1 Reduction topenlarge
Arch bars are applied and occlusion is checked. The occlusion is then secured by mandibulomaxillary fixation (MMF). Click here for a detailed description of the MMF technique.
Pearl: securing the reduction
It may be beneficial to use forceps to maintain the reduction while securing the MMF.
2 Fixation topenlarge
This technique in the management of a complex (comminuted) palatal fracture is commonly referred to as a closed technique. It is common to perform ORIF with the placement of a longer plate or individual smaller plates to span the alveolar fractures that are in continuity with the palatal fractures. We refer to this as a closed technique because an open reduction of the palate has not been performed, even though ORIF may be applied to the anterior alveolar ridge.
Note: In placing the second plate on the anterior alveolar fracture, consider the position of additional plates to be placed for the fixation of the Le Fort I fracture.
3 Addressing the Le Fort I fracture topenlarge
In the illustrated case, the Le Fort I fracture needs to be addressed after the palatal unit has been repaired. Please refer to the section on Le Fort fractures for further details.