The Tension Wire Method: A Simple, Effective Means of Mandibular Fixation

    loading  Checking for direct PDF access through Ovid

Abstract

Objective

To investigate the use of a tension wire band secured to monocortical screws for open reduction and internal fixation of simple, displaced, and/or unstable mandibular fractures.

Design

Retrospective review with follow-up duration of at least 6 weeks.

Setting

Level I university trauma center.

Patients

Twenty-nine patients (27 males and 2 females), aged 7 to 46 years. Ten patients had unilateral fractures (1 patient had 3 separate unilateral fractures) and 19 had bilateral fractures; 34 of 50 fractures were displaced; 19 were open intraorally. The location of fractures and the number (number repaired) were as follows: symphysis or parasymphysis, 13 (10); body, 9 (8); angle, 18 (14); ramus, 6 (4); and subcondylar, 4 (0). Two fractures were each comminuted into 3 fragments, and 1 patient had unilateral parasymphysial, body, and ramus fractures.

Intervention

Intermaxillary fixation was done in all patients except 1 child. Intraoral approaches were used exclusively. A pair of monocortical 2.0-mm screws were placed perpendicular to fracture lines, with 24-gauge wire loops passed around the screws and tightened to bring the fracture into reduction and provide stable fixation. A percutaneous trocar system was used to insert screws at the body, angle, and ramus sites.

Results

There were no instances of infection, malunion, or malocclusion in the 33 fractures repaired with this technique. A typical intermaxillary fixation with open reduction and internal fixation of a posterior fracture was done in less than 2 hours.

Conclusion

Open reduction and internal fixation of simple mandibular fractures with tension wire bands around monocortical screws is a simple, quick, and effective technique.

Related Topics

    loading  Loading Related Articles