Evaluation of Screw and Wire Traction in Anatomic Reduction of Mandibular Fracture | ||
| The Egyptian Journal of Plastic and Reconstructive Surgery | ||
| Article 7, Volume 48, Issue 4, October 2024, Pages 291-295 PDF (456.62 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejprs.2024.385103 | ||
| Authors | ||
| Khakled Reyad* ; Nada AbdelSattar Mahmoud; Mohamed Ibrahim Hussein; Lina Saleh | ||
| The Department of Plastic, Burn and Maxillofacial Surgery, Faculty of Medicine, Ain Shams University | ||
| Abstract | ||
| Background: Displaced mandibular fractures have numerous ways of being reduced, the aim of proper fracture reduction is to achieve good bone contact to allow for adequate healing. Reduction techniques include, bone holding forceps, manual reduction and reduction using maxilla-mandibular fixation techniques, which restore occlusion and then secondarily reduce the fracture site. Fracture immobilization using rigid fixation following reduction, maintains adequate bone contact allowing fracture line healing. The use of screw and wire traction provides stable fracture reduction anatomically without the need for IMF. Objective: Evaluation of the efficacy of screw & wire traction in anatomical reduction of mandibular fracture. Patients and Methods: This is a single arm interventional clinical trial including twenty adult individuals with mandibular fractures. Patients who are fulfilling the inclusion criteria of our study were sampled randomly. Aim of this study is to evaluate the efficacy of screw and wire traction in anatomical reduction of mandibular fracture on the accuracy of reduction, operative time and post-operative pain and edema. Results: Twenty cases were included in our study. Adequate fracture reduction was done in all patients confirmed by good clinical bone contact, good occlusion and post-operative CT results. Post-operative pain and edema were minimal due to decreased manipulation of the fracture and the simplicity of the technique. The occlusion of the patients was followed up 2 and 6 weeks post operatively with cases showing no occlusal disturbance and return to normal function within 3 months. Conclusion: Screw and wire traction for reduction of mandibular fractures anatomically showed success as regards to fracture reduction and showed no occlusal complication, we recommend this technique specially in symphyseal, para-symphyseal and angle fracture. The fracture line taking a strictly vertical axis shows the best outcome, however multiplanar fracture lines or L-shaped fractures are not good specimens for this method of reduction. | ||
| Keywords | ||
| Mandibular; Fracture; Screw; Wire; Traction | ||
| References | ||
|
Batbayar E.O., van Minnen B. and Bos R.R.: Non-IMF mandibular fracture reduction techniques: A review of the literature. Journal of Cranio-Maxillofacial Surgery, 45 (8): 1327-1332, 2017. 2- Singh S., Mishra N., Raut S. and Pati D.: Complications in Maxillofacial Trauma. In Maxillofacial Trauma. Springer. (pp. 411-444), 2021. 3- Choi B.H., Park J.H., Yoo T.M., Huh J.Y. and Suh C.H.: Evaluation of stress patterns generated by reduction forceps within a photoelastic mandibular model. Journal of Cranio-Maxillofacial Surgery, 31 (2): 120-125, 2003. 4- Levine P.A. and Goode R.L.: Mandibular fracture reduction with eccentric dynamic compression plate: New treatment for an old problem. Otolaryngology--Head and Neck Surgery, 89 (4): 569-574, 1981. 5- Degala S. and Gupta N.: “Tension Band Wiring” a simplified approach for fracture reduction and intermittent stabilization. Journal of Maxillofacial and Oral Surgery, 9 (4): 382-384, 2010. 6 Ingole P.D., Rajguru J.G., Budhraja N.J., Shenoi R.S., Karmarkar J.S. and Dahake R.N.: ATOM technique: Anatomic reduction using screw-wire Traction for Open reduction and internal fixation of Mandibular fractures. Journal of the Korean Association of Oral and Maxillofacial Surgeons, 48 (2): 122-124, 2022. 7- Bell R.B., Thompson L., Amundson M.J.P.S.P.O.O. and Surgery, M.: Contemporary Management of Mandibular Fractures, 581-647, 2022. 8- Dimitroulis G.: Management of fractured mandibles without the use of intermaxillary wire fixation. J. Oral Maxillofac Surg., 60 (12): 1435-1439, 2002. 9- Singh A.K., Dahal S., Singh S., Krishna K.C. and Chaulagain R.: Is manual reduction adequate for intraoperative control of occlusion during fixation of mandibular fractures? A systematic review and meta-analysis. British Journal of Oral and Maxillofacial Surgery, 60 (3): 271-278, 2022 | ||
|
Statistics Article View: 92 PDF Download: 178 |
||
