[The value of miniature compression screws in maxillofacial surgery]

According to the well-known principle of compression, a new kind of screw has been developed. It is a development of the miniaturized Michelet-Champy osteosynthesis device which we have used for the last 10 years in maxillofacial surgery. These traction-screws were initially elaborated for rigid stabilization after sagittal ramus osteotomies such as Obwegeser-Dal Pont. Usually, three screws are inserted at each side, via a transjugal approach. It is then possible to remove the intermaxillary fixation device at the end of the surgical procedure. However, these screws are also useful in other cases: for other kinds of mandibular osteotomies (visor osteotomy for instance), in traumatology (oblique mandibular or condylar fractures) or for fixation of onlay bone grafts on the facial structures. When iliac bone grafts, which are essentially cancellous bone are used, it is possible to use a small metallic ring to avoid penetration of the head of the screw into the graft. The screws can be inserted by a cutaneous punctiform incision when it is impossible to pass the screwdriver through the buccal incision. In all cases, this material is particularly easy to insert, allows good fixation, permits a solid interosseous compression, and is particularly well tolerated. The main drawback is the difficulty of choosing the right length of the screws because only two lengths are available at the present time. Despite this problem, these mini traction-screws seem to be useful for maxillofacial surgeons.