Disk-Repositioning Surgery

Disk-Repositioning Surgery

During the late 1970s and 1980s one of the most commonly  performed TMJ surgical procedures was disk repositioningand p)ication. The indication for this procedure is anterior disk displacement that has not responded to nonsurgical treatment and that most frequently results in
persistent painful clicking joints or closed locking (i.e., anterior disk displacement with or without reduction). Although these disorders are more frequently managed surgically with arthrocentesis or arthroscopy, many surgeons still prefer this type of surgical correction. In this operation the displaced disk is identified and repositioned into a more normal position by.removing a wedge of tissue from the posterior attachment of the disk and suturing the disk back to the correct anatomic position (Fig..30·Z7). In some cases this procedure is combined with recontouring
of the disk, articular eminence, and mandibular condyle. After surgery, patients generally begin a nonchew diet for several weeks, progressing to a relatively normal diet in 3 to 6 months. A progressive regimen of jaw exercises is also instituted in an attempt to obtain normal’ jaw motion within 6 to 8 weeks after surgery. In general the results of open arthroplasty have been good, with 8091)to 9S’){,of the patients experiencing less pain and improved jaw function.i” Unfortunately this’  surgery does not produce improvement in all paients, with 10% to lS(M,of patients describing no improvement or a worsening of the condition.

Medical Assignments

Head injury

There are 200-300 admissions annually for head injuryper 100000 population in most Western countries: 10 people

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