ABSTRACT
Objective To explore and estimate a new non-operative treatment of maxillary fracture with elastic traction for the purpose of early treatment and on-spot first aid. Methods 12 patients, who were suffer from maxillary fracture including Lefort Ⅰ, Ⅱ, Ⅲ fracture, zygomatico-maxillary complex fracture and nasomaxillary complex fracture within the past 2 or 3 weeks,were treated by closed tractive reduction with a patent craniomaxillary tractive device, a non-operative manner instead of surgical open reduction and rigid internal fixation. The devices were placed after dental splints had been ligated, and the traction force was adjusted depending on the extent of maxillary displacement and patient’s endurance. In general, the displaced maxilla could be pulled upwards, downwards, forward, leftward and rightward. For fallen maxilla, a special plate was placed on upper teeth and palate in order to push up the whole maxillary fragments. By adjusting the position of maxillary bar, the displacement could be reduction and correction. The elastic rubber loops were placed between dental splint and headframe, then the reduction of maxilla was accomplished. After reduction, external fixation such as intermaxillary fixation and craniomnetal bandage were used for maintenance. Results Tractive times of those 12 patients lasted from 2 days to 7 days, with an average of 4 days. After the non-operative trative reduction, satisfactory functional and cosmetic results were achieved with normal occlusion and facial contour in all patients. No obvious complications were found. Conclusion For fresh maxillary fracture except comminuted and impacted fracture, this new non-operative tractive treatment could be an ideal treatment rather than surgical open reduction.