Ankara Med J. 2021; 21(1): 115-123 | DOI: 10.5505/amj.2021.73693

Acil Servis’te Temporomandibular Eklem Dislokasyonu: Geriye dönük bir çalýþma

Filiz Baloglu Kaya¹, Engin Ozakin¹, Seyhmus Kaya², Muhammed Evvah Karakilic^1
1Eskiþehir Osmangazi Üniversitesi Týp Fakültesi, Acil Týp Ana Bilim Dalý, Eskiþehir.
²Eskiþehir Þehir Hastanesi Acil Týp Kliniði

GÝRÝÞ ve AMAÇ: Bu çalýþmanýn amacý, acil serviste (AS) Temporomandibular eklem (TME) dislokasyonu tanýsý alan olgularýn demografik ve klinik özelliklerini hasta idaresi ile birlikte deðerlendirmektir.
YÖNTEM ve GEREÇLER: Çalýþmamýz tek merkezli ve geriye dönük olarak 10 yýl ve 10 aylýk bir sürede (01.01.2010-30.10.2020) Eskiþehir Osmangazi Üniversitesi Saðlýk, Uygulama ve Araþtýrma Hastanesi Acil Servis’inde yapýlmýþtýr. Çalýþma sürecinde AS’ye baþvuran, TME dislokasyonu tanýsý alan, 18 yaþ ve üzeri tüm hastalar çalýþmaya dahil edilmiþtir. Olgularýn demografik verileri, dislokasyon tipi ve mekanizmasý, tekrarlayan dislokasyon hikayesi varlýðý, görüntüleme varlýðý, redüksiyon uygulamasý varlýðý, yapýldý ise redüksiyon sonlanýmý ve sedoanaljezi gerekliliði ile ilgili bilgileri dosya kayýtlarýndan alýnmýþtýr. Analiz için gerekli verilere kayýtlarda ulaþýlamamasý da dýþlama kriteri olarak belirlenmiþtir.
BULGULAR: Dosya kayýtlarý incelendiðinde 113 olgunun AS’de TME dislokasyonu tanýsý aldýðý görüldü. 66 olgu birincil baþvuru, 47 olgu ise bu olgularýn tekrarlayan baþvurularý idi. Birincil baþvurular deðerlendirildiðinde; yaþ ortalamasý 42,74±20,83 idi ve %69,7’si (n=46) kadýndý. %56,1 (n=37) bilateral eklem dislokasyonu mevcuttu. %98,5’i (n=65) non-travmatik idi. Olgularýn tamamýna bakýldýðýnda %91,2’sinde (n=103) radyolojik görüntüleme yapýlmadýðý belirlendi. Redüksiyon iþlemleri sýrasýnda %13,3 (n= 15) olguda sedoanaljezi uygulandýðý görüldü. Redüksiyon uygulamalarýnýn %98,2’sinin (n=111) baþarý ile sonuçlandýðý görüldü. Olgulara ait komplikasyon kaydýna rastlanmadý.
TARTIÞMA ve SONUÇ: TME dislokasyonu idaresi hasta konforu ile eklem fonksiyonu açýsýndan önemlidir. Acil týp hekimleri nadir de olsa karþýlaþtýklarý akut TME dislokasyonu idaresini baþarý ile gerçekleþtirmektedirler.

Anahtar Kelimeler: Temporamandibular eklem, dislokasyon, redüksiyon.

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Temporomandibular Joint Dislocation at the Emergency Department: A Retrospective Study

Filiz Baloglu Kaya¹, Engin Ozakin¹, Seyhmus Kaya², Muhammed Evvah Karakilic^1
1Eskisehir Osmangazi University Faculty Of Medicine And Health Science, Department Of Emergency Medicine, Eskisehir.
²Eskisehir City Hospital Department Of Emergency Medicine

INTRODUCTION: This study aims to evaluate demographic and clinical characteristics of the emergency department (ED) cases with a diagnosis of temporomandibular joint (TMJ) dislocation alongside the patient management of these cases.
METHODS: Our single-center and retrospective study was conducted at the ED of Eskisehir Osmangazi Health, Practice and Research Hospital in 10 years and 10 months (01.01.2010-30.10.2020). All 18 years and older patients diagnosed with TMJ dislocation at the ED during the studied period were included in the study. The information on demographics, dislocation type and mechanism, medical history of repeated dislocation, imaging, application of reduction, reduction outcome, and necessity of sedo-analgesia were obtained from the patients’ records. The lack of data required for analysis in the records was taken as an exclusion criterion.
RESULTS: When the file records were examined 113 cases were diagnosed with TMJ dislocation in ED. 66 cases were primary admissions and 47 cases were recurrent admissions of these cases. Primary applications are evaluated; the mean age was 42.74±20.83 and 69.7%(n=46) were women. The joint dislocation was present in 56.1%(n=37) bilaterally. 98.5%(n=65) of them were non-traumatic. When all the cases were evaluated, it was determined that 91.2%(n=103) did not perform radiological imaging. During reduction, it was observed that sedo-analgesia was applied in 13.3%(n=15) cases. It was observed that 98.2%(n=111) of the reduction applications resulted successfully. No complication records of the cases were found.
DISCUSSION AND CONCLUSION: Management of TMJ dislocation is important for patient comfort and joint function. Emergency physicians successfully manage acute TMJ dislocation, which they rarely encounter.

Keywords: Temporomandibular joint, dislocation, reduction.

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