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Medial Pterygoid Tendon

tendo musculi pterygoidei medialis

The medial pterygoid muscle inserts via a stout fibrous tendon into the medial surface of the mandibular angle and the adjacent ramus, from the pterygoid tuberosity up toward the mandibular foramen. The tendon fibres interdigitate with the masseter tendon on the lateral side of the ramus, forming a muscular sling around the mandibular angle. The tendon is identifiable on the medial ramus during sagittal split ramus osteotomy.

Region: Head & Skull

Clinical Relevance

Clinical Notes

The medial pterygoid tendon and its ramus insertion are relevant in sagittal split osteotomy for class III malocclusion correction, where the medial pterygoid attachment is stripped from the medial ramus during the surgical exposure but heals reliably after fixation. Medial pterygoid tendon trigger points contribute to trismus and temporomandibular pain, with tenderness accessible by intraoral palpation at the medial pterygoid insertion on the medial ramus. Botulinum toxin injection into the medial pterygoid for bruxism and trismus targets the muscle belly rather than the tendon.

Pathology

Common Injuries & Conditions

Medial Pterygoid Trigger Points and Trismus

Myofascial trigger points in the medial pterygoid produce restricted jaw opening and a deep posterior jaw pain, palpated intraorally at the medial ramus angle, managed with spray-and-stretch technique, trigger point injection, or botulinum toxin injection into the muscle belly.