Bilateral Lateral Arthroplasty in a Growing Patient for Type III TMJ Ankylosis

A 10 year old male patient reported with a chief complaint of inability to open mouth since 4 years. There was a history of fall from height, following which there was progressive limitation in mouth opening and jaw movements. Clinically there was maximal mouth opening (MMO) of 1-2 mm with restricted protrusive and laterotrusive jaw movements. On radiographic evaluation, there was a bifid condyle appearance which showed a medially displaced condyle along with complete lateral fusion of joint components bilaterally. With a diagnosis of Sawhney's type III ankylosis, lateral arthroplasty was planned under G.A. for both sides. On 2 years follow-up MMO of 30-34 mm was maintained along with unrestricted protrusive and bilateral laterotrusive movements. In this case, we show that the comparatively less invasive treatment plan of lateral arthroplasty involving preservation of medial condylar stump is adequate for the return of TMJ movements to near normalcy.