IMF screws with orthodontic E chains as a novel technique for intermaxillary fixation

Introduction: Either in conservative or in surgical management of maxillo-mandibular fractures, intermaxillary fixation (IMF) provides stable occlusion, while offering reduction in the fractured segments. Various techniques have been used for achieving IMF, among which Erich arch bar is the most conventional and routinely used technique. However, it poses a risk of percutaneous injury to the surgical team with every wire used in the technique, causes trauma to the periodontium of the teeth secured by wires and it is not very comfortable for the patient. The few IMF techniques that are recommended without wire require special armamentarium that are not universally available. Materials and Methods: Our novel IMF technique employing multiple looping of orthodontic E chains around IMF screws can provide adequate reduction and stabilization of the fractured segments with good occlusion before plating of the maxillo-mandibular fractures. It can also be utilized for extended periods for closed reduction or postoperatively for guiding the occlusion. Results: As seen in our clinical experience using this novel technique, there is no risk of percutaneous injury to the surgical team. It provides stable occlusion, optimal reduction in the fractured segments and is accepted well by patients as no wires are used. Conclusion: This novel technique can be used in all patients who require IMF and is particularly useful in patients with periodontally compromised teeth or in those who are partially edentulous where conventional arch bar fixation cannot be performed. This technique will considerably reduce the operative time and aid in better patient compliance.