Sagittal Fractures of the Palate: A New Method of Treatment

Abstract

A new technique is described for stabilizing complex vertical fractures of the maxilla. Advantageous use of the comminuted fracture pattern of the maxillary buttresses allows the maxilla to be divided into two parts at the Le Fort I level. with intermaxillary fixation applied, stabilization is achieved by applying miniplate fixation to the nasal side of the hard palate. The maxilla is reduced to the previously stabilized anterior midfacial buttresses with plates and screws. Comminuted segments of defects in the anterior buttresses are replaced with contoured calvarial grafts. This method has the advantage of maintaining transverse palatal width in a rigid fashion without the need for further osteotomies. It has satisfactorily restored preinjury occlusal relationships in six patients, without the need for dental splints. In no instance has hardware extrusion occurred after fixation.