Anterior temporomandibular dislocations are generally quite satisfying closed reductions. Patients, understandably, are exceedingly grateful to have their function restored. However, it typically requires parenteral analgesia, sometimes procedural sedation, and puts the practioner at risk of injury from inadvertent biting.
This interesting pilot describes a technique in which the patient, essentially, self-reduces the TMJ dislocation by using a syringe held between the posterior molars as a rolling fulcrum. I’d describe it in more detail, but I think, from the image reproduced here, you’ll get it:
These authors used this technique for 31 cases, and only one was ultimately unsuccessful.
While this is not the intended use for a syringe, I can’t hardly imagine any terrible harmful adverse effects from materials failure – and they don’t exceed the risks of procedural sedation. I certainly find it reasonable to experiment with this technique.
“The ‘Syringe’ technique: a hands-free approach for the reduction of acute nontraumatic temporomandibular dislocation in the Emergency Department.”
http://www.ncbi.nlm.nih.gov/pubmed/25278137
I don't think you can get it "post molar".
What they say in the paper is they take an appropriately sized syringe according to how much poor patient can open.
Then get it at the molar level .
Then (the half circle arrows on syringe) the patient is asked to gently bite
while rolling the syringe back and forth with mandibular (small) movements.
I agree with axel – the horizontal distance translation for reduction of the mandible is very small. The diameter of a syringe should be adequate, so even less than an entire revolution of the rolling motion should do it.
T t t !
Joint Commission would severely frown at your using that abbreviation !
I'm amazed at the number of TMJ (me too) dislocations they had !
I've seen very few. Actually 3 in 14 years. One at least was an American patient.
Maybe Americans are more prone to it because of too-big Macs (not the computer, the "food") to bite into ?
Up to now I had changed my technique to that where you get behind the patient to get better leverage.
HAs anyone tried the syringe technique ?
Reminds me of the cunning Aussie technique for shoulder relocation.
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This is similar to the tongue blade technique where the patient bites on pile of tongue blades and more are added as the muscles relax and give in, allowing for spontaneous reduction.