The use of interosseous dental wires and sutures for internal fixation in a patient with multiple comminuted middle facial fractures and facial nerve injury: A demonstrative case report

IntroductionThe use of plates and screws for facial fractures is considered the gold standard; providing accurate reduction and rigid fixation.Case reportWe report on a case with multiple comminuted middle facial fractures and concurrent facial nerve injury. The fractures were fixed with a combination of interosseous dental wires and polypropylene sutures with a satisfactory outcome.DiscussionWe aim to demonstrate two main advantages of wire/suture fixation in such cases when compared to plates and screws. Wire/suture fixation does not require periosteal dissection for fixation; and hence there is more preservation of the blood supply of the bony fragments. Furthermore, in the setting of concurrent facial nerve repair, the use of plates may risk re-injury of the repaired nerve during the late removal of the hardware. Interosseous wires/sutures do not require late removal and this is another advantage in these cases.ConclusionInterosseous dental wires and polypropylene sutures may be considered for fixation of multiple comminuted middle facial fractures and concurrent facial nerve injury.