"Dr. Leung, there was a student who had a jaw dislocation during the sampling process! I can't close my mouth now, hurry up and help..."
At 10:00 p.m. on June 9, When Liang Yancan, deputy chief physician of the Department of Stomatology of Sun Yat-sen Memorial Hospital of Sun Yat-sen University, was supporting nucleic acid sampling work at the South Campus of Sun Yat-sen University, he happened to encounter a male classmate with a dislocation of his chin and immediately reset him with a skillful technique of 3 seconds.
Previously, a citizen of Yuexiu District dropped his chin during a nucleic acid test, but fortunately the doctor who tested him was a doctor from the Guanghua School of Stomatology and the Affiliated Stomatological Hospital of Sun Yat-sen University, and he was able to reset on the spot.
Doctors especially remind:
Temporomandibular joint dislocation is prone to recurrence, and rapid opening of the mouth should be avoided when doing nucleic acid testing. If "jaw loss" has never occurred before, there is no need to worry about the onset of the disease during the collection of oropharyngeal swabs, and the probability of occurrence is very low.
After the boy did the nucleic acid test, his mouth could not be closed
"At that time, a male classmate was sitting in a chair, his mouth was wide open, his chin was extended forward, saliva was outflowing, and his expression was crying and laughing..." Liang Yancan, deputy chief physician who had just completed the sampling task for more than three hours, immediately rushed to support when he received the request for help. Combined with the male classmate's medical history of just finishing nucleic acid sampling, his initial diagnosis is acute anterior dislocation of the temporomandibular joint, which is commonly known as "jaw drop".
Deputy Chief Physician Liang Yancan asked the male classmate to sit on the edge of the field, with his back against the wall, ready to reset him. "I told him to look ahead, just like watching TV at home, and try to relax as much as possible...", deputy chief physician Liang Yancan said, but the male classmates may also be amused by their own experience, and have been laughing awkwardly, and it took a while to ease up.
At this time, Deputy Chief Physician Liang Yancan put two thumbs on the male classmate's mandibular molar, and the rest of the fingers supported the mandible, first downward forward force, and then sent up and backward, the male classmate's temporomandibular joint was successfully reset, and the whole process took only 3 seconds.
Subsequently, the male classmate told Liang Yancan, deputy chief physician, that he had experienced temporomandibular joint dislocation before, and that he was not fixed with a bandage after the reduction.
So Deputy Chief Physician Liang Yancan gave him a disease education, let him pay attention to the mandibular brake (fixed with bandages) for two weeks, if there is no brake or insufficient braking time after the reduction, the torn ligaments, joint capsules, etc. have not been well repaired, and repeated dislocations may occur, affecting daily life.
This disease is easy to recur, and it is also necessary to be careful after reduction
Liang Yancan, deputy chief physician of the Department of Stomatology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, said that temporomandibular joint dislocation refers to the complete separation between the condyle and the joint fossa, joint nodule or joint disc when the mouth is opened, and cannot automatically return to the normal position when the mouth is closed. Clinical manifestations are mainly manifested as mouth can not be closed normally, pain, slurred spitting, saliva outflow, etc.
Temporomandibular joint dislocation is dominated by acute anterior dislocation, mainly due to the degree of excessive opening, such as yawning, singing, laughing, mouth opening too wide when eating, and opening mouth for a long time (such as during stomatology treatment).
Acute preluxation is not properly treated, such as no immobilization or insufficient braking time after reduction, torn ligaments, joint capsules, etc. are not well repaired, and recurrent dislocations can occur. "For example, this male classmate has a previous history of dislocation, which can be diagnosed as recurrent dislocation." Deputy Chief Physician Liang Yancan said. If the acute preluxation is not treated in time, so that the temporomandibular joint is in a state of dislocation for a long time, it is easy to form a stale dislocation. Joint reduction is more difficult due to the proliferation of fibrous connective tissue in and around the joint fossa.
Deputy Chief Physician Liang Yancan said that the reduction of the temporomandibular joint usually uses manual reduction, and the temporomandibular fixation is routinely carried out for 2 to 3 weeks after reduction, and the skull and jaw bandage fixation method is often used. If manual reduction is not feasible, the appropriate surgical method of reduction is selected according to the specific situation of the patient. "Acute anterior dislocation of the temporomandibular joint is an acute onset and should be treated immediately to prevent the development of recurrent dislocations or old dislocations that are difficult to treat."
Tip: Do this to avoid temporomandibular joint dislocation
How can temporomandibular joint dislocation be avoided? Li Zhipeng, Deputy Chief Physician of Guanghua School of Stomatology and Affiliated Stomatological Hospital of Sun Yat-sen University, and Liang Yancan, Deputy Chief Physician of the Department of Stomatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, gave the following suggestions:
1. When collecting throat swabs for citizens with a history of recurrent temporomandibular joint dislocation, priority can be given to collecting nasopharyngeal swabs. If the field conditions do not allow the implementation of nasopharyngeal swab collection, when using oropharyngeal collection, you can slowly open your mouth, and gently support your chin with your hand to avoid rapid and large mouth opening. Citizens with such a medical history should inform the doctor in advance, so that the doctor can be prepared, weigh the pros and cons, and open his mouth as small as possible while completing the operation or treatment.
2. For people who have had many "jaw drops" in the past and have tried to reset successfully, in order to avoid the risk of infection, they should wear a mask first, leave the densely populated nucleic acid collection area, and try to reset themselves after hand disinfection.
3. If the reduction is unsuccessful or cannot be reduced by itself, you should go to the hospital in time to seek help from a stomatologist. After the manual reduction, an elastic bandage is also performed for 2 weeks and the opening of the mouth is restricted for 2 weeks. Do not open the mouth more than 1 cm during temporomandibular fixation, and try not to make a large mouth opening after the fixation is completed, and gradually train the range of motion of the temporomandibular joint.
4, usually should avoid crying, laughing, eating and other exaggerated mouth opening action; do not use teeth to bite walnuts, open bottle caps and other hard items; maintain adequate sleep, avoid physical fatigue, less yawning; food should choose soft, nutritious, chew slowly.
Text, photo, video/ Guangzhou Daily Xinhuacheng Reporter: Ren Shanshan Correspondents: Zhang Yang, Huang Rui, Wang Xinyi, Lv Yajie, Liang Jianfang
Source: Guangzhou Daily