A clinical analysis of intermaxillary fixation screws in 173 patients with jaw fracture

Abstract

Abstract: PURPOSE: To investigate the traction effect, complications and application strategy of intermaxillary fixation screws used in jaw fracture. METHODS: Intermaxillary fixation screws were used in 173 cases after internal fixation of jaw fracture. The traction effect, postoperative complications and application strategy were summarized and analyzed. RESULTS: In 173 patients, 122 had normal occlusion without traction, 43 had abnormal occlusion, but returned to normal after traction of 3-5 d. The total efficiency rate was 95%. The main complications were pain around the mucosa adjacent to the screws in 25 cases (14.5%), other complications, including root damage in 5 cases (2.9%), traction screw loosening in 12 cases (6.9%), fixation screw break in 7 cases (4.0%), dislocation and loosening of the teeth were seldom seen. CONCLUSIONS: Intermaxillary fixation screw is a safe and effective tool in the treatment of jaw fracture. Mastering and understanding the causes of complications and countermeasures are helpful to improve treatment efficiency and relieve pain of the patients.

Key words: Intermaxillary fixation screw, Jaw fracture, Complication, Strategy of prevention

CLC Number:

R782.4

GAO Zhi-biao, BAI Zhen-xi, CAO Wei-jing, WANG Yuan-ming. A clinical analysis of intermaxillary fixation screws in 173 patients with jaw fracture[J]. China Journal of Oral and Maxillofacial Surgery, 2016, 14(6): 545-548.

References

[1] Gordon RF, Reed JM, Anand VK. Results of intraoral cortical bone screw fixation technique for mandibular fractures [J]. Otolaryngol Head Neck Surg, 1995, 113(3): 248-252.
[2] 严洪海, 杜红红, 黄海蓉. 口内切口与牵引钉暂时颌间刚性牵引固定治疗下颌骨骨折45例分析 [J]. 上海口腔医学, 2007, 16(4): 385-387.
[3] 谭繁胜, 赵建江, 谭海波. 颌间牵引钉联合微型钛板内固定在颌骨骨折治疗中的应用 [J]. 现代口腔医学杂志, 2012, 26(6): 366-369.
[4] 许其章, 张红亮, 王占基. 颌间牵引钉辅助钛板内固定在颌骨骨折中的应用 [J]. 口腔颌面外科杂志, 2014, 24(3): 227-229.
[5] 王新, 崔菊萍, 邹建明. 自攻颌间牵引钉在咬合关系恢复及维持中的应用 [J]. 苏州大学学报(医学版), 2010, 30(4): 892-893.
[6] Key S, Gibbons A. Care in the placement of bicortical intermaxillary fixation screws [J]. Br J Oral Maxillofac Surg, 2001, 39(6): 484.
[7] Hashemi HM, Parhiz A. Complications using intermaxillary fixation screws [J]. J Oral Maxillofac Surg, 2011, 69(5): 1411-1414.
[8] Coletti DP, Salama A, Caccamese JF Jr. Application of intermaxillary fixation screws in maxillofacial trauma [J]. J Oral Maxillofac Surg, 2007, 65(9): 1746-1750.
[9] Rai A, Datarkar A, Borle RM. Are maxillomandibular fixation screws a better option than arch bar in achieving maxillomandibular fixation? A randomized clinical study [J]. J Oral Maxillofac Surg, 2011, 69(12): 3015-3018.
[10] 王新, 邹建明, 吴家末, 等. 自攻牵引钉应用于颌面骨折颌间牵引的并发症 [J]. 口腔医学研究, 2011, 27(3): 229-231.
[11] Rai AJ, Datarkar AN, Borle RM. Customised screw for intermaxillary fixation of maxillofacial injuries [J]. Br J Oral Maxillofac Surg, 2009, 47(4): 325-326.
[12] Purmal K, Alam MK, Pohchi A, et al. 3D mapping of safe and danger zones in the maxilla and mandible for the placement of intermaxillary fixation screws [J]. PLoS One, 2013, 8(12): e84202.
[13] 白振西, 高志彪, 肖霞, 等. 颌间牵引钉在颌骨骨折内固定手术治疗中的临床应用研究 [J]. 实用口腔医学杂志, 2015, 31(2): 219-224.
[14] 付升旗, 范锡印, 刘恒兴, 等. 下颌管与下颌后牙的位置关系及临床意义 [J]. 中国临床解剖学杂志, 2009, 27(6): 651-653.
[15] Cornelius CP, Ehrenfeld M. The use of MMF screws: surgical technique, indications, contraindications, and common problems in review of the literature [J]. Craniomaxillofac Trauma Reconstr, 2010, 3(2): 55-80.