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The tension wire method: a simple, effective means of mandibular fixation Wang RC; Keech DR; Elkins TP; Russell PArch Otolaryngol Head Neck Surg 1998[Apr]; 124 (4): 448-52OBJECTIVE: 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.|*Bone Screws[MESH]|*Bone Wires[MESH]|Adolescent[MESH]|Adult[MESH]|Child[MESH]|Female[MESH]|Follow-Up Studies[MESH]|Fracture Fixation, Internal/*methods[MESH]|Fracture Healing/physiology[MESH]|Humans[MESH]|Male[MESH]|Mandibular Fractures/diagnostic imaging/*surgery[MESH]|Middle Aged[MESH]|Radiography, Panoramic[MESH]|Retrospective Studies[MESH] |
