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Fracture dislocations of the middle third of the face usually involve a coplex combination of the three types of fractures initially described by LeFort and simple malar bone fractures classified by Knight and North. During 1989, 18 patients with midf acial fractures were treated with titanium rigid internal fixation devices (plates and screws). Access to the LeFort I and II components was through extended gingivobuccal incisions, and fixation was with titanium multihole compressin plates and screws 3 to 9 mm in length. These screws were placed in a monncortical fashion. The attempt was made to bridge the LeFort II and/onI components on each side with a single straight plate attached exactly over the zygomaticomaxillary buttress to reform the walls of maxilla. The separated nasomaxillar suture lines were reduced and stabilized, usually with a micro-compression plate in a monocortical fashion. Rigid internal fixation with titanium mini-and micro-compression plates should be considered as an alternative treatment for most fractures of the middle third of the face.

Rigid internal fixation with titanium plate for maxillofacial bone fractures to use oromaxillar approach