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4.02 Jaw Dislocation


Presentation

The patient's jaw is "out" and will not close, usually following a yawn, or perhaps after laughing, a dental extraction, jaw trauma or a dystonic drug reaction. The patient has difficulty speaking ans may have severe pain anterior to the ear. A depression can be seen or felt in the preauricular area and the jaw may appear prominent.

What to do:

What not to do:

  • Do not attempt to reduce a TMJ dislocation with the patient's jaw at the height of your shoulders or above. You will need the leverage you get from having the patient in a lower position.
  • Do not try to force the patient's jaw shut.

    Discussion

    The mandible usually dislocates anteriorly, and subluxes when the jaw is opened wide. Other dislocations imply the presence of a fracture and require referral to a surgeon. Dislocation is often a chronic problem (avoided by limiting motion) and associated with temporomandibular joint dysfunction. If dislocation is not obvious, then consider other conditions, such as fracture, hemarthrosis, closed lock of the joint meniscus, and myofascial pain.

    References:


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    from Buttaravoli & Stair: COMMON SIMPLE EMERGENCIES
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    Craig Feied, MD
    Mark Smith, MD
    Jon Handler, MD
    Michael Gillam, MD