Wire Osteosynthesis in the Treatment of Mandible Fractures in Low Resource Settings: A Force Study.

IF 0.8 2区 哲学 Q3 ETHICS Human Studies Pub Date : 2024-03-01 Epub Date: 2022-12-20 DOI:10.1177/19433875221143605
Shekhar K Gadkaree, Adeeb Derakhshan, Victor Nyabenda, Isaie Ncogoza, Gratien Tuyishimire, David A Shaye
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Abstract

Study design: Cadaveric investigation.

Objective: Rigid internal fixation (RIF) using plates and screws is often not feasible in low and middle-income countries due to limited resources. Interosseous wiring to achieve semi-rigid fixation is often used, but lacks biomechanical force data. Herein we aim to quantitatively compare interosseous wiring to RIF.

Methods: Cadaveric mandibles were fractured at the parasymphysis and angle. Fixation was achieved using interosseous wiring in both single wire loop and figure-of-eight formations, as well as plate and screw fixation (n = 5 for each fixation type at each fracture site). A force gauge was used to measure the number of Newtons (N) required to achieve diastasis and complete failure at the fixation site.

Results: For angle fractures, the mean force required for initial diastasis was 4.1, 5.9, and 10.9 N for single wire, figure-of-eight wiring, and plating respectively (P < .001). Complete failure was achieved with 152.9, 168.9, and 237.6 N of force for the three methods, respectively (P < .001). Complete failure was achieved for parasymphyseal fractures with 197.7, 263.0, and 262.8 N of force for single wire, figure-of-eight wiring, and plating respectively (P = .002). Forces to achieve initial diastasis for parasymphyseal fractures were not statistically significant among the three fixation methods (P = .29).

Conclusions: Figure-of-eight interosseous wiring resists comparable forces across mandibular fractures compared to the gold standard of plating. In resource-limited settings when plates and screws are not available, this technique can be considered to achieve semi-rigid fixation of mandibular fractures.

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钢丝骨合成术在资源匮乏地区下颌骨骨折治疗中的应用:力量研究。
研究设计尸体调查:在中低收入国家,由于资源有限,使用钢板和螺钉进行刚性内固定(RIF)往往不可行。通常使用骨间布线来实现半刚性固定,但缺乏生物力学力数据。在此,我们旨在定量比较骨间接线和 RIF:方法:尸体下颌骨骨骺旁和骨骺角骨折。采用单线环形和八字形骨间布线固定,以及钢板和螺钉固定(每个骨折部位每种固定方式的人数均为 5 人)。使用测力计测量固定部位达到舒张和完全破坏所需的牛顿(N)数:对于角状骨折,单线、八字形接线和钢板固定的初始舒张力平均值分别为 4.1、5.9 和 10.9 牛顿(P < .001)。三种方法的完全失败力分别为 152.9、168.9 和 237.6 牛顿(P < .001)。对于骺旁骨折,单线、八字形布线和钢板接合的完全失败力分别为 197.7、263.0 和 262.8 牛顿(P = .002)。三种固定方法在实现骺旁骨折初始舒张力方面的差异无统计学意义(P = .29):结论:与金标准的钢板固定相比,八字形骨间接线对下颌骨骨折的抗力相当。在资源有限、无法使用钢板和螺钉的情况下,可以考虑使用这种技术实现下颌骨骨折的半刚性固定。
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来源期刊
Human Studies
Human Studies Multiple-
CiteScore
1.70
自引率
10.00%
发文量
35
期刊介绍: Human Studies is an international quarterly journal dedicated primarily to take forward and enlarge the dialogue between philosophy and the human sciences. Therefore the journal addresses theoretical and empirical topics as well as philosophical investigations in different areas of the human sciences. Phenomenological perspectives and hermeneutical orientations, broadly defined, are the primary focus and frame for published papers. The journal benefits from scholars working in a variety of fields and who seek a forum to address these issues, in order to bridge the gap between philosophical and other modes of inquiry in the human sciences.    Considering this as the main conceptual aim of Human Studies its wide-ranging interdisciplinary coverage includes contributions from sociology, philosophy, psychology, political science, communication studies, social geography, anthropology, history, and qualitative social research (especially ethnomethodology). A particular accent is set upon communication possibilities between these different perspectives. Thus, interdisciplinary approaches using phenomenology as starting point and reference in trying to analyze and explain the social reality are encouraged and welcome. Both established lines of interpretation and contemporary questions can be used either as basis or subject-matter.  Human Studies is the official journal of the Society for Phenomenology and the Human Sciences (SPHS).
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