Wednesday, December 30, 2015

Temporomandibular joint dislocation

She is young female presented with 2nd episode of temporomandibular joint dislocation while she was yawning.  

She presented 10 hours after the episode  and she was immediately taken up for manual reduction.   She cried because of pain. Her was scared and apprehensive so manual reduction failed in emergency.   So it was decided to retry under propofol Anesthesia.  Since she was in pain and to relax her, 1 mg midazolam ( a tranquillizer and sedative) was given intravenously.  The case was scheduled after 4 hours as she had just taken water.  
She want into sleep soon after as she was tired since morning.  

I received the call 2 hours after that I need not to come now as Patient herself has reduced it.   I was glad and surprised.  Then I realized how important is for masticator muscles to relax before temporomandibular joint reduces itself or by physician action.     

Sketch photo of patient during her agony.  Note open mouth and slight deviation of chin on right side suggesting dislocation of temporomandibular joint of left side.  

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