Intraosseous Wiring Research Articles

Intraosseous wiring in ramus osteotomy

The value of intraosseous wiring of the fragments after oblique osteotomy of the mandibular rami was studied. A wired group (14 patients) and a nonwired group (15 patients) were compared cephalometrically. There were only small differences between the groups but there was a tendency toward a smaller postoperative posterior rotation of the mandible in the wired group. It was concluded that in routine cases of mandibular prognathism wiring is not necessary.

Improved maxillary stability with modified LeFort I technique

This modification of the LeFort I osteotomy places the horizontal bony cut higher and into the dense cortical bone of the maxillozygomatic complex. It gives greater stability and also provides a more solid bony base for intraosseous wiring of the mobilized segment. This usually eliminates the need for dento-osseous or maxillomandibular fixation, and the segments appear to solidify more quickly. Over the last year, we have used this technique in 23 cases (four maxillary advancements, seven one-piece maxillary intrusions, and 12 segmental maxillary intrusions) with very favorable results. This modification has given us greater control and stability, especially in combined maxillary and mandibular osteotomies.

Changes in the temporomandibular joint after oblique sliding osteotomy of the mandibular rami: A longitudinal radiological study

Changes in the temporomandibular joint following oblique sliding osteotomy of the mandibular rami were studied using axial, frontal and lateral radiographs. The condyle/fossa relationship was also studied with regard to the effect of intraosseous wiring of the proximal fragment. Antero-inferior displacements of the condyles were regularly seen after the osteotomies. The use of intraosseous wiring had no adverse effects on the temporomandibular joint.

A technique to facilitate drilling and passing intraosseous wiring in the hand

A technique to facilitate drilling and passing intraosseous wiring in the hand

Open Reduction and Internal Fixation of Mandibular Fractures

Open reduction and internal fixation of mandibular fractures by intraosseous wiring in conjunction with intermaxillary fixation remains the mainstay of mandibular fracture treatment despite the availability of newer methods. The principles of treatment are reviewed, including indications for use of this technique and its advantages and disadvantages. Various surgical techniques are also reviewed and key points in their application emphasized.

Intraosseous Wiring of Complex Hand Fractures

Our results with the use of intraosseous wires for 72 complex, open fractures are reported. The technique is described, and attention to detail is emphasized. The technique is indicated especially for articular or comminuted fractures with multiple small fragments. It also provides solid, anatomic fixation for other types of fractures and for replants. A K-wire may be added if necessary and is usually used if there has been some bone loss. Complications have been few, most the result of displacement at the fracture site due to improper use of the technique. A major advantage of the solid fixation obtained with this technique is that it avoids or minimizes the need for postoperative splinting and allows early active and passive range of motion. It is our impression that this has minimized joint stiffness and tendon adhesions and improved functional results.

Intraosseous wiring of the digital skeleton

One hundred cases of osteosynthesis done by the use of intraosseous wiring are presented. Two techniques of wiring are described, one used in transverse fractures and arthrodeses in which an additional Kirschner wire is employed, the other in which No. 0 monofilament wire can be placed perpendicular to the line of osteosynthesis. Forty-seven fractures were treated and there was union in all cases; 53 arthrodeses were performed, with failure in five, due, it is believed, to a failure to observe the essential elements of the technique, namely the need to obtain congruous bone ends and to maintain all internal fixation until there is clinical evidence of union. Overall, 83.2% of the maximum attainable total active range of motion was achieved in the 100 cases.

A fractured mandible, from initial operation to removal of tantalum mesh: Report of a case

Report is made of a case of fracture of the angle of the mandible. Treatment was attempted with the Sampson pericortical bone clamp, but was unsuccessful. Routine use of intraosseous wire led to a localized osteomyelitis, without union of the fracture. Treatment then was made with a particulate marrow graft contained within a tantalum mesh screen. The screen was removed 30 months postoperatively.

Post-operative relapse following sagittal split osteotomy

In a series of 16 cases treated for mandibular prognathism by the Obwegeser-Dal Pont osteotomy, the changes at operation and during the first post-operative year have been analysed using new techniques. The statistically significant changes were all horizontal. 50 per cent of the material showed evidence of relapse.Futher analysis of the cases showing relapse using the Adams blink comparator and the intra-osseous wire as an implant, revealed that condylar growth and altered mandibular posture were important factors producing relapse. The condylar growth factor can be minimised by delaying operation until towards the end of the growth period and the tendency for the patient to protrude the mandible might be lessened by detaching the medial pterygoid muscle and the spheno-mandibular ligament.