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一种使用颌间固定螺钉和钢丝对Le Fort I型骨折进行新型微创且经济有效的内固定方法:技术说明

A Novel Minimally Invasive and Cost-Effective Internal Fixation of the Le Fort I Fracture by Using Intermaxillary Fixation Screw and Wire: A Technical Note.

作者信息

Lal Babu, Burman Samriddhi, Alagarsamy Ragavi, Rai Anshul J, Kumar Jitendra, Rajpoot Ravina

机构信息

Department of Trauma and Emergency Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh India.

Department of Burns, Plastic and Maxillofacial Surgery, VMMC and Safdarjung Hospital, New Delhi, India.

出版信息

J Maxillofac Oral Surg. 2024 Aug;23(4):1053-1055. doi: 10.1007/s12663-024-02149-w. Epub 2024 Mar 20.

Abstract

INTRODUCTION

Le Fort I fractures represent a significant proportion of craniofacial trauma, often occurring alongside other injuries to the craniomaxillofacial region. Management options include open reduction and internal fixation (ORIF) or skeletal suspension, each with its limitations and considerations.

MATERIAL AND METHODS

This technical note presents a novel technique for managing isolated Le Fort I fractures using intermaxillary fixation (IMF) screws, offering a minimally invasive alternative to ORIF. The technique involves the strategic placement of IMF screws in the stable zygomatic bone, coupled with arch bar fixation and wire manipulation for maxillary fragment reduction.

RESULTS

This approach is cost-effective, can be performed under local anesthesia, and provides stability without the need for prolonged maxillomandibular fixation (MMF).

CONCLUSION

The simplicity and efficacy of this technique make it suitable for emergency settings and cases where traditional approaches may not be feasible. However, this technique is only feasible in isolated Le Fort I fractures and is contraindicated in comminuted Le Fort I fractures and in edentulous patients with upper jaw involvement.

摘要

引言

勒福Ⅰ型骨折在颅面创伤中占很大比例,常与颅颌面区域的其他损伤同时发生。治疗选择包括切开复位内固定(ORIF)或骨骼悬吊,每种方法都有其局限性和注意事项。

材料与方法

本技术说明介绍了一种使用颌间固定(IMF)螺钉治疗孤立性勒福Ⅰ型骨折的新技术,为ORIF提供了一种微创替代方法。该技术包括在稳定的颧骨中战略性地放置IMF螺钉,同时进行牙弓夹板固定和钢丝操作以复位上颌骨碎片。

结果

这种方法具有成本效益,可以在局部麻醉下进行,并且无需长时间的颌间固定(MMF)即可提供稳定性。

结论

该技术的简单性和有效性使其适用于紧急情况以及传统方法可能不可行的病例。然而,该技术仅适用于孤立性勒福Ⅰ型骨折,在粉碎性勒福Ⅰ型骨折以及上颌骨受累的无牙患者中禁用。

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本文引用的文献

1
Le Fort Fractures: A Collective Review.勒福骨折:综合综述
Bull Emerg Trauma. 2017 Oct;5(4):221-230. doi: 10.18869/acadpub.beat.5.4.499..
2
Management of Le Fort I fracture.勒福Ⅰ型骨折的处理
Arch Craniofac Surg. 2017 Mar;18(1):5-8. doi: 10.7181/acfs.2017.18.1.5. Epub 2017 Mar 25.
3
Retrospective analysis of surgically treated Le Fort fractures.经手术治疗的勒福骨折的回顾性分析。
Arch Otolaryngol. 1983 Jul;109(7):446-8. doi: 10.1001/archotol.1983.00800210022004.
4
Technique for rigid fixation of Le Fort and palatal fractures.勒福骨折和腭骨骨折的坚固内固定技术。
J Oral Maxillofac Surg. 1986 Nov;44(11):921-2. doi: 10.1016/0278-2391(86)90234-x.

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