Rapid IMF. Temporary mandibularfixation device.

Technique Guide

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WarningThis description is not sufficient for immediate application ofthe instrumentation. Instruction by a surgeon experienced inhandling this instrumentation is highly recommended.

Table of Contents

Introduction

Surgical Technique

Warnings and Precautions 12

Product Information 13

Indications and Contraindications 2

Good Planning and Practice 3

Placement of Anchorage Ties 4

Placement of Elastic Chain 7

Removal of Ties 10

2 Synthes Rapid IMF Technique Guide

Indications and Contraindications

Indications

Rapid IMF is an adjustable flexible plastic band that wrapsaround a tooth to create an anchorage point for temporarymaxillomandibular fixation and immobilization (similar to anorthodontic band). Rapid IMF is suitable for:

– Preoperative fixation– Perioperative fixation– Short-term (up to 3 weeks) fixation for minimally

displaced fractures– Splintage of post-jaw-dislocation

Contraindications

– Complex fractures– Periodontal disease– Dental neglect– Orthognathic surgery– Use in children (under 15 years)

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B A

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A B

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Upper right

Lower right Lower left

Upper left

Slim, rigid tip makes the tie easyto insert

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Good Planning and Practice

Planning

– Assess which teeth will serve for anchorage by viewing thepreoperative X-ray.

– At least six anchorage points are required.– Choose teeth with good bony support which are not

overly crowded and which have contact points on bothsides.

– Ties should be selected and positioned based on quadrantimage below.

Practice

– Tighten the ties to a firm fingertight; similarly the elasticloading is recommended to be firm.

– While in place, ties must always be loaded by elastic chaintension to avoid mucosal pressure ulceration.

– Check health of anchored teeth. – If left on postoperatively, follow-up must be conducted at

regular intervals (e.g. days 1, 3, etc.) to ensure proper ten-sioning of the components until removal.

– Use a scalpel and straight mosquito forceps for assistancein the procedure.

– After removal of device, patient should be switched to asoft diet

4 Synthes Rapid IMF Technique Guide

Placement of Anchorage Ties

2

With the help of forceps, guide the metal tip of the tiethrough the interdental space on the lateral side of the toothfrom buccal to lingual.

1

Select a tooth in each quadrant (see page 3, planning) withcontact points medially and laterally. Proper orientation ofthe tie is with the belt extending posteriorly and the narrowtip of the anchorage peg pointing apically.

3

From the lingual side, ease the belt through, applying lightpressure. Keep the belt off the contact points to ease inser-tion.

Do not pull the belt through completely. Leave enoughlength on the buccal side so the anchorage point can bepositioned on the medial side of the tooth (see arrow).

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5

Pass the belt back through the medial interdentalspace as shown. Ease the entire belt through, applyinglight pressure.

4

Confirm the position by pressing the anchorage point into the medial interdental space.

6

Pass the belt through the anchorage point until the beltengages the locking mechanism.

6 Synthes Rapid IMF Technique Guide

Placement of Anchorage Ties

8

Final tightening is completed by grasping the belt close tothe anchorage point and rotating the tip so that the belt istightened by at least one more notch. Tighten in a controlledmanner, to avoid stretching the belt.

7

Pull the belt away from the contact point and push the an-chorage point down the belt, firmly into the interdentalspace on the medial side of the tooth.

9

Remove the excess belt with a scalpel by cutting on the flatedge on the buccal surface of the anchorage point.

Assess firmness by pressing down on the anchorage point.Do not lever the tip of the anchorage point.

Repeat steps until there are a minimum of 3 ties in both themaxillary and the mandibular arches. Distribute ties evenlyacross each arch.

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2

Pull the chain link down until it is secured under the “lip“ onthe anchorage point.

1

With the help of forceps, pass a chain link over an anterioranchorage point.

3

Maintaining gentle traction on the chain, loop the chainbehind anchorage points in a zigzag manner, like lacing ahiking boot.

Placement of Elastic Chain

8 Synthes Rapid IMF Technique Guide

Placement of Elastic Chain

5

Secure as shown.

4

Secure the final link over an easily accessible upper anterioranchorage point.

6

Cut excess chain.

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7

Check for proper occlusion. Readjust if required.

Important: Always check and adjust the chain tension atreview days (e.g. days 1, 3, etc.).

10 Synthes Rapid IMF Technique Guide

Removal of Ties

2

Lever the top of the tie outward as shown.

1

Remove elastic chain.

3

Cut the belt at the weak point (which is marked by a verticalline on the belt) as shown.

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4

Grasp the tie with forceps and disengage.

5

Gently remove the tie and belt.

12 Synthes Rapid IMF Technique Guide

Warnings and Precautions

– Ties must always be loaded by elastic chain tension to pre-vent mucosal pressure ulceration.

– The tie belt should not be crushed by forceps as this willreduce lock strength.

– Ties must be removed from any teeth with evidence, orsuspicion, of traction-induced movement, or from teeththat become sensitive or painful.

– The surgeon should discuss with the patient the use andexpectations of the product, and postoperative care.

– Patients must be reviewed according to product guidelines.

Important: The product must be restricted to appropriateteeth, and sufficient anchorage points must be used for ade-quate reduction and stabilization. At least 6 anchoragepoints are required, but 8 are recommended if dentitionallows it.

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08.000.501.01S Rapid IMF Device, 1 procedure pack, ster-ile, containing 5 upper right / lower leftties, 5 upper left / lower right ties and2 elastic chains

Note: For single use only, do not resterilize.

Product Information

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