Trick of the Trade: Massaging a mandibular dislocation back in

Continuing the theme of mandible dislocation tricks (protecting your thumbs, post-reduction stabilization), Dr. Daniel Gromis from Advocate Christ Medical Center describes a novel reduction technique, based on the Cunningham shoulder reduction technique using muscle relaxation.


Dr. Rob Orman of ERCast fame had posted this initially on his site, and it's too awesome of a trick for me not to include in my Tricks of the Trade series.

Trick of the Trade:

1. Massage the masseter muscles before and during the procedure
2. Apply rotational force (rather than downward and posterior force) on mandibular ramus

The rotational approach to reduction is similar to the wrist pivot method described in the Journal of Emergency Medicine (thanks to Dr. Graham Walker for the reference).

Reference
Lowery LE, Beeson MS, Lum KK. The wrist pivot method, a novel technique for temporomandibular joint reduction. J Emerg Med. 2004 Aug;27(2):167-70. Pubmed .