Ayah Mohamed
Royal Free London NHS Foundation Trust, London, United Kingdom
Title: The use of an endotracheal tube in the biphasic fixation of a mandibular fracture
Biography
Biography: Ayah Mohamed
Abstract
The concept of external fixation applied to the mandible describes a technique where long screws are passed through the skin, into either side of a fracture and secured in place using an external fixator. It is indicated in heavily comminuted fractures, in cases of pathological fractures or grossly infected fractures.
We present a modified version of the biphasic system in the repair of a left angle fracture in a 28-year-old male. The 3-week old fracture was heavily infected, hence external fixation was indicated. Following curettage and alignment of the fracture, two 50mm Schanz screws were placed either side of the fracture. A size 7 endotracheal tube was measured to length and perforations created corresponding to the pin positions. Acrylic resin was syringed into the prepared endotracheal tube, which was then seated, held in position until the resin was fully set and remained in place for the length of the healing period.
This technique uses readily available, cost-effective equipment. It is less technically demanding than the conventional technique as it omits the adjustable connecting rods between the pin pairs yet provides a secure framework without the bulky equipment yielding a successful outcome.
Whilst external fixation has been used in mandibular fractures, its use has diminished for several reasons. This case demonstrates that a sound practical knowledge of some of the traditional techniques holds a place in modern trauma management.