Failed closed reduction of a bifocal mandibular fracture because of dislocation of the mandibular ramus behind the styloid: case report

We present an unusual dislocation of the mandibular ramus after a low condylar fracture associated with a fracture of the opposite body of mandible. As closed reduction failed, both fracture sites were exposed. The mandibular ramus was dislocated behind the styloid process, which was not shown on the preoperative radiographs. The intermediate fragment was freed and the fractures treated by miniplate osteosynthesis. The patient made an uneventful recovery with no residual deformity.