Maxillary microplate internal fixation

The symmetrical, irregular pyramidal bone is formed in the midline and is the largest bone in the middle of the face. The upper part constitutes the bottom of the mouth, the lower part is the top of the oral cavity, the inner side forms the outer side wall of the nasal cavity, the center of the maxillary body is the maxillary sinus, the sinus cavity is tapered, the lining of the cavity is covered with mucous membrane, and the sinus ostium is located in the upper part of the inner side wall of the nasal midsection. The crack is connected to the nasal cavity. The maxilla has four bone protrusions, the frontal process, the condyle, the condyle, and the alveolar process. In the upper front, it is connected with the humerus, the nasal bone, and the ethmoid bone. In the posterior, the posterior margin of the hard palate and the maxillary nodule are respectively seamed with the tibia and sphenoid wing and are fixed at the base of the skull. The junction between the maxilla and the jaws on both sides constitutes a pear-shaped hole and a nasal cavity. The vertical plate of the ethmoid bone forms a septum with the septal cartilage and the vomer. Treatment of diseases: jaw fractures Indication The maxillary mini-plate internal fixation is suitable for: 1. Maxillary linear fracture. 2. In the orthognathic surgery, the maxillary LeFortI and type II osteotomy were fixed. Contraindications 1. Those who are severely misplaced and fail to reset. 2. Pulverized fractures or excessive bone defects. 3. Concurrent wound infections. Surgical procedure 1. Maxillary LeFort I fracture fixation (1) Incision and exposure: bilateral fractures were made between the first molars on both sides; unilateral fractures, from one canine to the other, the anterior sulcus mucosa, periosteal incision, from the subperiosteal Fold up the tissue flap to fully reveal the lower and lateral edges of the plow hole, the anterior lateral wall of the maxilla, the inferior foramen, and the gingival ridge. (2) Fracture reduction and fixation: Observe the fracture line running and dislocation. After the swaying reduction, it is generally below the plow hole. The sacral alveolar ridge is fixed with two holes of steel plate and 5~7mm screws. Those with a sacral fracture were separated and placed under the anterior and posterior nasal base. (3) suture wound: after irrigating the wound, suture the anterior sulcus mucosal incision with suture and intermittent suture. 2. Facial mid-fracture fixation (1) Coronal incision of the scalp: From the tragus on one side, the tragus in the crotch of the crotch, the top of the hairline, and the contralateral crotch to the opposite side. If the unilateral fracture occurs, the incision will reach the opposite side of the ankle. (2) revealing the fracture site: cut the epidermis, cap-shaped diaphragm, flip the scalp flap down on the periosteum, cut the periosteum 1.0cm on the brow arch, continue to separate downward under the periosteum, in the upper hole The lower bone is removed and the hole is opened; the flaps are flapped on both sides of the fascia. The tibia fracture can be explored along the lateral side of the iliac crest, and the nasal bone and other fractures can be explored along the medial side of the iliac crest. The sacral and maxillary fractures can also be explored from the lateral side. (3) Fracture reduction and fixation: The displacement of the fractured bone is generally controlled by the periosteal separator, and the scar can be loosened when there is adhesion of the scar tissue. After the bone is restored, the humerus is generally located on the lateral side of the iliac crest, and the iliac crest and the inferior temporal margin are fixed in the steel plate. Nasal and frontal bone fractures are usually fixed with a 5 to 7 mm screw with two holes and four holes. (4) suture, placement and drainage: after rinsing the wound, the scalp flap was reset, the scalp and cap-like aponeurosis were sutured once, and half of the rubber tube drainage strip was placed in the ankle. complication 1. For open fractures, debridement is not complete, wound infection is forced to remove steel plates and screws. 2. The mandibular mid- and corner fractures, the upper two-hole steel plate is close to the oral cavity, and the mucoperior suture is not good enough to be taken out.