Wire internal fixation: an obsolete, yet valuable method for surgical management of facial fractures

Abstract

In some developing countries wire is still widely used in facial fractures internal fixation. This study presents the effectiveness and complications of wire osteosynthesis in a university teaching hospital in Burkina Faso and discusses some of its other benefits and disadvantages. Notes of 227 patients with facial fractures treated by wire internal fixation at department of stomatology and maxillofacial surgery of CHU Souro Sanou, Burkina Faso between 2006 and 2010 are reviewed retrospectively. A satisfactory treatment outcome was recorded in 91.2% of the 227 patients. Complications occurred in 8.8% of the patients who had operative site infection (3.1%), malocclusion (1.8%), sensory disturbance (1.8), facial asymmetry (1.3%), delayed bone union (0.9%) or enophtalmos (0.4%). The overall complications rate was 7.4% after mandibular osteosynthesis, 6.9% after Le Fort osteosynthesis and 6.5% after zygoma osteosynthesis. Post operative infections occurred irrespective to the surgical site. The other complications were more specific to the surgical site. Wire internal fixation may be a reasonable alternative for the surgical treatment of non-comminuted facial fractures and those without bone substance loss, in the setting of limited resources.

Off-Label Treatment for Severe Craniomaxillofacial Fractures in Low-Income Countries—A Novel Operation Method with the External Face Fixator

“…Some techniques describe a wiring of the mandible to the zygomatic arch intraorally. However, these techniques require an unfractured mandible and zygomatic arch, and as most CMF present with a concomitant fracture of the mandible (10 out of 13) (76.92%), the reduction and fixation of both by wiring might be difficult or impossible [ 28 ]. Even when achieved, the occlusion must be fixed for the duration of healing and the mouth closed.…”

“…As a result, the treatment of CMF is challenging [ 31 ]. Until now, such fractures were treated non-operatively with a Barton Bandage or interdental wiring [ 28 ]. This resulted in insufficient fracture reduction, lockjaw, and a significant reduced quality of life.…”

The use of interosseous dental wires and sutures for internal fixation in a patient with multiple comminuted middle facial fractures and facial nerve injury: A demonstrative case report

“…The main aim of the current communication is to demonstrate that the use of a combination of interosseous wires and sutures for fixation of middle facial fractures may provide a satisfactory outcome. This method of fixation is currently considered obsolete, although it is still used in countries with poor resources [ [2] , [3] , [4] ]. Our case also demonstrates that the use of this method of fixation may still have a place (even in the presence of resources) in multiple comminuted facial fractures with concurrent facial nerve injury.…”

Interfacility Transfer Guidelines for Isolated Facial Trauma: A Multi-disciplinary Expert Consensus.

“…Le Fort fractures are rarely isolated and have a strong association with multisystem, high-energy trauma. [152][153][154] The presence of a Le Fort II or III fracture increases the risk of intracranial injuries, 155 the need for neurosurgical intervention, [155][156][157] the need for tracheostomy, 157 and death. 155 Comminuted or displaced Le Fort fractures portend higher levels of injury-related disability.…”