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

Abstract

Background: Displaced mandibular fractures have numerousways of being reduced, the aim of proper fracture reductionis to achieve good bone contact to allow for adequatehealing. Reduction techniques include, bone holding forceps,manual reduction and reduction using maxilla-mandibular fixationtechniques, which restore occlusion and then secondarilyreduce the fracture site. Fracture immobilization using rigidfixation following reduction, maintains adequate bone contactallowing fracture line healing. The use of screw and wire tractionprovides stable fracture reduction anatomically without theneed for IMF.Objective: Evaluation of the efficacy of screw & wire tractionin anatomical reduction of mandibular fracture.Patients and Methods: This is a single arm interventionalclinical trial including twenty adult individuals with mandibularfractures. Patients who are fulfilling the inclusion criteriaof our study were sampled randomly. Aim of this study is toevaluate the efficacy of screw and wire traction in anatomicalreduction of mandibular fracture on the accuracy of reduction,operative time and post-operative pain and edema.Results: Twenty cases were included in our study. Adequatefracture reduction was done in all patients confirmed bygood clinical bone contact, good occlusion and post-operativeCT results. Post-operative pain and edema were minimal due todecreased manipulation of the fracture and the simplicity of thetechnique. The occlusion of the patients was followed up 2 and6 weeks post operatively with cases showing no occlusal disturbanceand return to normal function within 3 months.Conclusion: Screw and wire traction for reduction of mandibularfractures anatomically showed success as regards tofracture reduction and showed no occlusal complication, werecommend this technique specially in symphyseal, para-symphysealand angle fracture. The fracture line taking a strictlyvertical axis shows the best outcome, however multiplanar fracturelines or L-shaped fractures are not good specimens for thismethod of reduction.