Continuing the theme of mandibular dislocation tricks (protecting your thumbs, post-reduction stabilization), Dr. Daniel Gromis from Advocate Christ Medical Center describes a novel reduction technique, based on the Cunningham shoulder reduction technique using muscle relaxation.


Trick of the Trade

  1. Massage the masseter muscles before and during the procedure
  2. Apply rotational force (rather than downward and posterior force) on mandibular ramus

The rotational approach to reduction is similar to the wrist pivot method described in the Journal of Emergency Medicine (thanks to Dr. Graham Walker for the reference).1


Lowery L, Beeson M, Lum K. The wrist pivot method, a novel technique for temporomandibular joint reduction. J Emerg Med. 2004;27(2):167-170. [PubMed]
Michelle Lin, MD
ALiEM Founder and CEO
Professor and Digital Innovation Lab Director
Department of Emergency Medicine
University of California, San Francisco
Michelle Lin, MD


Professor of Emerg Med at UCSF-Zuckerberg SF General. ALiEM Founder @aliemteam #PostitPearls at Bio:
Michelle Lin, MD