Lockjaw

Is your jaw locked open? A dislocated jaw or lockjaw is an anterior condylar dislocation

Lockjaw or a dislocated jaw is a scary thing for the person experiencing it, especially if it’s the first time. It’s important to stay calm and know that this is an issue that we can fix.

Lockjaw technique to fix a jaw locked open.

Important to do quickly as the longer the jaw is dislocated the more muscle spasm and inflammation and the tougher it will be to fix.

Traditional technique is down and back but this article reminds us that the force back should be very minimal if any.

“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 (dislocated jaw)

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 ways to do it

Need for local anesthetic for a locked jaw

When patients need local anesthetic know it is not given in the areas that dentists typically give injections and is probably best left to those with more experience in this area.

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

Post operative care following a jaw dislocation

Post op care of a dislocated jaw

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

                                                      

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