Evaluation of Screw and Wire Traction in Anatomic Reduction of Mandibular Fracture

Abstract

Abstract Background Displaced mandibular fractures have numerous ways of being reduced, the aim of adequate fracture reduction is to achieve good bone contact to allow for adequate healing. Reduction techniques include, bone holding forceps, manual reduction and reduction using IMF techniques which restore occlusion and then secondarily reduce the fracture site. Fracture immobilization using rigid fixation then follows reduction thus maintaining adequate bone contact allowing fracture line healing. The use of screw and wire traction provides stable fracture reduction anatomically without the need for IMF. Aim of the Work The aim of this study is to evaluate the efficacy of screw and wire traction in anatomical reduction of mandibular fracture on the accuracy of reduction, operative time and post-operative pain and edema. Patients and Methods This is a single arm interventional clinical trial including twenty adult individuals with mandibular fractures. Patients who are fulfilling the inclusion criteria of our study were sampled randomly. Results Twenty cases were included in our study. Adequate fracture reduction was done in all patients with good clinical bone contact and with good post-operative CT results, post-operative pain and edema were minimal due to decreased manipulation of the fracture and the simplicity of the technique. The occlusion of the patients was followed up 2 and 6 weeks post operatively with cases showing no occlusal disturbance and return to normal function within 3 months. Conclusion Screw and wire traction for reduction of mandibular fractures anatomically showed success as regards to fracture reduction and showed no occlusal complication, we recommend this technique specially in symphyseal, paranymphs and angle fracture. The fracture line taking a strictly vertical axis shows the best outcome, however multiplanar fracture lines or L-shaped fractures are not good specimens for this method of reduction.