A Reduction Technique for a Depressed and Impacted Nasomaxillary Buttress Fracture.

The aim of this study is to introduce an easy method of reducing the depressed and impacted segment in a nasomaxillary buttress fracture. Through the gingiva-labial vestibular incision, the fracture segments were exposed. A blunt end of the Cottle elevator was inserted to the cleft of the fracture segments. An upward and lateral force was applied until the impacted segment was released and reduced to its anatomical position. Then, the segments were fixed with a miniplate. Fifteen patients (12 males, 3 females, mean age: 34.5 +/- 11.7 years) were operated on. In 14 patients, the fragments were reduced in the anatomical position and secondary surgery was not required. In 1 patient, however, the infraorbital rim could not be reduced enough through a gingival incision and a secondary surgery was performed to reduce the orbital rim. A blunt end of the Cottle elevator is shallow and long enough to be inserted into the cleft and strong enough to transfer the force to reduce it into its anatomical position. This reduction technique using a Cottle elevator is easy and can be used for reducing the depressed and impacted segment in nasomaxillary buttress fractures. (C) 2016 by Mutaz B. Habal, MD.

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