Traumatic chronic TMJ dislocation: report of an unusual case and discussion of management

Dislocation of the temporomandibular joint (TMJ) is most often spontaneous, but it can be associated with direct or indirect head and neck trauma. The disorder may be treated in general by simple closed techniques, if managed acutely. If the dislocation becomes chronic, however, open reduction is usually required. The article discusses various methods for an open surgical approach described in the literature. A case of a prolonged TMJ dislocation is presented, involving a severe bilateral mandibular dislocation with the condyles displaced into the infratemporal fossa and the lateral poles of the condyles articulating on the inner aspect of the zygomatic arch. An open approach, involving masseter, temporalis, and the medial pterygoid muscles, was utilized, followed by the use of scissors mouth props, Erich arch bars, and postoperative elastic traction.