1. Imaging Findings

Based on the provided coronal and axial CT images, there is a visible discontinuity of the bone structure in the left mandibular condylar region (suspected condylar neck/subcondylar area). A clear local fracture line is present, accompanied by medial displacement of the condyle, indicating a fracture in the left mandibular condylar region with some degree of displacement/subluxation. Compared with the opposite side, the left condyle shows abnormal positioning, namely a typical medial displacement, consistent with the pulling effect of the lateral pterygoid muscle. No obvious intracranial hemorrhage or other evident maxillofacial fractures are observed on the images (though further evaluation is recommended due to imaging range and slice thickness limitations).

2. Possible Diagnoses

1. Left Mandibular Condylar Neck/Subcondylar Fracture: Based on imaging and trauma history, this is the most likely diagnosis, also consistent with the patient’s facial pain, limited mouth closure, and trauma mechanism.
2. Fracture of the Mandibular Condyle (Condylar Head): Sometimes a condylar head fracture appears similar to a condylar neck fracture on imaging, but it is usually closer to the articular surface. Carefully review thin-slice CT or use 3D reconstruction to confirm. However, from the imaging findings and clinical description, a condylar neck or subcondylar fracture seems more likely.
3. Other Maxillofacial Bone or TMJ Structure Injury: Such as disc or ligament injury, fractures of other parts of the mandibular ramus, etc. These can typically be further ruled out with additional CT or MRI evaluations.

3. Final Diagnosis

Combining the patient’s trauma history, clinical symptoms, and CT imaging findings, the most likely final diagnosis is: Left Subcondylar Fracture of the Mandible (with Medial Displacement or Subluxation of the Condyle).

4. Treatment Plan and Rehabilitation

4.1 Treatment Strategy

• Conservative Treatment: Suitable for patients with mild displacement and acceptable occlusion. This typically involves elastic fixation or relative immobilization (soft diet, reduced mouth opening) and so forth.
• Surgical Treatment: For cases of obvious displacement, occlusal disturbance, or suspected joint dysfunction, open reduction and internal fixation may be considered, or use an intraoral/endoscopic approach to minimize scarring of the facial area and reduce the risk of facial nerve injury.
• Pharmacological Treatment: For significant pain or inflammation, oral analgesics and anti-inflammatory drugs can be prescribed. If there is notable masticatory muscle spasm, muscle relaxants might be used if necessary.
• Follow-up: Monitor fracture healing progress, and obtain repeat CT or MRI if necessary to evaluate fracture alignment and temporomandibular joint (TMJ) function.

4.2 Rehabilitation and Exercise Prescription

Once the fracture alignment is basically stable, gradual rehabilitation can be started. The main goal is to restore normal chewing function and mandibular joint mobility. The following plan is recommended:

• Early Stage (from initial fixation until about 2 weeks post-operation):
  • Focus on rest and reducing swelling, avoid excessive mouth opening or lateral movements. A soft or liquid diet is recommended.
  • Perform gentle jaw opening and closing exercises 2–3 times per day, each time 5–10 repetitions, with a range of motion that does not cause significant pain.
• Middle Stage (approximately 2–6 weeks post-operation):
  • Under specialist guidance, gradually increase the extent of jaw opening and lateral movements to improve joint flexibility.
  • Thermotherapy or physical therapy can be used to relieve muscle tension and reduce adhesions.
  • Apply FITT-VP principles: exercise 2–3 times a day; each session for about 10–15 minutes; moderate intensity, without causing severe pain or discomfort; maintain regular exercises and gradually increase range and frequency.
• Late Stage (after 6 weeks post-operation):
  • After confirming stable fracture healing, begin bilateral balanced chewing training, and gradually transition to a normal diet.
  • According to recovery of joint function and masticatory muscle strength, progressively enhance oral and jaw muscle training, such as resistance exercises (with a doctor or therapist providing light resistance during mouth-opening exercises).
  • Be cautious to avoid sudden excessive biting force, and gradually resume normal daily life and physical activities.

For patients with osteoporosis or other systemic conditions, additional protection measures should be taken during rehabilitation. The rehabilitation period may be extended, and bone healing should be closely monitored. If severe pain, joint clicking, or locking occurs, seek medical attention promptly for re-evaluation.

Disclaimer

This report is based on available imaging and medical history for reference only and cannot replace an in-person consultation or professional medical advice. The specific treatment plan should be decided by the attending physician according to the patient’s actual situation. If you have any doubts or your symptoms worsen, please seek medical attention promptly.