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Fractures: Bone Repair01:27

Fractures: Bone Repair

Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...

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Related Experiment Video

Updated: May 12, 2026

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
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Reduction of Temporomandibular Joint Dislocation With Open Approach Using Prearticular Incision Following Sagittal

Noriaki Aoki1, Megumi Matsumoto, Junichi Baba

  • 1Department of Oral and Maxillofacial Surgery, Saiseikai Yokohamashi Nanbu Hospital, Yokohama, Japan.

The Journal of Craniofacial Surgery
|April 17, 2025
PubMed
Summary

This case report details managing temporomandibular joint (TMJ) dislocation after bilateral sagittal split osteotomy (BSSO). A prearticular incision approach was successfully used for reduction, a first for this specific complication.

Keywords:
Bilateral sagittal split osteotomyhabitual mandibular dislocationsprearticular incision

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Orthognathic Surgery
  • Temporomandibular Joint Disorders

Background:

  • Bilateral sagittal split osteotomy (BSSO) is a standard procedure for correcting jaw deformities.
  • Temporomandibular joint (TMJ) dislocation is an infrequent but serious intraoperative complication during orthognathic surgery.
  • Patients with a history of habitual TMJ dislocation may be at increased risk.

Purpose of the Study:

  • To report a rare case of intraoperative TMJ dislocation following BSSO.
  • To describe a novel surgical approach for reducing TMJ dislocation in this context.
  • To highlight the successful management of anterior condylar displacement after BSSO.

Main Methods:

  • A 22-year-old female patient underwent BSSO for a protruding lower jaw.
  • Initial management involved open reduction of TMJ dislocation via a prearticular incision.
  • Subsequent surgeries utilized combined intraoral and preauricular approaches for condylar repositioning.

Main Results:

  • Postoperative radiography confirmed anterior dislocation of the right condylar head after the initial BSSO.
  • The dislocated mandibular condyle required multiple surgical interventions for successful reduction.
  • The combined intraoral and preauricular approach ultimately achieved proper condylar reduction.

Conclusions:

  • This case represents the first documented instance of TMJ dislocation reduction with a prearticular incision following BSSO.
  • Complex TMJ dislocations post-BSSO may necessitate multi-stage surgical management.
  • Careful surgical technique and anatomical confirmation are crucial for managing intraoperative TMJ complications.