title: Impalement of an unusual foreign body on the temporomandibular joint causing severe trismus.
abstract: A penetrating injury by a foreign body is comparatively common in the oral and maxillofacial region. On the other hand, injury to the temporomandibular joint (TMJ) by a foreign object is very rare. The TMJ is an anatomically narrow space surrounded by hard bony processes. An unusual case of trauma with severe trismus caused by a foreign body that impaled the TMJ is reported. A 55-year-old man presented with a 5 × 1-cm laceration to the right cheek caused by a flying object propelled during the use of a lawn mower. The edge of the foreign body had a metallic wire, which became imbedded in the wound. His jaw opening was severely limited. Computed tomography revealed that the foreign body was 3 mm in diameter and was impaled on the articular capsule. The object was successfully removed, and the wound and interior of the TMJ were irrigated. Rehabilitation of mouth opening was started on postoperative day 3. On day 9, mouth opening had improved to 35 mm, and he was discharged. After 1 year, mouth opening was 45 mm with no sign of any TMJ disorders.
authors.affiliation: Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: Ryohei
authors.initials: R
authors.lastname: Ito
authors.affiliation: Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: Kosei
authors.initials: K
authors.lastname: Kubota
authors.affiliation: Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Furudate
authors.affiliation: Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakagawa
authors.affiliation: Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Kon
authors.affiliation: Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Tamura
authors.affiliation: Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Kobayashi
mesh_terms: D005547:Foreign Bodies / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013704:Temporomandibular Joint / Q000473:pathology*; D013705:Temporomandibular Joint Disorders; D014057:Tomography, X-Ray Computed; D014313:Trismus / Q000209:etiology*
keywords: foreign body; impalement; penetrating injury; temporomandibular joint; trismus