DIRECT,rigid fixation of the bone fragments is best in treating severe fractures of the jaws. This is accomplished by drilling one or more steel pins or Kirschner wires longitudinally through the bone across each fracture site to firmly engage both fragments. The resulting steel skeleton within the bone transforms a shattered, limp jaw into a solid unit and maintains its integrity until bony union has occurred and the pins can be removed (Fig. 1).
The serious complications to be avoided in jaw fractures are osteomyelitis, nonunion, and malunion; all of them can be prevented by early accurate reduction and firm fixation. Wobbly fixation is no better in the jaws than in other fractures, and the end-results may even be worse. The rigidity of the internal fixation described here is due to the fact that the steel pins have such leverage advantage that the bone ends cannot move unless they first shear the metal
McDOWELL F, BROWN JB. INTERNAL FIXATION OF JAW FRACTURES: Further Report. AMA Arch Surg. 1952;64(5):655–664. doi:10.1001/archsurg.1952.01260010673015
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: