Introduction: Le Fort I fractures represent a significant proportion of craniofacial trauma, often occurring alongside other injuries to the craniomaxillofacial region. Management options include open reduction and internal fixation (ORIF) or skeletal suspension, each with its limitations and considerations.
Material and Methods: This technical note presents a novel technique for managing isolated Le Fort I fractures using intermaxillary fixation (IMF) screws, offering a minimally invasive alternative to ORIF. The technique involves the strategic placement of IMF screws in the stable zygomatic bone, coupled with arch bar fixation and wire manipulation for maxillary fragment reduction.
Results: This approach is cost-effective, can be performed under local anesthesia, and provides stability without the need for prolonged maxillomandibular fixation (MMF).
Conclusion: The simplicity and efficacy of this technique make it suitable for emergency settings and cases where traditional approaches may not be feasible. However, this technique is only feasible in isolated Le Fort I fractures and is contraindicated in comminuted Le Fort I fractures and in edentulous patients with upper jaw involvement.
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http://dx.doi.org/10.1007/s12663-024-02149-w | DOI Listing |
JSES Int
November 2024
Department of Orthopaedic Surgery, University of Iowa, Iowa City, IA, USA.
Background: Limitations to using the knee as donor cartilage include cartilage thickness mismatch and donor site morbidity. Using the radial head as donor autograft for capitellar lesions may allow for local graft harvest without distant donor site morbidity. The purpose of this study is to demonstrate the feasibility of performing local osteochondral autograft transfer from the nonarticular cartilaginous rim of the radial head to the capitellum.
View Article and Find Full Text PDFMil Med
January 2025
Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA.
Introduction: As illustrated by the "Walker Dip," there is growing concern regarding the lack of combat casualty care during peacetime. Surgical volume and case complexity are paramount for training and skill sustainment. We sought to quantify the recent orthopedic trauma surgical case load of all military orthopedic surgeons across the Military Health System (MHS).
View Article and Find Full Text PDFClin Orthop Relat Res
December 2024
Division of Plastic and Reconstructive Surgery, Fox Chase Cancer Center, Philadelphia, PA, USA.
Background: Opioid use disorder (OUD) has been implicated as a potential risk factor for adverse outcomes and readmissions in various surgical procedures. Patients admitted with an open fracture of the lower extremity often have multifarious pain needs, require surgical procedures, and have prolonged rehabilitation; previous OUD complicates this process. Our goal was to describe at a national level how OUD is associated with readmission, complications, and healthcare expenditure for patients admitted with open lower extremity fractures.
View Article and Find Full Text PDFCureus
December 2024
Department of Family Medicine, Broward Health Medical Center, Fort Lauderdale, USA.
Surgeons periodically encounter challenging clinical scenarios that require them to develop nuanced management strategies to achieve the best outcome for the patient. This is especially true in medically underserved patient populations, where follow-up and proper recovery protocols are often not accomplished. In this report, we discuss the case of a 26-year-old female with a history of medical non-compliance who presented to the emergency department with signs and symptoms of surgical site infection two months following the repair of her comminuted ulna fracture caused by a gunshot wound.
View Article and Find Full Text PDFJ Craniofac Surg
January 2025
Division of Pediatric Craniofacial Surgery, Nemours Children's Health, Jacksonville, FL.
External rigid distraction is an established method for achieving subcranial Le Fort III advancement in severe syndromic craniosynostosis. Craniofacial surgeons commonly use halo-type devices for these corrections, as they allow for multiple vectors of pull and facilitate larger midfacial advancements. Although most complications related to their use involve pin displacement or infection, rare complications such as skull fractures have been reported.
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