Courtemanche D J, Mutimer K L, Holmes A D, Levant B A, Clement J G
Department of Plastic Surgery, Royal Children's Hospital, Melbourne, Victoria, Australia.
Aust N Z J Surg. 1992 Jun;62(6):482-8. doi: 10.1111/j.1445-2197.1992.tb07230.x.
A study was designed to help ascertain the effects of rigid internal fixation in the growing skull. Five piglets underwent plating of the left coronal suture at 3 weeks of age. At the time of surgery metal markers were placed to follow bone growth. Cephalometric radiographs, direct osteometry at sacrifice, gross pathological examination and specimen radiography revealed a localized disturbance of growth. There was a restriction of sutural displacement and appositional bone growth at the site of the plate. Local restriction of sutural growth was almost complete during the experimental period. There was an alteration to a 'mature' suture morphology, without synostosis, of the suture on the plated side not seen on the control side. A plagiocephalic pig was not produced nor was there an orbital deformity. A large local contour deformity developed and by the end of the experimental period the plate had become completely incorporated in bone. These effects were statistically significant as well as clinically significant. The clinical use of this type of fixation in reconstructive surgery of the infant craniofacial skeleton is questioned in light of the result.
一项研究旨在帮助确定坚固内固定对生长中的颅骨的影响。五只仔猪在3周龄时接受了左侧冠状缝的钢板固定。手术时放置金属标记物以跟踪骨骼生长。头颅测量X线片、处死时的直接骨测量、大体病理检查和标本X线摄影显示生长局部紊乱。钢板部位的缝线移位和贴附性骨生长受到限制。在实验期间，缝线生长的局部限制几乎是完全的。在植入钢板一侧的缝线出现了向“成熟”缝线形态的改变，没有骨性融合，而对照侧未见到这种情况。没有产生斜头畸形猪，也没有眼眶畸形。出现了一个大的局部轮廓畸形，到实验期结束时，钢板已完全融入骨中。这些影响在统计学上和临床上都具有显著意义。鉴于这一结果，这种固定方式在婴儿颅面骨骼重建手术中的临床应用受到质疑。
