Bilateral Posterior Dislocation of Mandibular Condyle: A Rare Entity in Maxillofacial Injuries.

Abstract

Dislocation of the mandibular condylar head refers to ectopic positioning of the intact condylar head out of the glenoid fossa. Most commonly reported anterior dislocation results from anteromedial pull of the lateral pterygoid muscle and laxity of the surrounding tissue with advanced age. This case report brings forth a unique case of bilateral posterior condylar dislocation in an edentulous patient who reported after 4 weeks of traumatic injury. The condition was managed surgically by reduction of the dislocated condyle and placement of mersilene tape on one side and temporalis muscle on the other side as anchorage ligament to stabilize the condyle and prevent any future recurrence. The patient was maintained on long-term follow-up for up to one year with no reported recurrence or reduction in mouth opening. This is the first ever case report that highlights bilateral posterior dislocation of intact mandible unlike the previous four reports which have brought forth unilateral dislocation on English literature search. Posterior dislocation of mandibular condyle is encountered in edentulous patients who experience posteriorly directed impact which forces the condylar head behind the postarticular ridge. Unlike anterior dislocation, clinical features include reduced mouth opening and retruded mandible in bilateral dislocation. It has been observed that manual correction by pressing the mandible downwards and forwards yields good results in early cases. Cases that are reported late require surgical exploration for reduction and placement of anchorage ligament to prevent recurrence in unstable condyle.