Ahmad Mukhtar Modibbo, James Olutayo, Farate Abubakar, Olasoji Hector Oladapo, Suleiman Ibrahim Kayode, Abdullahi Mohammed Adam Sheikh, Umar Farouk Kabir
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Maiduguri, Maiduguri, Borno State, Nigeria.
Department of Oral and Maxillofacial Surgery, University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria.
J West Afr Coll Surg. 2025 Oct-Dec;15(4):471-480. doi: 10.4103/jwas.jwas_145_24. Epub 2025 Apr 5.
Traditionally, arch bars are used for mandibulomaxillary fixation (MMF) following mandibular fractures. Intermaxillary fixation screws (IMFS) are a suitable alternative to mitigate the drawbacks of arch bar fixation.
We compared the use of arch bars versus IMFS for treatment of mandibular fractures including evaluation of sonographic findings and the patients' quality of Life (QoL).
This is a randomised prospective study.
The study was conducted at the Department of Oral and Maxillofacial Surgery, University of Maiduguri Teaching Hospital.
Fifty patients with mandibular fractures were recruited and randomly divided into two groups, 25 each in the arch bars and IMFS treatment groups. The parameters evaluated were as follows: mouth opening, malocclusion, pain, fracture healing using an ultrasound scanner, operating time, wire-prick injuries, oral hygiene, and QoL.
There was a significantly higher pain score by the 3 and 6 postoperative weeks ( = 0.015 and = 0.003, respectively) and shorter operating time ( < 0.001) in the IMFS group, while a notable higher wire-prick injury ( < 0.001) and poor oral hygiene ( = 0.25) were observed in the arch bar group. An ultrasound scan at 6 postoperative weeks showed complete hyperechoic bridging callus in (61.5%) the arch bar group and (50%) in the IMF screw group, with no statistically significant difference. Regarding the QoL, patients treated with arch bars had more difficulty in continuing with their normal diet and indicated "they will not undergo the same treatment again." On the other hand, IMFS patients had significantly isolated themselves because of feelings of bad mood, and their sleep and speech patterns were significantly affected.
Although some similarities were observed in both groups, this study observed that IMFS addressed some of the limitations associated with arch bars such as prolonged operative time, wire-prick injury, and poor oral hygiene. Therefore IMFS is relatively safer and can be used for long-time MMF.
PACTR202408851121914.
04 July 2024, "retrospectively registered."
Pan African clinical trials registry.
传统上，弓形杆用于下颌骨骨折后的下颌骨上颌骨固定（MMF）。颌间固定螺钉（IMFS）是减轻弓形杆固定缺点的合适替代方法。
我们比较了弓形杆与IMFS在下颌骨骨折治疗中的应用，包括超声检查结果评估和患者生活质量（QoL）评估。
这是一项随机前瞻性研究。
该研究在迈杜古里大学教学医院口腔颌面外科进行。
招募50名下颌骨骨折患者，随机分为两组，弓形杆治疗组和IMFS治疗组各25例。评估的参数如下：开口度、咬合不正、疼痛、使用超声扫描仪评估骨折愈合情况、手术时间、钢丝刺伤、口腔卫生和生活质量。
IMFS组术后3周和6周时疼痛评分显著更高（分别为P = 0.015和P = 0.003），手术时间更短（P < 0.001），而弓形杆组观察到钢丝刺伤显著更多（P < 0.001），口腔卫生较差（P = 0.25）。术后6周的超声扫描显示，弓形杆组（61.5%）和IMFS螺钉组（50%）出现完全高回声桥接骨痂，差异无统计学意义。关于生活质量，接受弓形杆治疗的患者在继续正常饮食方面有更多困难，并表示“他们不会再次接受相同的治疗”。另一方面，IMFS治疗的患者因情绪不佳而显著孤立，他们的睡眠和言语模式受到显著影响。
尽管两组观察到一些相似之处，但本研究发现IMFS解决了一些与弓形杆相关的局限性，如手术时间延长、钢丝刺伤和口腔卫生差。因此，IMFS相对更安全，可用于长期MMF。
PACTR202408851121914。
2024年7月4日，“回顾性注册”。
泛非临床试验注册中心。
