Mechanical and clinical rationale of prototype bone reduction forceps.

Objective: To describe the mechanical rationale and clinical application of prototype right-angle reduction forceps.

Methods: A pair of prototype right-angle reduction forceps was designed and manufactured specifically to improve the consistency and ease of fracture reduction. It was used to reduce mandible fractures of the mandible body, parasymphysis, and symphysis in 4 patients. The fractures ranged from minimally displaced to comminuted and displaced fractures.

Results: The pilot monocortical holes used for insertion of the right-angle reduction forceps into the mandible were easier to drill than the old method of drilling angled holes for standard reduction forceps. The older method required constant guesswork as to the correct angle of the hole relative to the tines of the curved reduction forceps. The right-angle reduction forceps required no guesswork because the pilot hole is drilled at a right angle to the surface of the outer bone cortex and at more than 1 cm laterally on each side of the fracture line. There were no episodes of outer cortical bone avulsion or any necessity for redrilling new pilot holes. These forceps provided sufficient force for excellent reduction of the fracture edges. The design also provided improved access for plating superior and inferior to its shaft while it was engaged.

Conclusions: Although curved bony reduction forceps are standard in most mandibular plating sets, they provide less predictable and efficient reduction of fractures than the right-angle reduction forceps. Prototype reduction forceps require little to no additional training to use properly.