A Novel Technique For Arch Bar Fixation Using Suturing Needle And Wires - A Prospective Study

Abstract

Advancements in surgery aim to make procedures atraumatic and reduce operative time. Techniques for interdental wiring, like Erich’s arch bar fixation, have seen improvements over time. Maxillomandibular fixation (MMF) is the oldest and most widely used technique of immobilization of jaws for management of facial trauma. Although arch bar provides sufficient immobilization, it has a number of disadvantages. It is a cumbersome procedure and requires much time especially for trainees to pass the wires interdentally. Many simple modifications have been tried in reducing application time and hence increasing patient comfort, but none tried to modify the wire. The aim of this study is to evaluate a new technique in reducing intra operative time, patient comfort in terms of pain and ease of operator in Erich’s arch bar fixation.

Results:

It was found that the operative procedure was difficult in 4.3%, moderate in 47.8% and easy in 47.8% of the participants in experimental group (Group A), while difficult in 52.2%, moderate in 39.1% and easy in 8.7% of the participants in the control group (Group B). The mean visual analog score (VAS) was 2.96 with standard deviation (SD) of 0.97 in group A while 4.65 with SD of 0.88 in group B. Mean operative time in group A was 41.61 minutes with SD 5.4 while in group B was 60.04 minutes with SD of 6.2.

Conclusion:

The technique is time-saving and more comfortable to operator as well as patient over conventional use of straight wires in Erich’s arch bar fixation.