By H. M. Tschop (auth.), Bernd Spiessl M. D.,D. D. S. (eds.)
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Additional info for New Concepts in Maxillofacial Bone Surgery
The facial in juries were similar to those seen in the first case, but in addition, he had an open fracture of both femora. Two teams operated on him at the same time, one dealing with the femoral fractures, and the other with the facial injuries. As the patient had a Le Fort-I-Type fracture of the maxilla and most of his teeth had to be removed, intermaxillary fixation during surgery was not possible. The patient lost all his teeth, except for the canine tooth on the right and one molar. After the normal arch in the lower jaw had been restored by means of arch bars and acrylic material, a bony defect was visible on the left side (Fig.
Tension and pressure side oflower jaw in the lateral ramus of the lower jaw, this position functional use. (a) There are tension forces in the alwould correspond approximately to that of the veolar process and pressure forces at margin 41 Fig. 54 (b) With a fracture a gap opens on tension side, (c) Neutralization of tension forces by an arch bar functioning as tension-band mandibular canal. Clearly a fixation cannot be positioned here and must, therefore, be placed on the surface of the bone. The most favorable position to apply a compression force at the surface is the point nearest the center of the fracture plane.
These lateral pressure rollers for the reduction and prepressure in the alveolar process are necessary when using the EDCP for the following reasons: 1. Reduction can be realized in the whole fracture region. The ends of the fragments can be brought exactly parallel to one another so that the complimentary structures on the fracture faces interdigitate correctly when the pliers are closed. 2. The fracture can be set under a higher and more uniform compression. 3. The compression force is not obtained entirely with the excentrically placed screws in the plate Fig.
New Concepts in Maxillofacial Bone Surgery by H. M. Tschop (auth.), Bernd Spiessl M. D.,D. D. S. (eds.)