BMJ Case Reports 2016; doi:10.1136/bcr-2015-213917

Single-stage temporomandibular joint arthroplasty in a patient with complete bony ankylosis and previous extradural haematoma

Editor's Choice
  1. Peter Revington2
  1. 1Department of Oral and Maxillofacial Surgery, North Bristol NHS Trust, Bristol, UK
  2. 2Department of Oral and Maxillofacial Surgery, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
  1. Correspondence to Emma Brown; elbrown7{at}
  • Accepted 22 September 2016
  • Published 8 October 2016


We present a case of a man aged 20 years who was referred with the inability to open his mouth as a consequence of severe ankylosis of his temporomandibular joint. He had previously undergone an attempt to release the ankylosis at the referring institution; however, this was complicated by an extradural haematoma as a result of iatrogenic injury. We describe a one-stage procedure which provided safe excision of the ankylotic mass along with immediate total joint replacement with a custom implant. We advocate the use of preoperative vascular imaging along with the use of custom-made cutting guides to minimise vascular injury.


  • Contributors EB and MHW wrote and edited the manuscript. PR was the supervising consultant and provided guidance on content, and final editing of the manuscript before submission.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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