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Intermaxillary fixation is not usually necessary to reduce mandibular fractures

Lookup NU author(s): Anthony Hildreth, John Hawkesford


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We undertook a retrospective study of all isolated mandibular fractures which had required active management over a 1-year period at the Maxillofacial Unit at Newcastle General Hospital. Patients with single or multiple fractures of the mandible were included in the study; if there were other simultaneous fractures of the facial skeleton, those patients were excluded. All case notes and radiographs were reviewed by a single operator. A total of 202 cases of fractured mandible were identified of which 115 fulfilled the selection criteria of: isolated fracture, no previous facial fracture, treatment by open reduction and internal fixation using titanium osteosynthesis miniplates, and all case notes and radiographs available to study. Sixty-six patients had their fractures reduced manually to obtain anatomical reduction without the use of peroperative intermaxillary fixation (IMF). Forty-nine were treated conventionally using peroperative IMF. The two groups were broadly similar in severity and type of fracture, and the method of reduction seemed to be decided by the operator according to their preference. IMF was not used routinely postoperatively. Overall there were significantly fewer occlusal discrepancies in the early postoperative period in those patients treated by anatomical reduction (6/66 compared with 16/49, P = 0.002) but there was no difference in the final outcome of the occlusion between the two methods of reduction. Avoidance of the use of peroperative IMF is more economical in time and cost, is safer for the operator, and more comfortable for the patient. As this technique produces comparable results in the long term with fewer early complications, we conclude that IMF is not usually necessary to reduce fractures confined to the mandibular bone.

Publication metadata

Author(s): Hawkesford JE; Hildreth AJ; Fordyce AM; Lalani Z; Songra AK; Carton ATM

Publication type: Article

Publication status: Published

Journal: British Journal of Oral and Maxillofacial Surgery

Year: 1999

Volume: 37

Issue: 1

Pages: 52-57

Print publication date: 01/02/1999

ISSN (print): 0266-4356

ISSN (electronic): 1532-1940

Publisher: Churchill Livingstone


DOI: 10.1054/bjom.1998.0372


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