![]() ![]() T1 - Fixation Sequence in a Patient with Multiple Mandibular and Midface Fractures Satisfactory aesthetic and functional outcomes were obtained after using the “bottom-up,” “tooth-bearing–non-tooth-bearing,” and “outside–inside” fixation sequence in this case", “L” plates were fixed on the zygomaticomaxillary and nasomaxillary buttresses. For the midface fractures, plates 1.5 were placed on the frontozygomatic fracture line and the left inferior orbital rim using a subciliary approach with a lateral extension. Miniplates were placed on the anterior and posterior parts of the left condyle using a preauricular approach. The right mandibular angle fracture was fixed using a reconstruction plate in the inferior border of the mandible and a miniplate 2.0 to maintain the position of the comminuted bone fragments. Miniplates were placed in the inferior border of the mandible and superior to the mental foramen in the left mandibular body using an intraoral approach. Open reduction internal fixation and wire intermaxillary fixation were performed. The patient presented with a Le Fort I fracture along with fractures in the left mandibular body, left condyle, right mandibular angle (comminuted fracture), inferior orbital rim (bilateral), and left zygomaticomaxillary complex. Satisfactory aesthetic and functional outcomes were obtained after using the “bottom-up,” “tooth-bearing–non-tooth-bearing,” and “outside–inside” fixation sequence in this caseĪbstract = "Herein, we describe the management of multiple mandibular and midface fractures using the “bottom-up,” “tooth-bearing–non-tooth-bearing,” and “outside–inside” fixation sequence in an 18-year-old female. ![]() The last fractures to be reconstructed are generally the fractures of the orbital walls and orbital floor.Herein, we describe the management of multiple mandibular and midface fractures using the “bottom-up,” “tooth-bearing–non-tooth-bearing,” and “outside–inside” fixation sequence in an 18-year-old female. The surgeon needs to decide whether the malalignment at the Le Fort I level will be associated with occlusal problems. If a patient has a malalignment at the Le Fort I level, the surgeon needs to reassess the other fracture alignments, and consider a correction.įrom an esthetic standpoint, a minimal malalignment at the Le Fort I level is not as noticeable as a malalignment of the orbits. If everything has been perfectly aligned, the fractures at the Le Fort I level should also align perfectly. The next step in midface reconstruction is fixation across the Le Fort I level. Note: Where reconstruction of the medial canthal tendon is necessary it is the final step before wound closure. The completion of the reconstruction of the periorbital areas is performed by addressing the NOE and nasal fractures. The proper alignment of the zygomatic arch and the infraorbital rim must be taken into consideration during the reduction of the various fractures. The zygoma is positioned into its proper three-dimensional position taking care to properly line up the lateral wall of the orbit with the greater wing of the sphenoid.Ĭlick here for description of fracture fixation of zygomatic complex fractures. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |