Lockjaw Anterior Condylar dislocation

Lockjaw Anterior Condylar dislocation

Traditional technique is down and back but this article tells of a different technique that makes sense to me.

“Placing the thumbs onto the external oblique ridge and the fingers under the lower border of the mandible, slowly increasing force should be applied in a caudal direction to overcome the spasm of the temporalis, pterygoid and masseter muscles. Very little ‘posterior’ force is required as once the condylar head is inferior to the articular eminence the muscle pull will draw the condyle back into the fossa and reduce the dislocation.”

Traditional technique for lockjaw

Manual manipulation of lockjaw – downward, posterior gradually increasing pressure

  1. Patient sits vertical and doc stands in front of patient slightly below elbow height
  2. Patient head firmly against head rest
  3. Thumbs wrapped in towel for protection
  4. Firm, increasing downward pressure with rotational posterior force
  5. Ask patient to open widely during
  6. Try bilaterally but may have to do unilaterally
  7. Refer OS if not done quickly for IV muscle relaxants and benzos

Video of traditional procedure but many had comments on better way to do it

LA if needed

  1. Peri-capsular LA
  2. Deep temporal n. block

Post op care

  1. Immediate support with Jaw bra or similar
  2. Restricted opening 6 weeks
  3. Soft diet, analgesics, NSAIDs
  4. Advise future dislocations

                                                      

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