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IMF Screws: A Favorable Alternative To Arch Bars
Alisa O. Girard, MD1, Amaal H. Khan, BS
2, Aneri U. Patel, BS
2, Jordan Fishman, MD, MPH
1.
1Cooper University Hospital, Camden, NJ, USA, 2Cooper Medical School, Camden, NJ, USA.
PURPOSE: Closed reduction of mandible fractures may be achieved through a variety of maxillomandibular fixation (MMF) approaches, though arch bars remain the mainstay. Current literature offers little insight into best practices, and MMF choice is often left to surgeon preference. This study aims to compare arch bars versus intermaxillary fixation (IMF) screws outcomes for closed reduction of isolated mandible fractures.
METHODS: Retrospective chart review was conducted on patients who underwent isolated mandible fracture treatment via MMF with arch bars or IMF screws at one institution between 2009 and 2023. Patients who underwent internal fixation, closed reduction with other MMF approaches, or combination approaches were excluded. Patient demographics, fracture pattern, MMF technique, and postoperative outcomes were analyzed. Student’s t-test and Fisher’s exact test were used for continuous and categorical variables, respectively (significance p<0.05).
RESULTS:
226 patients underwent MMF via arch bars (69%) or IMF screws (31%). Groups were comparable at baseline besides age and tobacco use. Time to surgery since injury was greater for IMF screws and they were applied more quickly than arch bars. IMF screws were more frequently removed in clinic versus OR compared with arch bars.
CONCLUSION: IMF screws are favorable for closed reduction of mandible fractures due to shorter operative time, ease of awake removal, and noninferior outcomes compared with arch bars.
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