Tuesday, November 3, 2009

IMF

Although I'm now at a different mission hospital (Kijabe) the frequency of treating broken jaw bones has not decreased. Our treatment methods at Kijabe vary slightly as we also have the option of open reduction using plates and screws. This patient declined this surgical procedure and opted for the more standard fixation of the maxilla to the mandible using arch bars and wires for 4-6 weeks (more affordable option at 5000 KSH).

You can see the bilateral jaw fractured at the right parasymphyseal region and also near the mandibular angle on the left; and of course the giant discrepancy in occlusion between teeth #28 and #29 below.



The IMF in place below.




Four week post-op results are seen below. Appropriate occlusion present, and good approximation of the fracture sites. We will keep him in IMF for 2 more weeks to insure healing and then remove the wires.

4 comments:

Megan said...

Way to go! He looks like he could be a rapper on MTV with all that metal in his mouth. Hope he heals properly.

Anonymous said...

Dad says that the alignment of the teeth looks very good. Mom

afreakforjc said...

Hey Malin, I had almost the exact same fracture, except the angle fracture was between #31 and 32. I couldn't get a circumdental wire around 32, so I just did my best with 31 and shut things tight. you keep them in MMF for 6 wks? Any problems with ankylosis? ~drew huang.

The Friess Family said...

Drew-

6 weeks is our standard length to keep patients in IMF. If you were able to achieve tight occlusion with the IMF you will most likely get good union of the mandible. Total ankylosis is unlikely..but there may be some loss of range of motion and maximum opening. Finger execises (1, 2, 3 fingers in the mouth) like physical therapy can help. Let me know how it turns out.

Malin