Unilateral mandible fracture with bilateral TMJ dislocation

Temporomandibular joint (TMJ) dislocation occurs when the condylar head slips forward causing the posterior articulating surface of the condyle to advance ahead of the articular eminence, possibly becoming entrapped. Following dislocation, the ligaments around the joint often stretch, causing severe muscle spasms and joint pain. There is no standard evaluation and treatment method for acute TMJ dislocation, but the most effective course is immediate reduction. This paper presents a 42-year-old woman who sustained a unilateral mandible fracture with bilateral TMJ dislocation in an automobile crash. Although the fracture was apparent on plane film and panorex, the dislocation was not found until six weeks later, when the jaw was unwired. At that time, the dislocation was suspected because of decreased range of motion, but was not verified until an MRI was performed. The result was long-term therapy, eventual bilateral TMJ surgery, and chronic TMJ pain for the patient.