Tuesday, January 26, 2016

Extra-oral reduction of mandible dislocation

ALiEM - January 26, 2016 - By Kara Toles
Anterior dislocation of the mandible is a clinical scenario that is not infrequently encountered by the ED provider and requires prompt intervention. The classic technique for reduction of the mandible requires the provider to place his/her thumbs or fingers into the patient’s mouth along the lower molars and apply force inferiorly and posteriorly. However, this technique is fraught with difficulties and inefficiencies including the following:
  1. It requires a surprising amount of force.
  2. The patient usually has to be sedated, possibly under procedural sedation, which usurps valuable resources in a busy ED.
  3. The ED provider has to incur the risk of personal injury and possible disease transmission by placing their hands into one of the most bacteria-ridden surfaces on this earth: the human mouth.
Luckily, there is a better way! Dr. Chen et al. from the Department of Plastic and Reconstructive Surgery at Chang Gung University in Taiwan describe a simple, effective, and novel technique to reduce the anteriorly displaced mandible. In their experience, no sedation was required for any of their cases.