Joanna Baptist, Venkatesh Naidu Parachuri, Premalatha Shetty, S. K. Madhu
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引用次数: 0
摘要
无论是在上颌骨-下颌骨骨折的保守治疗还是手术治疗中,颌骨间固定术(IMF)都能提供稳定的咬合,同时还能缩小骨折的部分。实现颌间固定的技术多种多样,其中埃里希拱杆是最传统、最常用的技术。然而,该技术中使用的每一根钢丝都会给手术团队带来经皮损伤的风险,对钢丝固定的牙齿牙周造成创伤,而且患者感觉不太舒适。我们的新型 IMF 技术采用了在 IMF 螺钉周围多圈缠绕正畸 E 链的方法,可以在上颌骨-下颌骨骨折钢板固定之前充分缩小和稳定骨折段,并实现良好的咬合。根据我们的临床经验,使用这种新技术不会给手术团队带来经皮损伤的风险。这项新技术可用于所有需要 IMF 的患者,尤其适用于牙周受损或部分缺牙的患者,因为这些患者无法进行传统的牙弓杆固定。这项技术将大大缩短手术时间,并有助于提高患者的依从性。
IMF screws with orthodontic E chains as a novel technique for intermaxillary fixation
Either in conservative or in surgical management of maxillo‐mandibular fractures, intermaxillary fixation (IMF) provides stable occlusion, while offering reduction in the fractured segments. Various techniques have been used for achieving IMF, among which Erich arch bar is the most conventional and routinely used technique. However, it poses a risk of percutaneous injury to the surgical team with every wire used in the technique, causes trauma to the periodontium of the teeth secured by wires and it is not very comfortable for the patient. The few IMF techniques that are recommended without wire require special armamentarium that are not universally available.Our novel IMF technique employing multiple looping of orthodontic E chains around IMF screws can provide adequate reduction and stabilization of the fractured segments with good occlusion before plating of the maxillo‐mandibular fractures. It can also be utilized for extended periods for closed reduction or postoperatively for guiding the occlusion.As seen in our clinical experience using this novel technique, there is no risk of percutaneous injury to the surgical team. It provides stable occlusion, optimal reduction in the fractured segments and is accepted well by patients as no wires are used.This novel technique can be used in all patients who require IMF and is particularly useful in patients with periodontally compromised teeth or in those who are partially edentulous where conventional arch bar fixation cannot be performed. This technique will considerably reduce the operative time and aid in better patient compliance.