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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor
Category: Medical
Satisfied Customers: 29563
Experience:  MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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how soon should a dislocated jaw be put back in before permanent

Resolved Question:

how soon should a dislocated jaw be put back in before permanent damage occurs? can it be left out of place too long, if so how long is too long?
Submitted: 4 years ago.
Category: Medical
Expert:  Dr. Arun Phophalia replied 4 years ago.

Greetings.

 

A dislocated jaw should be put back as soon as possible as there is a risk of osteoarthritis setting in due to damage to the cartilage and other complications as following:

 

1) chronic recurrent dislocations,

2) ischemic necrosis of the condylar head,

3) traumatic damage to the articular disk,

4) mandibular osteomyelitis

5) permanent malocclusion

 

These complications are dependent on various factors;

 

a) Age of the patient

b) Duration of the dislocation

c) Severity of the dislocation (more severe dislocation can injure the blood supply)

d) Associated soft tissue injury

 

So a set rule for a duration cannot be assigned and this is absolutely dependent on the individual dislocation. But as soon as reduction means within 72 hours and not later than 7-10 days, which will increase the complication rate even in mild to moderate dislocation.

 

Please feel free for your follow up questions.

 

Dr. Arun

Customer: replied 4 years ago.
I am a 32 year old female. I was hit on the chin while at work. Went to local ER and proceeded to wait 6 hours with the left side of jaw dislocated to the point where it was almost sitting on my right shoulder. Since this incident I have had 5 other dislocations to this side of the jaw. My mouth is currently wired shut, this is the second time it was wired shut. Mouth was wired shut the first time on the second day following incident. This was after 4 recurrent dislocations following ER treatments in a 36 hour period. I was wired shut the first time for 2 weeks, oral surgeon removed the wires and instructed me to wear elastics for another 2-4 weeks. After a week I yawned in my sleep and dislocated again with elastics in place. Now rewired oral surgeon suggests arthroplasty, osteoplasty, and intradental fixation. Oral surgeon states that complications would not have been this severe if ER had replaced jaw in a more timely manner. Do you concur?
Expert:  Dr. Arun Phophalia replied 4 years ago.

Hello,

 

You had a severe jaw dislocation. So a reduction (manual or surgical) should be done as soon as possible. With your description, it is likely that an inadequate procedure at that time or later when it re-dislocated is more likely to be responsible for the later problems. It should have been wired immediately on the very day. I concur that a wiring at the earliest may have prevented these subsequent complications.

 

It is pleasure and privilege assisting you.

 

I hope this was helpful to you. If it was, please remember to ACCEPT the answer so I can get compensated for my work. if you have any more questions, please feel free to ask. I am truly privileged to help you, and I want to make sure that you are satisfied with the answer. Good luck!

 

Dr. Arun

Customer: replied 4 years ago.
In your opinion would there be cause for following up in a legal manner? As this was likely caused by an inadequete procedure performed by the ER staff would that open them up to be responsible or negligent, medical malpractice maybe?
Expert:  Dr. Arun Phophalia replied 4 years ago.

Hello,

 

Yes, this seems to be an inadequate care. A usual procedure is to hire a lawyer, who will get an opinion from a doctor about the standard of care protocols. On that basis, a suit may be pursued.

 

Dr. Arun

Dr. Arun Phophalia, Doctor
Category: Medical
Satisfied Customers: 29563
Experience: MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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