The tension wire method: a simple, effective means of mandibular fixation.
OBJECTIVE
To investigate the use of a tension wire band secured to monocortical screws for open reduction and internal fixation of simple, displaced, and/or unstable mandibular fractures.


METHODS
Retrospective review with follow-up duration of at least 6 weeks.


METHODS
Level I university trauma center.


METHODS
Twenty-nine patients (27 males and 2 females), aged 7 to 46 years. Ten patients had unilateral fractures (1 patient had 3 separate unilateral fractures) and 19 had bilateral fractures; 34 of 50 fractures were displaced; 19 were open intraorally. The location of fractures and the number (number repaired) were as follows: symphysis or parasymphysis, 13 (10); body, 9 (8); angle, 18 (14); ramus, 6 (4); and subcondylar, 4 (0). Two fractures were each comminuted into 3 fragments, and 1 patient had unilateral parasymphysial, body, and ramus fractures.


METHODS
Intermaxillary fixation was done in all patients except 1 child. Intraoral approaches were used exclusively. A pair of monocortical 2.0-mm screws were placed perpendicular to fracture lines, with 24-gauge wire loops passed around the screws and tightened to bring the fracture into reduction and provide stable fixation. A percutaneous trocar system was used to insert screws at the body, angle, and ramus sites.


RESULTS
There were no instances of infection, malunion, or malocclusion in the 33 fractures repaired with this technique. A typical intermaxillary fixation with open reduction and internal fixation of a posterior fracture was done in less than 2 hours.


CONCLUSIONS
Open reduction and internal fixation of simple mandibular fractures with tension wire bands around monocortical screws is a simple, quick, and effective technique.
Wang
R C
RC
Division of Otolaryngology-Head and Neck Surgery, Texas Tech University Health Sciences Center, Lubbock, USA.
Keech
D R
DR
Elkins
T P
TP
Russell
P
P
D000293:Adolescent; D000328:Adult; D001863:Bone Screws; D001864:Bone Wires; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D008297:Male; D008337:Mandibular Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D011862:Radiography, Panoramic; D012189:Retrospective Studies