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Letters to the Editor
November 1998

Screw Wire Osteosynthesis for Mandibular Fractures—Reply

Arch Otolaryngol Head Neck Surg. 1998;124(11):1271. doi:10-1001/pubs.Arch Otolaryngol. Head Neck Surg.-ISSN-0886-4470-124-11-olt1198

In reply

We thank Busch for his comments and agree with his statements regarding the advantages of intermaxillary fixation.

Although variants of our technique have been independently described by Halling et al (1991) and Dym et al (1992), the former used a figure of 8 wire placed around screws as a method of reduction prior to rigid compression plate fixation in severely displaced angle fractures, rather than for definitive fixation. The latter technique by Dym et al, in which a single screw wire device is placed at the buccal alveolar cortex for reduction and fixation of unfavorable angle fractures, can allow and accentuate separation of the fragments at the opposite, inferior border of the mandible in both the experience of Halling et al and ours. Multiplanar fixation advocated by us helps solve this problem. Neither article discusses physical principles used to prevent lingual fracture distraction, the concept of multiplanar fixation, repair of fractures other than at angle locations, limitations and contraindication of their techniques, pediatric mandibular fracture application, and postoperative computed tomographic scan assessment of reduction in severely displaced fractures.

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