J Korean Assoc Oral Maxillofac Surg.  2013 Oct;39(5):238-241.

Reduction of superior-lateral intact mandibular condyle dislocation with bone traction hook

• Kim BC
• Kang Samayoa SR
• Kim HJ

Abstract

Lateral and superior-lateral dislocations of the intact condyle are a rare complication, following traumatic insult to the mandible. We report an unusual case of a 54-year-old male patient who experienced both types of dislocations of the intact condyles with symphysis fracture following a road-traffic accident. Under general anesthesia, conventional manipulation was unsuccessful in relocating the condyles into the glenoid fossa. After applying a percutaneous traction force, using a bone traction hook placed at the sigmoid notch, the displaced intact mandibular condyles were repositioned, and the symphyseal fracture was finally reduced and fixed. The mouth opening was within normal limits, and favorable occlusion was confirmed one month postoperatively. To our knowledge, this is the first case of dislocation of both intact condyles--associated with symphysis fracture--being reduced with bone traction hook.

Keyword

Lateral dislocation; Mandibular fractures; Reduction; Condyle

MeSH Terms

Anesthesia, General
Colon, Sigmoid
Dislocations*
Humans
Male
Mandible
Mandibular Condyle*
Mandibular Fractures
Middle Aged
Mouth
Traction*

Figure

• 

  Fig. 1 Three-dimensional reconstruction of the computed tomography scan showing the bilateral dislocation of the condyles situated lateral to the zygomatic arch and associated with symphysis fracture. A. The posterior-anterior view shows symphyseal fracture with marked lateral displacement on the left side of the mandible. B. The right lateral view exhibits the right condyle head dislocated superior-laterally to the zygomatic arch. C. Lateral view, left side.

• 

  Fig. 2 Successful reduction of the right intact condyle was performed by applying external force with bone traction hook via stab incision at the level of sigmoid notch of the same side.

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  Fig. 3 Postoperative posterior-anterior (A) and lateral (B) cephalographic images demonstrating the satisfactory reduction of symphyseal fracture and bilateral reduction of both mandibular intact condyles. Slight lateral displacement of the right condyles is noticeable in the lateral view.

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