Intermaxillary fixation screws in mandibular trauma

Abstract

Traditional maxillomandibular fixation with arch bar wiring to provide indirect stabilisation of the fractured jaws has long been replaced with miniplate osteosynthesis to reduce the duration of mouth closure. Therefore, a faster, safer and simpler method of maxillomandibular fixation for peri- and intraoperative stabilisation of jaw fractures has been tried as an option using intermaxillary fixation (IMF) screws. This study presents a review of 20 randomly selected cases of mandibular fractures treated by open reduction and internal fixation (ORIF) with miniplate osteosynthesis with peri/intraoperative use of IMF screws made of high resistance stainless steel, the use of which remains undocumented. The favourable results are an increased level of comfort for the operator, reduced working time therefore allowing time more efficient patient care as well as almost omitting the incidence of needle-stick type injuries due to limited use of wires and postoperative removal taking under 2 min in experienced hands. These advantages make it the preferred technique wherever possible, especially in hepatitis B, C and human immunodeficiency virus (HIV)-positive patients. The study is also aimed at sharing the experience in the use of IMF screws in terms of their number, placement and size, etc.