21453 Closed treatment of mandibular fracture with interdental fixation

Name of the Procedure:

Closed Treatment of Mandibular Fracture with Interdental Fixation
Common name(s): Jaw Wiring, Intermaxillary Fixation (IMF)

Summary

In layman's terms, this procedure involves wiring the teeth together to keep the jaws in place and allow a broken lower jaw (mandible) to heal properly.

Purpose

This procedure addresses fractures of the lower jaw. The goal is to stabilize the broken bone segments to facilitate proper healing, relieve pain, and restore function.

Indications

• Traumatic injury resulting in a mandibular fracture.
• Misalignment of the bite due to a broken jaw.
• Difficulty eating, speaking, or breathing caused by a jaw fracture.

Preparation

• Patients may be required to fast for several hours before the procedure.
• Adjustments to medications, as advised by the healthcare provider.
• Pre-procedure imaging tests, such as X-rays or CT scans, to assess the fracture.

Procedure Description

1. The patient is given local anesthesia or general anesthesia, depending on the severity of the fracture and patient preference.
2. The surgeon places metal wires or elastic bands around the teeth to stabilize the jaw.
3. The wires are tightened, binding the upper and lower jaws together.
4. Additional dental splints or arch bars may be used for extra support.
5. The jaw is kept immobile to ensure proper alignment and healing.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

The procedure is performed in a hospital or outpatient surgical center.

Personnel

• Oral and maxillofacial surgeon
• Anesthesiologist or nurse anesthetist
• Surgical nurses

Risks and Complications

• Infection at the wire or pin sites
• Difficulty breathing, eating, or clearing oral secretions
• Damage to dental structures or misalignment of the bite
• Potential need for additional surgical intervention if healing does not progress as expected

Benefits

• Stabilizes the broken jawbone, allowing for proper healing.
• Reduces pain and improves function.
• Correction of bite alignment.
• Allows for normal eating and speaking once healed.

Recovery

• Patients will need to follow a liquid or soft food diet while the jaw is wired shut.
• Good oral hygiene is critical to prevent infection.
• Regular follow-up appointments to monitor healing.
• Wires are typically left in place for 6 to 8 weeks.
• Pain management with prescribed medications.
• Physical restrictions on strenuous activities until healing is complete.

Alternatives

• Open reduction and internal fixation (surgical placement of plates and screws).
• Observation and conservative management (for minor, non-displaced fractures).
• Each alternative has its pros and cons, such as varying degrees of invasiveness, recovery time, and potential for complications.

Patient Experience

• During the procedure, if local anesthesia is used, the patient may feel pressure but should not feel pain.
• Post-procedure, patients may experience discomfort, swelling, and difficulty with oral hygiene and eating.
• Pain management includes prescribed medications and maintaining a liquid diet.
• Frequent check-ins with the healthcare provider to ensure proper healing and to manage any complications.