MMF Monthly Issue 6 September 2021
Updated: Dec 16, 2021
Patient Case Report
Use Of Minne Ties Under Local In The ER For Bilateral Mandible Fractures David Montag, MD, MS (Hennepin County Medical Center) A healthy 26-year-old woman presented to the ED after a bicycle accident in which she sustained an incomplete left parasymphyseal mandible fracture and a right mildly displaced mandibular ramus fracture (figures 1 and 2). In addition, she had fractured her left central maxillary incisor, but otherwise had excellent dentition. The patient was given the option of proceeding to the operating room to have formal arch bars or hybrid arch bars placed vs. Minne Ties placed under local anesthesia in the ER. Four 1.0mm Minne Ties (18 gauge) on both the left and right side from the second molars to the canines. The Ties were removed in the office with topical anesthetic during the patient's 2-week follow-up. The patient's occlusion was subjectively similar to her pre-morbid condition, and she rated the discomfort of removal of the Minne Ties as a 1/10. She also denied any pain or discomfort of her buccal mucosa or lip mucosa associated with the Minne Ties. "Overall, this was felt to be an excellent treatment by the patient and from a treating physician's perspective." Read the full case report by Dr. Montag here.
Figure 1: Pre-operative right mandibular ramus fracture with mild displacement. Figure 2: Pre-operative left mandibular non-displaced parasymphysis fracture.
Invisian Medical at National Conferences
Invisian Medical will be exhibiting at 3 national conferences this fall: The AAO-HNSF 2021 Annual Meeting, The 2021 AAOMS Annual Meeting, and The 2021 ASTMJS Fall Meeting. Come find us at the AAO-HNSF meeting at booth 531, and the AAOMS meeting at booth 756. We hope to see you there, we will have exciting new things to share!
MMF Article: A Clinical Comparison and Economic Evaluation of Erich Arch Bars, 4-Point Fixation, and Bone-Supported Arch Bars for Maxillomandibular Fixation
In a 2019 paper published in JAMA Otolaryngology – Head & Neck Surgery, Edmunds, et al compared clinical outcomes and hospital charges associated with use of Erich arch bars, hybrid arch bars, and IMF screws. Their population included 93 patients with mandible fractures from 2005 to 2015. The mean operative time when using Erich arch bars was 98.7 minutes, 48.8 minutes when using 4-point fixation (IMF screws), and 55.9 minutes when using bone-supported arch bars (hybrid arch bars). Table 3 from the paper (see below) presents overall hospital charges at the authors’ institution with each MMF technique. The financial differences were magnified when removal was considered. The paper concluded: “Bone-supported arch bars have comparable complication outcomes, operative time for placement, and overall charges when compared with Erich arch bars and 4-point fixation and have a lower likelihood of requiring removal in an operative setting.” Click here to read the full article
JAMA Otolaryngology Head Neck Surg. 2019;145(6):536-541. doi:10.1001/jamaoto.2019.0183
Published online April 4, 2019
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