This is a case of a 20 year old male I saw in the Emergency Room with jaw swelling and pain on chewing. A few hours before the consult, he went clubbing, got into a fight, and was punched in the jaw by the assailant.

A 3D facial CT scan was done revealing mandibular fractures in the symphysis (between the 2 central incisors) and the angle (behind the 3rd molar).

He was then scheduled for an operation: open reduction and internal fixation of mandibular fractures using titanium plates under general anesthesia.

On the left is a picture intraoperatively. This is an interdental wiring procedure, a first step in the reduction of the fractures used by an ear nose and throat doctor .

Above are pictures taken after the fractures were reduced and fixated with titanium plates and screws. Note that all incisions are intra-oral. The only external incision on the face was a 2 MILLIMETER incision on the right cheek where the trocar for the drill entering the mandibular angle was placed.

These are the xrays taken post operatively. There is a very thin line where the fracture is reduced . Note how the jaw is now back to its normal position.