Kaur Tejinder, Dhawan Amit, Bhullar Ramandeep Singh, Kapila Sarika, Gupta Sakshi, Resham Ritika
Department of Oral and Maxillofacial Surgery, Sri Guru Ram Das Institute of Dental Sciences and Research, Mall Mandi, GT Road, Amritsar, 143001 India.
J Maxillofac Oral Surg. 2022 Jun;21(2):433-441. doi: 10.1007/s12663-021-01528-x. Epub 2021 Mar 8.
Maxillomandibular fixation (MMF) is a basic and fundamental principle in the management of the maxillofacial trauma patients. Some fractures require only intraoperative MMF, during open reduction and internal fixation but not in the postoperative period. The present study was aimed to assess and compare the efficacy of embrasure wire with Erich arch bar as methods of intraoperative maxillomandibular fixation in the management of mandibular fractures.
The prospective randomized study was undertaken in 30 patients who required intraoperative maxillomandibular fixation for mandibular fractures. Patients were randomly divided into two groups of 15 each (Erich arch bar in Group A and embrasure wire in Group B). The preoperative assessment included evaluation of demographic data, fracture location, mechanism of injury, degree of displacement of fracture and occlusion. Intraoperative parameters assessed were the time consumed for the application of MMF technique, injury to the operator/assistant, injury to the patient, stability of MMF technique, incidence of glove perforations and the cost of the MMF device.
The mean time required for MMF and incidence of glove perforation were significantly ( < 0.001) less in embrasure wire group than the Erich arch bar group. The MMF technique maintained stable occlusion during open reduction and internal fixation in both the groups.
Embrasure wire is an effective, reliable alternative form of intraoperative MMF, as needle-stick injury and time taken for placement were less as compared to the Erich arch bar group. However, Erich arch bar wiring is a versatile method and recommended where postoperative maxillomandibular fixation is also required.
颌间固定（MMF）是颌面创伤患者治疗中的一项基本且重要的原则。一些骨折仅在切开复位内固定术中需要颌间固定，术后则无需。本研究旨在评估和比较楔状丝与埃里氏牙弓夹板作为下颌骨骨折术中颌间固定方法的疗效。
对30例需要下颌骨骨折术中颌间固定的患者进行前瞻性随机研究。患者随机分为两组，每组15例（A组使用埃里氏牙弓夹板，B组使用楔状丝）。术前评估包括人口统计学数据、骨折部位、损伤机制、骨折移位程度和咬合情况。术中评估的参数包括应用颌间固定技术所需时间、对术者/助手的损伤、对患者的损伤、颌间固定技术的稳定性、手套穿孔发生率以及颌间固定装置的成本。
楔状丝组颌间固定所需平均时间和手套穿孔发生率显著低于埃里氏牙弓夹板组（<0.001）。两组在切开复位内固定过程中，颌间固定技术均维持了稳定的咬合。
与埃里氏牙弓夹板组相比，楔状丝是一种有效的、可靠的术中颌间固定替代形式，因为针刺伤和放置时间较少。然而，埃里氏牙弓夹板结扎是一种通用方法，在术后也需要颌间固定的情况下推荐使用。
