Background: Displaced mandibular fractures have numerous
ways of being reduced, the aim of proper fracture reduction
is to achieve good bone contact to allow for adequate
healing. Reduction techniques include, bone holding forceps,
manual reduction and reduction using maxilla-mandibular fixation
techniques, which restore occlusion and then secondarily
reduce the fracture site. Fracture immobilization using rigid
fixation following reduction, maintains adequate bone contact
allowing fracture line healing. The use of screw and wire traction
provides stable fracture reduction anatomically without the
need for IMF.
Objective: Evaluation of the efficacy of screw & wire traction
in anatomical reduction of mandibular fracture.
Patients and Methods: This is a single arm interventional
clinical trial including twenty adult individuals with mandibular
fractures. Patients who are fulfilling the inclusion criteria
of our study were sampled randomly. Aim of this study is to
evaluate the efficacy of screw and wire traction in anatomical
reduction of mandibular fracture on the accuracy of reduction,
operative time and post-operative pain and edema.
Results: Twenty cases were included in our study. Adequate
fracture reduction was done in all patients confirmed by
good clinical bone contact, good occlusion and post-operative
CT results. Post-operative pain and edema were minimal due to
decreased manipulation of the fracture and the simplicity of the
technique. The occlusion of the patients was followed up 2 and
6 weeks post operatively with cases showing no occlusal disturbance
and return to normal function within 3 months.
Conclusion: Screw and wire traction for reduction of mandibular
fractures anatomically showed success as regards to
fracture reduction and showed no occlusal complication, we
recommend this technique specially in symphyseal, para-symphyseal
and angle fracture. The fracture line taking a strictly
vertical axis shows the best outcome, however multiplanar fracture
lines or L-shaped fractures are not good specimens for this
method of reduction.