Syringe Technique: With the patient in a sitting position, the physician places a 5 or 10 ml syringe between the posterior upper and lower molars or gums on the affected side. The patient is asked to gently bite down and grasp the syringe as the patient is instructed to roll the syringe back and forth, resulting in the reduction of the dislocated TMJ.
- Up to 50% of true knee dislocations will spontaneously reduce prior to arrival. Be suspicious of a dislocation in any patient who describes the joint moving out of place or if they have significant swelling, joint effusion or ecchymosis despite normal X-rays
- In all patients with suspected dislocation, perform a neurovascular exam immediately as popliteal artery injury is common. If they’ve got an absent Dorsalis Pedis or Posterior Tibial pulse, reduce immediately and get a CT angiogram as quickly as possible to assess for popliteal injuries
- If distal pulses are intact, you can either do Ankle Brachial Indices (ABIs) and if normal, observe and repeat them or get a CT Angiogram (CTA). If the ABI is abnormal or the patient had an absent or decreased pulse at any point, get the CTA