UMEM Educational Pearls

Title: What's the diagnosis? Image submitted by George Kochman

Posted: 8/5/2012 by Haney Mallemat, MD (Emailed: 8/6/2012) (Updated: 8/6/2012)
Click here to contact Haney Mallemat, MD

Question

Patient presents with an inability to close his mouth after yawning. The physician attempts the Gromis method for the problem (Xray below)? What's the diagnosis and what's the Gromis method?

Answer

Answer: Mandibular dislocation...and the Gromis method?

• The Gromis method (a.k.a. the "Masseteric Massage" technique) is an alternative method for reducing mandibular dislocations.

• Firm, direct, and constant pressure is applied bilaterally to the masseter muscles, which relaxes the muscles (i.e., reduces spasm) and allows mandibular reduction with less traction than traditional reduction techniques and with no procedural sedation.

• Rob Orman (@emergencypdx) posts a video of Dr. Daniel Gromis demonstrating the technique: http://vimeo.com/46453741

• Finally, UMEM pearl regulars may recognize this Xray from a post last year where we described another alternative method to reduce mandibular dislocations. Here it is again: http://www.youtube.com/watch?v=Kp8AzHIC0hM

References

Follow me on Twitter (@criticalcarenow) and Google+ (+haney mallemat)