Wire Suspension Internal Fixation

Wire suspension internal fixation for the treatment of maxillary fractures. That is, the stainless steel wire and the maxillary arch splint are ligated and suspended upward to be directly fixed on the frontal condyle, the zygomatic arch, and the inferior temporal margin. The lateral margin incision approach is simple, and the position of the suspending point is more moderate and posterior than other parts. The advantage of the suture point is to prevent the common problem of the posterior part of the maxillary dentition (the main reason for the anterior teeth opening). Treating diseases: maxillary retraction Indication Wire suspension internal fixation is applicable to: LeFort I, II, III fractures. Surgical procedure 1. Surgical approach: It is easier to expose the surgical field along the lateral side of the lateral iliac crest, and cut the skin, subcutaneous tissue, bone, and membrane, revealing the crease or the broken end, and 5mm above the frontal crevice. A hole in the lateral malleolus (ie, frontal condyle) is drilled into a 0.5mm-diameter, 20cm-long soft stainless steel wire, folded in half, and the double-stranded steel wire is pierced with a thick long waist or threaded through a needle. The side is equivalent to the vestibular groove of the first molar; the other is inserted on the hanging wire of the frontal condylar bone hole, bypassing another stainless steel wire, folded into double strands, and the outer side of the eyebrow is subcutaneously The slit is inserted into the double row of holes at the end of each button and kinked as a spare wire for wire drawing. 2. After the upper and lower jaw hook arch splint elastic traction reduction and fixation, it should be checked whether the bilateral condyle is in the joint socket and maintain the median occlusion relationship, which is very important to avoid the problem of joint residual. 3. After the reduction of the maxillary fracture, the double-strand wire piercing the vestibular groove is ligated to the first molar of the maxillary arch splint, and the upper jaw is suspended upward, and there is no healthy tooth in the upper jaw for the ligation of the arch. When the splint and the suspension are suspended, or the upper jaw has been ligated with the dental arch splint but the force is insufficient, and the displacement is easy when the traction is performed, or the mandibular body fracture is combined at the same time, the suspended steel wire can be directly ligated and fixed on the lower jaw arch splint. To obtain a stable occlusion, but should pay attention to the problem of the respiratory tract of the casualty and take appropriate measures. 4. The sacral arch suspension method is suitable for LeFort I type horizontal fractures to avoid facial incisions. A soft stainless steel wire with a diameter of 0.5 mm and a length of 15 cm was placed at the upper edge of the zygomatic arch (sacral condyle), and the needle was introduced into the mouth from the vestibular groove through the trocar, and the other end was inserted with a straight needle through the zygomatic arch. The side is introduced into the mouth from the vestibular groove, and the double-stranded steel wire is ligated and fixed on the upper jaw arch plate of the molar region to suspend and fix. complication 1. Premature release of the intermaxillary traction fixation, due to the imbalance of healing and contraction of the bone cross-section fibers, leading to sequelae of anterior teeth opening and closing. 2. LeFort II and III fractures can be displaced backwards and downwards due to the strong traction of the internal and external muscles of the wings. It is still not enough to antagonize the pterygoids to make the maxillary fractures backward. Displacement, so if necessary, the gypsum cap or the head ring bracket external device (connected to the front middle traction rod) should be combined. The stainless steel wire is ligated in the middle of the maxillary arch splint, and the rubber band is used to connect the drawbar and the steel wire to make the maxillary fracture block Front traction reset, coordinated with uplift.

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