Resident Manual of Trauma to the Face, Head and Neck

b. Bridle Wire Bridle wire is a single ligature placed for temporary stabilization of mobile fractures (Figure 5.12). Bridle wire is often placed under local anesthesia. Teeth adjacent to the fracture should be avoided.

Figure 5.12 Bridle wire placed to reduce discomfort is stabilizing a parasymphyseal fracture (left). Bridle wire and IMF screws are stabilizing a nondisplaced parasymphyseal fracture (right).

c. Ivy Loops Ivy loops are used for MMF for minimally displaced fractures when the full patient has a full dentition. The loop is constructed with 24-gauge wire. A small loop is made in the center of the wire (Figure 5.13). The loose ends are passed through the interproximal of two stable teeth, brought around the mesial and distal interproximal of each tooth. The distal wire is brought under (or through) the loop and anchored to the mesial wire with a clockwise twist. An opposing loop is then created to make a pair. The loop produced is then used to pass a third 24-gauge wire to anchor the MMF wire. A minimum of two sets of Ivy loops is recommended bilaterally.

Figure 5.13 Ivy loop passed between the interproximal space of #30 and #31.

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