A Reduction Technique for Depressed Medial Maxillary Fractures

Area of Science:

• Oral and Maxillofacial Surgery
• Neurosurgery
• Otolaryngology

Background:

• Medial maxillary fractures present challenges in reduction, especially when direct access for elevators is unavailable.
• Traditional methods may be insufficient for complex fractures involving the medial maxillary wall.

Purpose of the Study:

• To describe a new technique for reducing medial maxillary fractures by utilizing the accessory maxillary ostium (AMO).
• To provide an alternative method for fracture reduction when clefts for elevator insertion are absent.

Main Methods:

• A gingivolabial vestibular incision was used to expose fractured segments.
• When no cleft was present, a Cottle elevator was inserted via a nasal approach into the AMO.
• Gentle pressure and upward force were applied through the AMO to reduce the fractured segment.

Main Results:

• The technique successfully allowed for the reduction of fractured segments in medial maxillary fractures.
• Post-reduction alignment was visualized through the gingivolabial vestibular incision.
• Stabilization was achieved using miniplate fixation or tissue glue depending on fracture stability.

Conclusions:

• Introducing an elevator through the accessory maxillary ostium (AMO) is a viable technique for mobilizing fractured segments in medial maxillary fractures.
• This method offers a solution for cases where traditional elevator insertion points are not accessible.