Role of intermaxillary screw fixation in maxillofacial trauma: A prospective study

Abstract

Background & Objectives: Ntermaxillary fixation (IMF) is quite widely used in the treatment of maxillofacial trauma and this treatment modality represents the cornerstone of fracture reduction and immobilization nowadays. Self-tapping Maxillo Mandibular Fixation (MMF) screws were introduced in 1989. Some of the drawbacks associated with the use of arch bars were eliminated by their emergence. Objective of this study was to characterize the various advantages, disadvantages, limitations, problems and specific complications, related to the use of self-tapping MMF screws. Methodology: Forty patients who reported to Department of OMFS, having maxillofacial fractures requiring IMF were included in the study. Duration of IMF, screw site and complications associated with the use of IMF screws were recorded. These screws were used either as an adjunct to open reduction techniques or for definitive closed reduction. Cases were followed up for 1 month to evaluate dental occlusions and bone healing.Results: Forty patients were analyzed out of these patients, 16 suffered with single man­dibular fractures, 14 with multiple mandibular fractures, 2 with maxillary fractures and 8 with combined maxillo-mandibular fractures. 34 patients were treated with ORIF (open reduction and internal fixation) whereas 6 patients were treated with closed reduction only. The average surgical time for imf screws fixation was about 15 ± 2.55 minutes. The most common complications were pain and edema in 14 patients. Tissue overgrowth was seen in 16 cases whereas screw loosening was seen in 2 patients where two screws loosen both in maxilla. No other complication like screw shear, fractured screws or ingested hardware was seen.Interpretation & Conclusion: Intermaxillary fixation with IMF screws is efficacious and safe. Screw placement consumes less time and reduces the intraoperative period. However, surgeon should know the potential complications and limitations of this technique in order to provide effective treatment.