Awl versus intravenous cannula stillete in circummandibular wiring-a prospective comparative study

Novel and Affordable Low-Cost Technique for Fixation of Parasymphyseal Fractures in Infants With Unerupted Dentition

PURPOSE

Pediatric mandibular fractures are immensely challenging compared to adult fractures. The current update management spectrum ranges from the conservative one in the form of soft diet and regular follow-up, or less invasive surgical intervention by closed reduction and nonrigid fixation, to open reduction and internal fixation with plates and screws. In this study, we investigated the use of a straightforward fabricated mold for the parasymphyseal mandibular fracture in infants with an unerupted dentition.

PATIENTS AND METHODS

This prospective study was conducted on 8 infants presenting with parasymphyseal fractures with unerupted dentitions in our specialized trauma center. In the operating room before the induction of anesthesia, the authors used a straightforward plastic airway to create a splint. The curved part was split into 2 transverse halves making 2 U-shaped curved pieces that were utilized as a mold. Intraoperatively, the U-shaped piece was placed over the mandible and stabilized with circummandibular wires. This molded airway is used to stabilize the fracture site for 2-3 weeks. The average period of follow-up was around 6 months.

RESULTS

The average time of mandibular fixation was 17.6 ± 2.4 SD (14 to 20) days. The mean of the total operative time was 38.7 ± 3.5 SD minutes, ranging from 35 to 45 minutes. Our infants were observed in the outpatient clinic for 6 months postoperatively during the follow-up period. There were no noticeable complications nor any interference with tooth eruption or mandibular growth.

CONCLUSIONS

The results of this study suggest that this technique is straightforward to use and affordable. It does not require a long learning period. It also exhibits the advantage of reducing the cost in many developing countries.

"A Bend to a Needle Makes the Arch Stable" a Modified Technique for Zygomatic Arch Reduction and Stabilization

Background

Gillies temporal approach and intra oral supraperiosteal approach are the most commonly used approaches for reduction of isolated zygomatic arch fractures.

Purpose

To set forth a less invasive technique for reduction and stabilization of isolated zygomatic arch fractures.

Materials and Methods

A 24-G stainless steel wire is passed through a 16-G cannula needle and is shaped to form a semi-circle. The precontoured needle was then inserted into the inferior part of the depressed zygomatic arch and the tip passed out through the superior part. The wires are then twisted and pulled laterally to reduce the fracture and are tied over an external splint to stabilize the arch.

Conclusion

The technique discussed in this article is simple, less time consuming, cost effective and less traumatic than the conventionally performed techniques for reduction and stabilization of isolated zygomatic arch fractures.