【論文摘要】Manual Reduction of Acute Bilateral Temporomandibular Dislocation: Case Report

【論文摘要】急性雙側顳顎關節脫臼的徒手復位：個案報告

陳柏禎(Bo-Jhen Chen)

《物理治療》 44卷2期 (2019/06) Pp. 142-143

https://doi.org/10.6215/FJPT.201906.P45

摘要

Background and Purpose: Although non-traumatic temporomandibular joint (TMJ) dislocation is infrequent, it requires immediate reduction to prevent subsequent dysfunction and recurrent dislocation. Applying conventional techniques is difficult in the emergency department or dentistry due to muscle spasm. Lack of experience or repetitive failed reduction can prolong patients' distress. We described a modified manual method of a case with acute spontaneous TMJ dislocation. Methods: The case was a 27-year-old female with no previous episode of cervical or TMJ complains. She noticed severe jaw pain after a simple yawning and was unable to close the mouth. Physical examination identified anterior dislocation of the bilateral TMJ with right rotation. With the individual seated and the upper body stabilized by the plinth, the intraoral Hippocratic maneuver was performed. Stabilization exercises for facial and neck muscles were prescribed as home exercise program. Results: The first trial with sole posteroinferior force failed to relocate the joint. The second trial was modified with additional rotation component. Immediate reduction was achieved with one attempt within one minute. The individual reported immediate symptoms relief and could speak and chew normally without sequela. The hyperactive muscle tone over the surrounding area was diminished. Following dental check-up revealed no structural lesion to the joint and its associated tissues. Conclusion: Without administering sedatives or analgesics, the case reported satisfied result with manual approach. Experience and knowledge in force delivery as well as arthrokinematics is essential to manage TMJ dislocation. Clinical Relevance: Before providing invasive or pharmacological procedure, simple manual technique could be used as the primary consideration to treat non-fracture TMJ dislocation.