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Wiring

LOWER BORDER INTEROSSEOUS WIRING FOR MANDIBULAR FRACTURES INDICATIONS (1) Control of the posterior fragment when this has no teeth. CONTRAINDICATIONS (1) Established infection of the fracture site. (2) Children in whom unerupted teeth may be injured.

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173 views17 pages

Wiring

LOWER BORDER INTEROSSEOUS WIRING FOR MANDIBULAR FRACTURES INDICATIONS (1) Control of the posterior fragment when this has no teeth. CONTRAINDICATIONS (1) Established infection of the fracture site. (2) Children in whom unerupted teeth may be injured.

Uploaded by

drmadhang
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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LOWER BORDER INTEROSSEOUS WIRING FOR MANDIBULAR FRACTURES

‡ INDICATIONS (1) Control of the posterior fragment when this has no teeth. (2) Control of both fragments when the patient has no teeth or insufficient teeth for interdental wiring. You will usually need interdental wiring or an arch bar also. ‡ CONTRAINDICATIONS (1) Established infection of the fracture site. (2) Children in whom unerupted teeth may be injured.

UPPER BORDER INTEROSSEOUS WIRING FOR MANDIBULAR FRACTURES


‡ INDICATIONS This is seldom necessary. In bilateral fractures insert an upper border wire to prevent the muscles pulling the anterior fragment downwards, and making the fracture line gape. ‡ METHOD Wire the upper border before the lower one. Make an incision along the crest of the alveolus inside the patient¶s mouth. Drill small holes on either side of the fracture line, pass a piece of soft stainless steel wire through it, reduce the fragments, and twist the ends of the wire tight. Cut the ends short and tuck them into the nearest drill hole. Close the incision very carefully, because infection is common

Indications for removal of teeth in the line of fracture


‡ Tooth luxated from its socket and/or interfering with reduction of the fracture. ‡ Tooth that is fractured Tooth with advanced dental caries ‡ Tooth with advanced periodontal disease with mobility which would not contribute to establishment of stable occlusion. ‡ Tooth with existing pathology such as cyst formation or pericoronitis.

Indications to leave teeth in the line of fracture


‡ Tooth that does not interfere with reduction and fixation of fracture. ‡ If tooth removal requires removal of excessive amount of bone so as to compromise the fracture site an possible plate/screw fixation. ‡ Tooth that is in good condition and assists in establishing occlusion and reducing the fracture.

‡ When an infection arises during the postoperative period, carefully evaluate teeth in the line of fracture as potential sources of the infection.

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