Trick of the Trade: Protecting your thumbs in mandible relocations

Posted by Michelle Lin, MD on

Does anyone think that this is generally a bad idea when closed-reducing mandible dislocations? Yes, it’s easiest to apply downward pressure on the mandible by pushing down on the occlusal surfaces of the molar teeth. Sometimes, however, when the mandible relocates into place, the teeth clamp shut abruptly – placing your thumbs at risk. How can you prevent any injuries to yourself?

One way is to slide gauze into the mouth during your procedure. Start the video around the 1:30 mark for an exam.

Trick of the Trade: Mandible Relocations

Apply a protective roll of gauze over each thumb. Additionally, you can wear a second glove to cover the gauze. No, those are NOT just fat thumbs under the gloves.

Thanks to Dr. Liz Brown (UCSF-SFGH EM resident) for the trick!

Author information

ALiEM Founder and CEO
Professor and Digital Innovation Lab Director
Department of Emergency Medicine
University of California, San Francisco

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