Refracture of the mandible following stable internal fixation would be rare. A 28-years-old male patient was transferred to our emergency center due to fall caused by epilepsy seizure. Computed tomography (CT) showed left condylar base fracture with medial displacement and dislocation, and symphysis fracture. The fracture of condyle and symphysis were performed osteosynthesis with 2 mini-plates on ideal lines of osteosynthesis. The proximal segment of the condyle was placed totally three 7-mm-screws and 2 mini-plates. Six days after surgery, the patient transferred to our emergency center again due to fall by epileptic seizure. The patient drunk a lot of alcohol on the day before. CT indicated that left side fracture of condylar neck with medial displacement above the fixation plates, and no fracture of symphysis. The fracture line run on upper screw of posterior plate. The proximal segment of condyle could not be repositioned in the secondary surgery. The epilepsy patient following mandibular fracture might cause further epilepsy seizures. The risk factors of recurrence seizures should be evaluated including alcohol intake, less sleep and a history of noncompliance to anti-epileptic drugs.

Sport-related mandibular fracture is a common injury in the field of maxillofacial surgery. However, the treatment of mandibular condylar fractures in professional soccer goalkeepers is rarely reported. A 32-year-old male professional soccer goalkeeper was referred for malocclusion after collision with an opponent player during a game. The patient’s mandible was displaced between the left lower lateral incisor and left lower canine. Computed tomography showed right condylar base fracture with medial displacement and left para-symphysis fracture. Internal fixation using retromandibular anterior trans-parotid approach via 25-mm skin incision immediately below the earlobe and intraoral vestibular approach were performed under general anesthesia 2 days after the injury. The patient was discharged without complications 3 days after surgery, with mandibular protrusion and diduction exercises with limitation of mouth opening. Soft diet and limitation of mouth opening was performed for 4 weeks after surgery. To achieve early return-to-play, rehabilitation based on Fowell and Earls’ return-to-play guidelines following facial fractures was started, with moderate exercise 5 days after surgery, and progressively full exercise without contact 8 days after surgery. He started normal team training with individualized jaw-guard 4 weeks after surgery. His body weight decreased by 2.2 Kg 1 week after surgery, gradually recovered, and became normal 4 weeks after surgery. The patient returned to a game 2 months after surgery. This case report can be a reference case in condylar fractures of professional soccer players, as the available scientific literature is limited with regard to return-to-play after maxillofacial fracture in professional athletes.

No abstract