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Lag Screw Fixation in the Upper Craniomaxillofacial Skeleton

Lag Screw Fixation in the Upper Craniomaxillofacial Skeleton Abstract • Rigid internal fixation of the craniomaxillofacial skeleton has become commonplace in osseous reconstructive procedures of the face. While miniplates are useful in many traumatic, reconstructive, and congenital anomaly cases, they are often unnecessary. Lag screw fixation is routinely used in the mandible and has the advantage of maximal stability when compared with other fixation techniques. These principles can similarly be applied in a variety of situations in the upper facial skeleton, including fracture and bone graft fixation, as well as in pediatric craniofacial surgery. We review the technique and appropriate indications and demonstrate via case examples this diversity of applicability for using lag screw techniques. Finally, results of 83 cases in which this technique has been used will be reviewed, including complications. (Arch Otolaryngol Head Neck Surg. 1993;119:297-304) References 1. Prein J, Kellman RM. Rigid internal fixation of mandibular fractures: basics of AO technique . Otolaryngol Clin North Am. 1987;20:441-456. 2. Kellman RM. Repair of mandibular fractures via compression plating and more traditional techniques: a comparison of results . Laryngoscope . 1984;94:1560-1567.Crossref 3. Ardary WC. Plate and screw fixation in the management of mandible fractures . Clin Plast Surg. 1989;16:61-67. 4. Champy M, Lodde JP, Schmitt R, et al. Mandibular osteosynthesis by miniaturized screwed plate via a buccal approach . J Oral Maxillofac Surg. 1978;6:14-21. 5. Lesy FE, Smith RW, Odland RM, Marentette LJ. Monocortical miniplate fixation of mandibular angle fractures . Arch Otolaryngol Head Neck Surg. 1978;117:149-154. 6. Kellman RM, Schilli W. Plate fixation of fractures of the mid and upper face . Otolaryngol Clin North Am. 1987;20:559-571. 7. Gruss JS, Phillips JH. Complex facial trauma: The evolving role of rigid internal fixation and immediate bone graft reconstruction . Clin Plast Surg. 1989;16:93-104. 8. Holmes KD, Matthews BL. Three-point alignment of zygoma fractures with miniplate fixation . Arch Otolaryngol Head Neck Surg. 1989;115:961-963.Crossref 9. Rahn BA. Direct and indirect bone healing after operative fracture treatment . Otolaryngol Clin North Am. 1987;20:425-440. 10. LaTrenta GS, McCarthy JG, Breitbart AS, et al. The role of rigid internal fixation in bone-graft augmentation of the craniofacial skeleton . Plast Reconstr Surg. 1989;84:578-588.Crossref 11. Leonard MS. The use of lag screws in mandibular fractures . Otolaryngol Clin North Am. 1987;20:479-493. 12. Schmoker R. Experimental studies on the stability of the dynamic compression implant (DCI) . In: Spiessl B, ed. New Concepts in Maxillofacial Surgery . New York, NY: Springer-Verlag NY Inc; 1976:144-149. 13. Phillips JH, Rahn BA. Fixation effects on membranous and endochondral onlay bone-graft resorption . Plast Reconstr Surg. 1988;82:872-877.Crossref 14. Yaremchuk MJ. Vascularized bone grafts for maxillofacial reconstruction . Clin Plast Surg. 1989;16:29-39. 15. Craft PD, Sargent LA. Membranous bone healing and techniques in calvarial bone grafting . Clin Plast Surg. 1989;16:11-19. 16. Smith JD, Abramson M. Membranous vs endochondral bone grafts . Arch Otolaryngol Head Neck Surg. 1974;99:203-205.Crossref 17. Hardesty RA, Marsh JL. Craniofacial onlay bone grafting: a prospective evaluation of graft morphology, orientation, and embryologic origin . Plast Reconstr Surg. 1990;85:5-14.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology - Head & Neck Surgery American Medical Association

Lag Screw Fixation in the Upper Craniomaxillofacial Skeleton

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Publisher
American Medical Association
Copyright
Copyright © 1993 American Medical Association. All Rights Reserved.
ISSN
0886-4470
eISSN
1538-361X
DOI
10.1001/archotol.1993.01880150051008
Publisher site
See Article on Publisher Site

Abstract

Abstract • Rigid internal fixation of the craniomaxillofacial skeleton has become commonplace in osseous reconstructive procedures of the face. While miniplates are useful in many traumatic, reconstructive, and congenital anomaly cases, they are often unnecessary. Lag screw fixation is routinely used in the mandible and has the advantage of maximal stability when compared with other fixation techniques. These principles can similarly be applied in a variety of situations in the upper facial skeleton, including fracture and bone graft fixation, as well as in pediatric craniofacial surgery. We review the technique and appropriate indications and demonstrate via case examples this diversity of applicability for using lag screw techniques. Finally, results of 83 cases in which this technique has been used will be reviewed, including complications. (Arch Otolaryngol Head Neck Surg. 1993;119:297-304) References 1. Prein J, Kellman RM. Rigid internal fixation of mandibular fractures: basics of AO technique . Otolaryngol Clin North Am. 1987;20:441-456. 2. Kellman RM. Repair of mandibular fractures via compression plating and more traditional techniques: a comparison of results . Laryngoscope . 1984;94:1560-1567.Crossref 3. Ardary WC. Plate and screw fixation in the management of mandible fractures . Clin Plast Surg. 1989;16:61-67. 4. Champy M, Lodde JP, Schmitt R, et al. Mandibular osteosynthesis by miniaturized screwed plate via a buccal approach . J Oral Maxillofac Surg. 1978;6:14-21. 5. Lesy FE, Smith RW, Odland RM, Marentette LJ. Monocortical miniplate fixation of mandibular angle fractures . Arch Otolaryngol Head Neck Surg. 1978;117:149-154. 6. Kellman RM, Schilli W. Plate fixation of fractures of the mid and upper face . Otolaryngol Clin North Am. 1987;20:559-571. 7. Gruss JS, Phillips JH. Complex facial trauma: The evolving role of rigid internal fixation and immediate bone graft reconstruction . Clin Plast Surg. 1989;16:93-104. 8. Holmes KD, Matthews BL. Three-point alignment of zygoma fractures with miniplate fixation . Arch Otolaryngol Head Neck Surg. 1989;115:961-963.Crossref 9. Rahn BA. Direct and indirect bone healing after operative fracture treatment . Otolaryngol Clin North Am. 1987;20:425-440. 10. LaTrenta GS, McCarthy JG, Breitbart AS, et al. The role of rigid internal fixation in bone-graft augmentation of the craniofacial skeleton . Plast Reconstr Surg. 1989;84:578-588.Crossref 11. Leonard MS. The use of lag screws in mandibular fractures . Otolaryngol Clin North Am. 1987;20:479-493. 12. Schmoker R. Experimental studies on the stability of the dynamic compression implant (DCI) . In: Spiessl B, ed. New Concepts in Maxillofacial Surgery . New York, NY: Springer-Verlag NY Inc; 1976:144-149. 13. Phillips JH, Rahn BA. Fixation effects on membranous and endochondral onlay bone-graft resorption . Plast Reconstr Surg. 1988;82:872-877.Crossref 14. Yaremchuk MJ. Vascularized bone grafts for maxillofacial reconstruction . Clin Plast Surg. 1989;16:29-39. 15. Craft PD, Sargent LA. Membranous bone healing and techniques in calvarial bone grafting . Clin Plast Surg. 1989;16:11-19. 16. Smith JD, Abramson M. Membranous vs endochondral bone grafts . Arch Otolaryngol Head Neck Surg. 1974;99:203-205.Crossref 17. Hardesty RA, Marsh JL. Craniofacial onlay bone grafting: a prospective evaluation of graft morphology, orientation, and embryologic origin . Plast Reconstr Surg. 1990;85:5-14.Crossref

Journal

Archives of Otolaryngology - Head & Neck SurgeryAmerican Medical Association

Published: Mar 1, 1993

References