Superolateral Dislocation of the Mandibular Condyle: A Series of Seven Cases

Abstract

Introduction Anterior and anteromedial dislocations of the mandibular condyle are seen frequently in mandibular fractures. Less frequent are dislocations of the condylar head in the lateral, medial and posterior direction whereas superior dislocation into the middle cranial fossa is rare. We report a series of seven cases encountered over the years, which, incidentally, is the largest case series reported till date with lateral and superolateral dislocation of the condyle after a traumatic injury. Materials and method In all cases but one, the condyle was reduced by manual manipulation with the patient in general anaesthesia. In all cases but one there was simultaneous fracture in the mandibular symphyseal region. The associated fractures were reduced and fixed with bone plates and screws. Results Patients were generally free from any long term complications of injury or surgery except for facial nerve paresis of a transient nature in one case. Conclusion To our knowledge, this clinical series presents the first reported case of superolateral dislocation which required open reduction. The etiology and mechanism of dislocation has been discussed along with a brief review of the literature.

Superolateral dislocation of an intact mandibular condyle into the temporal fossa: case report and literature review

“…Contrary to this, some reports suggest that superolateral dislocations can take place without any associated mandibular fracture . According to Li et al , for such dislocation to occur, the prerequisite factors are multiple multidirectional impacts of force, wide open mouth and flabby joint capsule and pterygoid muscles.…”

“…Closed reduction methods are successful in cases in which early diagnosis of the injury has been made. Studies have shown good results with closed reduction of superolateral dislocation of mandibular condyle . Delay in the reduction may make closed reduction impossible because of the development of fibrosis within the joint cavities, myospasm, bony union or a combination of these .…”

Unusual Supero-Lateral Dislocation of Intact Bilateral Mandibular Condyles Associated with Right Parasymphysis Mandibular Fracture:A Case Report and Review of Literature

“…The rest 6 cases were type I dislocated. The Worthington described his type of case with the term unusual and the information was not available for the case of Radhakrishkna (Table III) (Table IV) [1][2][3][4]7,10,12,13,[22][23][24][25][26][27][28] while 34 dislocations (46.26%) was managed by surgical modalities [5][6][7]9,11,14,[16][17][18][19][20][21][22]24,26,27,29] while no treatment was given for 2 cases (2.98%) resulting in fibrosseous ankylosis [4] (Table V). It can be concluded that most of all surgeons had used open reduction techniques for management of supero-lateral dislocation.…”

“…Kotak rajkumar et al [27] did capsulorraphy by suturing split thickness temporalis myofascial flap on lateral aspect of capsule was to prevent repeated early dislocation of superolateral condyle. The closed reduction/non surgical technique mostly had been managed by manual manipulation under sedation [2] or general anesthesia [3,26] with muscle relaxants. Worthington [1] had tried managing his case by passing a wire through bone at left angle to facilitate downward traction but no avail and finally open reduction was done.…”

“…[1,10,7,11,13,24,26] Out of these 9 cases, there were only 2 cases having fracture and supero-lateral displacement of same side condyle, [24] while rest 6 cases of condylar fractures were on the opposite side of superolaterally displaced condyle. [1,10,7,11,13,26] There is 1 case of bilateral condylar fracture having bilateral supero-lateral dislocation. [24] (Table VII) …”