Surgical treatment of bony ankylosis in a child using a composite cartilage-bone iliac crest graft

A previously unreported approach to the treatment of temporomandibular ankylosis in the child is reported. The procedure involves using the iliac crest and fixing it to the zygomatic portion of the temporal bone, with the cartilagenous portion facing the stump of the mandibular ramus. The procedure is easier to accomplish than a costochondral graft, does not require maxillomandibular fixation, and offers the possibility of appositional growth. In our case, opening has been maintained and growth sustained in a five-year-old child for 18 months without physiotherapy.