When describing these injuries, one should probably give a separate diagnosis to each half of the face. In these injuries, severe comminution of the face is present, and underlying skull injury is likely. These patients are often in unstable condition with associated axial and appendicular skeletal injuries as well. This category includes several varieties of otherwise unclassifiable fractures, which are named for the portion of the face primarily involved. CT is mandatory for adequately displaying all of the bony and soft tissue components of these injuries.
Bilateral symmetry can be very helpful.
Carefully trace along the lines of Dolan. Use CT liberally in working up facial fractures. The mandible is another commonly fractured bone in the head, and most of these fractures are obvious on clinical exam. Clinical findings include facial distortion, malocclusion of the teeth, or abnormal mobility of portions of the mandible or teeth. You can experiment with this tendency of ring bones to break in more than one place by going through a bag of pretzels and trying to break one of them in just one place.