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. 2021 Oct;75(5):366-370.
doi: 10.5455/medarh.2021.75.366-370.

A Novel Approach to the Treatment of Le Fort Fractures Using Internal Fixation to Achieve Mandibulomaxillary Fixation

Le Hoai Phuc  1 , Cao Huu Tien  1 , Doan-Van Ngoc  2 , Nguyen-Van Tuan  1   3 , Le Trung Chanh  1   4 , Lam Hoai Phuong  5 , Nguyen Minh Duc  6
Affiliations

A Novel Approach to the Treatment of Le Fort Fractures Using Internal Fixation to Achieve Mandibulomaxillary Fixation

Le Hoai Phuc et al. Med Arch. 2021 Oct.

Abstract

Background: We aimed to determine the minimum effective period of mandibulomaxillary fixation after the inadequate internal fixation of Le Fort I or Le Fort II fracture.

Objective: The aim of this study was to investigate the stability of the skeleton after the treatment of Le Fort I or Le Fort II fractures by measuring bite forces and to determine the minimum time required for effective mandibulomaxillary fixation following treatment with internal fixation and mandibulomaxillary fixation.

Method: A prospective study was performed to examine the treatment of Le Fort I or Le Fort II fracture in the Department of Maxillofacial Surgery at the National Hospital of Odonto-Stomatology in Ho Chi Minh City, Vietnam. A total of 31 patients were included, with up to 1 month of follow-up after discharge from the hospital. Midface bone stability and the mandibulomaxillary fixation time were evaluated using bite force criteria after 1, 2, and 4 weeks.

Results: Midface bone stability values 1, 2, and 4 weeks after treatment were 87.1%, 100%, and 100%, respectively. After 1 week, 87.1% of patients achieved intermaxillary fixation, and 96.3% of these patients were treated with at least three rigid plates. The remaining 12.9% of patients achieved fixation after 2 weeks, and all of these patients were fixed only at zygomaticomaxillary sutures (p < 0.05). Bite forces increased significantly at 2 weeks compared with 1 week and at 4 weeks compared with 2 weeks (p < 0.05).

Conclusion: When treated using only rigid fixation, through the placement of plates and screws at zygomaticomaxillary buttresses, patients with Le Fort I and Le Fort II fractures can achieve mandibulomaxillary fixation after 2 weeks. For Le Fort I fractures, rigid fixation using plates and screws at zygomaticomaxillary buttresses and canine buttress at three positions can achieve mandibulomaxillary fixation after only 1 week (p = 0.0001).

Keywords: Le Fort; internal fixation; mandibulomaxillary fixation; mandibulomaxillary fixation time; nasomaxillary sutures; zygomaticomaxillary sutures.

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Conflict of interest statement

There are no conflicts of interest to declare.

Figures

Figure 1.
Figure 1.. Three examination time points were evaluated after discharge
Figure 2.
Figure 2.. Assessment of midface stability upon re-examination after 1 week and 2 weeks.
See this image and copyright information in PMC

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