Internal Fixation of the Mandible

The rigid internaI fixation of mandibular fractures has become a widely ac cepted practice among European surgeons. The caution or even outright re jection voiced at a congress of the German Society of Maxillofacial Sur 1970s is no longer prevalent. Through a process of geons held in the late critical review and implementation, rigid internaI fixation has become an established treatment modality at numerous centers, especially in Switzer land, the Federal Republic of Germany, and the Netherlands. By comparison, the method has received very little attention in North America and the Anglo-Saxon countries. By and large, surgeons in these countries continue to treat mandibular fractures by intermaxillary fixation, possibly supplemented by the use of interosseous wires. Many recent edi tions of surgical texts confirm this. Lately, however, there appears to be a surge of interest in methods of functionally stable internaI fixation, especially in the United States of America, and AO/ ASIF instruction courses are increasingly in demand. This book is intended to aid course participants in their lessons and practi cal exercises and also to guide the clinical practitioner in the application of AO/ ASIF principles. Basel, September 1988 B.SPIESSL VII Acknowledgments I have received help from many sources. The colleagues of the past 20 years who have contributed to the case material upon which this manual is based are too numerous to credit by name.

Klappentext

This manual is conceived as an aid to AO course participants both in grasping theoretical principles and in performing practical exercises, as well as a practical guide for clinicians in the application of AO principles. These principles are discussed in Part I and related to notions of stability, biomechanics, and technique. In addition to interfragmentary fixation and load bearing, the technique of external fixation is explained. The use of rigid external fixators with the mandible is proposed as a replacement for pin fixation, which has been obsolete for over two decades. Part II is a practical guide to the theoretical principles set forth in the first section of the volume, with the focus on case studies classified according to fracture type. This section provides a solid empirical basis of particular value in establishing indications and selecting appropriate techniques. Equally important is the anatomy of surgical points of access. In Part III, the increasing variety of indications for rigid internal fixation is confirmed. Three areas take on particular relevance here: the surgical treatment of pseudarthrosis, the by-pass of primary defects as an integral part of mandibular tumor surgery, and sagittal splinting and condylar replacement for orthopedic interventions involving the locomotor system of the mandible. A foldout entitled "AO Classification of Mandibular Fractures" is inserted at the back of the book. Its purpose is to help the clinician confronted by an acute case to determine its classification.

Inhalt
I: Basic Principles.- 1 Goals of the AO/ASIF Technique.- 2 The Stability Principle.- 3 Biomechanics.- 4 Principles of the ASIF Technique.- 5 ASIF Instrumentation.- 6 Preoperative, Intraoperative, and Postoperative Guidelines.- II: Internal Fixation of Fresh Fractures.- 1 Introduction.- 2 Classification of Fractures.- 3 Indications for Internal Fixation.- 4 Surgical Approaches.- 5 Closed Fractures.- 6 Open Fractures.- 7 Treatment of Mandibular Fractures in Children.- III: Reconstructive Surgery.- 1 Introduction.- 2 Nonunion.- 3 Reconstruction of Segmental Defects in Tumor Surgery.- 4 Prophylactic Use of the Neutralization Plate.- 5 Partial Prosthetic Arthroplasty.- 6 Osteotomies.- Foldout AO Classification of Mandibular Fractures.