Palato-lingual Direct-cross Wire Maxillo-mandibular Fixation: A Modified Technique for management of Mandibular...

Maxillo-mandibular fixation (MMF)is inevitable in craniomaxillofacial trauma despite open or closed reduction. Conventionally, for MMF Erich's arch bar is used. In our study, a novel technique with 26 -gauge direct wires were used for MMF. A prospective study was planned to determine the efficacy of these wires in MMF with several criteria.

The study groups were divided in to two groups say Group A and Group B where in the prior group MMF was done with Erich's arch bar whereas in latter it was done with novel technique. In group B, the wires were passed buccally at 1 st molar region through mesial and distal embrasure in the 1 st quadrant and from the palato-lingual side the wires were taken back to the buccal side. The same procedure was performed on the opposite side as well in the anterior region. Postoperative occlusion, pain score, Oral Hygiene Index (OHIs), Hard tissue Irritation of Mucosa Scale (HIMS)* and few other criteria were evaluated.

There was significant difference (0.001) in time taken to place direct wire through novel technique when compared to conventional technique. There were also significant differences in VAS score, OHIS, HIMS grading between groups respectively (P0.001) proving novel technique to be a better alternative to Erich's arch bars in closed reduction.

The novel technique is relatively easy to perform and provides MMF in a shorter time period. It also provides better oral hygiene, less pain and less irritation to surrounding soft tissues. Although a prospective study with larger sample size is required to better evaluate its need in maxillofacial injuries.