{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T13:12:03Z","timestamp":1788786723678,"version":"build-2803163510"},"reference-count":10,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,8,31]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>Displacement of an intact mandibular coronoid process lateral to the zygomaticomaxillary complex (ZMC) is a rare complication of ZMC fractures. We report a case of a woman in her early 30s with malar flattening and inability to achieve full mouth closure following a fall from an electric scooter. Her CT scan revealed a comminuted right ZMC fracture with the ipsilateral intact coronoid process displaced laterally to the ZMC. This rare injury pattern produced mechanical restriction of mandibular movement in both opening and closure. Urgent operative management of the ZMC fracture allowed for spontaneous coronoid reduction allowing passive occlusion intraoperatively and active full mouth closure once awake. At the 3-month follow-up, mandibular movement and malar symmetry had fully recovered. This case highlights the importance of considering coronoid displacement in patients with midfacial trauma and mechanical jaw restriction, the value of CT and the role of early surgical management in preventing long-term dysfunction.<\/jats:p>","DOI":"10.1136\/bcr-2025-270719","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T12:55:13Z","timestamp":1788785713000},"page":"e270719","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Mechanical jaw restriction after zygomaticomaxillary complex fracture: an unusual coronoid\u2013zygomatic relationship"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2481-1155","authenticated-orcid":false,"given":"Harman","family":"Singh","sequence":"first","affiliation":[{"name":"South Metropolitan Health Service and East Metropolitan Health Service Library and Information Service, Royal Perth Hospital, Perth, Western Australia, Australia"},{"name":"Department of Oral and Maxillofacial Surgery, Royal Perth Hospital, Perth, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel Viran","family":"Thambar","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Royal Perth Hospital, Perth, Western Australia, Australia"},{"name":"School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Cooper","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Royal Perth Hospital, Perth, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"key":"2026090705550835000_19.9.e270719.1","doi-asserted-by":"crossref","DOI":"10.1093\/jscr\/rjae144","article-title":"Anterior dislocation of the coronoid process above a ZMC fracture: case report and a technical note","volume":"2024","author":"Nini","year":"2024","journal-title":"J Surg Case Rep"},{"key":"2026090705550835000_19.9.e270719.2","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/j.fsc.2017.06.006","article-title":"Management of Zygomaticomaxillary Complex Fractures","volume":"25","author":"Strong","year":"2017","journal-title":"Facial Plast Surg Clin North Am"},{"key":"2026090705550835000_19.9.e270719.3","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1016\/j.otc.2013.06.002","article-title":"Surgical management of complex midfacial fractures","volume":"46","author":"Kochhar","year":"2013","journal-title":"Otolaryngol Clin North Am"},{"key":"2026090705550835000_19.9.e270719.4","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1016\/j.coms.2013.07.011","article-title":"Management of fractures of the zygomaticomaxillary complex","volume":"25","author":"Marinho","year":"2013","journal-title":"Oral Maxillofac Surg Clin North Am"},{"key":"2026090705550835000_19.9.e270719.5","article-title":"Zygomatic arch fracture with coronoid impingement","volume":"15","author":"Mundinger","year":"2015","journal-title":"Eplasty"},{"key":"2026090705550835000_19.9.e270719.6","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1016\/j.kjms.2011.11.016","article-title":"Incidence and clinical significance of zygomaticomaxillary complex fracture involving the temporomandibular joint with emphasis on trismus","volume":"28","author":"Chang","year":"2012","journal-title":"Kaohsiung J Med Sci"},{"key":"2026090705550835000_19.9.e270719.7","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1097\/SCS.0b013e3182418ea6","article-title":"Intraoral approach to zygomatic fracture: modified technique for infraorbital rim fixation","volume":"23","author":"de Souza Carvalho","year":"2012","journal-title":"J Craniofac Surg"},{"key":"2026090705550835000_19.9.e270719.8","doi-asserted-by":"crossref","unstructured":"Panneerselvam E , Ravi P , Sasikala B . Fractures of the zygomaticomaxillary complex. In: Bonanthaya K , Panneerselvam E , Manuel S , et al , eds. Oral and maxillofacial surgery for the clinician. Singapore: Springer Nature Singapore, 2021: 1151\u201399.","DOI":"10.1007\/978-981-15-1346-6_56"},{"key":"2026090705550835000_19.9.e270719.9","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/S1010-5182(05)80539-6","article-title":"The alterations in sensitivity of the infraorbital nerve following fractures of the zygomaticomaxillary complex","volume":"18","author":"Zachariades","year":"1990","journal-title":"J Craniomaxillofac Surg"},{"key":"2026090705550835000_19.9.e270719.10","doi-asserted-by":"crossref","first-page":"2083","DOI":"10.1097\/SCS.0000000000010481","article-title":"Recovery of the Infraorbital Nerve Following Open Reduction and Fixation Surgery of Zygomaticomaxillary Complex Fractures-A Prospective Cohort Study Based on Quantitative Sensory Testing","volume":"35","author":"Wang","year":"2024","journal-title":"J Craniofac Surg"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-270719","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T12:55:15Z","timestamp":1788785715000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-270719"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":10,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,7]]},"published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1136\/bcr-2025-270719"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-270719","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]}}}