. 62-15). They are often undiagnosed, and are often bilateral.
The patient has pain, swelling, and tenderness over his temporomandibular joint on the injured side. He cannot move his jaw normally. Movement away from the injured side is particularly difficult. When he tries to move his jaw, it deviates towards the side of the fracture. His bite may or may not be normal and he occasionally bleeds from his ear.
All movements are painful and limited. Sometimes the patient’s bite is normal, or he may have an anterior open bite. Often he has a midline fracture also.
The mandibular condyles are difficult to X–ray, and need special views, so it is fortunate that X–rays are not essential. Management depends on whether or not the patient has an anterior open bite. If you fail to correct this, his molar teeth may later have to be ground away, so that his incisors can meet. If he has no teeth, an anterior open bite is less important, because it can be corrected with dentures.