A Modification of the Classical Dautrey's Procedure - A Case Report

Abstract

Rationale: The rationale was to establish a permanent surgical solution for nonreducing dislocations of the temporomandibular joint (TMJ).

Patient concerns: The patient presents with a long-standing history of chronic subluxation of the TMJ bilaterally, with the need to forcibly manipulate and reduce the dislocated jaw.

Diagnosis: Chronic recurrent dislocation of the TMJ.

Treatment: A modified Dautrey's procedure was performed on the right side, with the osteotomized segment being transferred medially and inferiorly.

Outcome: After 5 years of follow-up, there was no incidence of recurrent dislocation.

Take-away lesson: This modification is a viable option in both unilateral and bilateral reducing and nonreducing dislocations.

Keywords: Chronic recurrent dislocation; osteotomy; temporomandibular joint; zygomatic arch.

Figure 1

Bilateral nonreducing dislocation of the temporomandibular joint

Figure 2

Preoperative X-ray

Figure 3

Planned osteotomy cuts and medially displaced fragment

Figure 4

Postoperative occlusion and mouth opening

Figure 5

Postoperative view showing no malar flattening

Figure 6

Classical Dautrey's osteotomy and modified osteotomy

Figure 7

Postoperative closed-mouth and open-mouth OPG

Figure 8

Postoperative temporomandibular joint view (open-mouth and closed-mouth)