Refractory Temporomandibular Joint Dislocation - Reduction Using the Wrist Pivot Method

Area of Science:

• Emergency Medicine
• Orthopedics
• Maxillofacial Surgery

Background:

• Temporomandibular joint (TMJ) dislocation is a common emergency department presentation.
• Manual reduction techniques are standard, often facilitated by sedation.
• Refractory cases can pose significant management challenges.

Observation:

• A 19-year-old male presented with atraumatic temporomandibular joint dislocation.
• Multiple reduction attempts by emergency physicians, with and without sedation, were unsuccessful.
• The temporomandibular joint dislocation was ultimately reduced using the wrist pivot technique.

Findings:

• The wrist pivot technique proved effective in a case of refractory temporomandibular joint dislocation.
• Sedation did not facilitate reduction with standard maneuvers.
• This technique offers an alternative for difficult TMJ dislocations.

Implications:

• Clinicians should consider the wrist pivot technique for refractory temporomandibular joint dislocations.
• Exploring alternative reduction methods is crucial when standard approaches fail.
• This case expands the armamentarium for managing challenging TMJ dislocations.