Mandible dislocation: Difference between revisions
Russellm77 (talk | contribs) |
Russellm77 (talk | contribs) |
||
| Line 19: | Line 19: | ||
*Wrap physician's thumbs circumferentially with 4x4's and tape | *Wrap physician's thumbs circumferentially with 4x4's and tape | ||
**Thumbs will be placed intra-orally and may be bitten upon relocation | **Thumbs will be placed intra-orally and may be bitten upon relocation | ||
*Can stand anterior or posterior to patient | *Can stand anterior or posterior to patient (see image below) | ||
**First, downward pressure is applied to release condyles | **First, downward pressure is applied to release condyles | ||
**Second, move chin posteriorly to seat condyles in fossa | **Second, move chin posteriorly to seat condyles in fossa | ||
| Line 27: | Line 27: | ||
*Avoid wide opening of mouth, Barton's bandage may be helpful | *Avoid wide opening of mouth, Barton's bandage may be helpful | ||
*Refer recurrent dislocations | *Refer recurrent dislocations | ||
== Disposition == | == Disposition == | ||
Revision as of 23:33, 13 September 2011
Background
- Anterior dislocation of mandibular condyle(s) in relation to fossa
- Risk factors include prior dislocation,weak capsule, and torn ligaments
- Yawning, "popping" ears, or laughing may predispose
Diagnosis
- Clinical diagnosis, but XR/CT if fracture suspected in setting of trauma
- Pt unable to open mouth with locked jaw
- Unilateral or bilateral
- Jaw deviates to contralateral side if unilateral
- Palpation of TMJ reveals anterior condyle(s)
- Palpate with fingers in the auditory canal
Treatment
- Analgesia
- Benzodiazepines for muscle relaxation
- Wrap physician's thumbs circumferentially with 4x4's and tape
- Thumbs will be placed intra-orally and may be bitten upon relocation
- Can stand anterior or posterior to patient (see image below)
- First, downward pressure is applied to release condyles
- Second, move chin posteriorly to seat condyles in fossa
- Posterior position is easier in this author's opinion
- Allows for increased leverage, less patient anxiety
- Soft diet for one week
- Avoid wide opening of mouth, Barton's bandage may be helpful
- Refer recurrent dislocations
Disposition
- Outpatient management as above
- ENT or OMFS referral with recurrent dislocations
