Liu Chunming, Hou Min, Liang Limin, Huang Xuming, Zhang Tong, Zhang Haizhong, Ma Xiao, Song Ruyao
301 Hospital and Postgraduate Medical College of P.L.A., Beijing, PR China.
J Craniofac Surg. 2005 Jul;16(4):537-48. doi: 10.1097/01.scs.0000159083.21931.c5.
A new technique of osteotomy distraction osteogenesis (ODO) and sutural distraction osteogenesis (SDO) by the use of bone-borne traction hooks is presented. The technique of osteotomy plus distraction osteogenesis is suitable for adult patients. The technique of sutural distraction osteogenesis is suitable for young patients, ages 6 through 12 years. The distraction system consists of a face-bow, orthodontic elastics, and bone-borne traction hooks. The bone-borne traction hooks are made of titanium, with two traction hooks running laterally or downwardly. When a Le Fort III osteotomy is needed, bone-borne traction hooks are inserted through the nostrils into a bone hole drilled at the lateral-inferior pyriform aperture. When no osteotomy is needed, only the bone-borne traction hooks are placed. Heavy elastics were used in the technique of osteotomy distraction osteogenesis for Le Fort III osteotomy adult patients, whereas light forces and thus light elastics were used for younger patients. Three adult patients and four children were treated by osteotomy distraction and sutural distraction, respectively. All seven patients with midfacial hypoplasia established a harmonious facial profile and normal occlusal relationships. Radiographic examination showed balanced advancement of the midfacial skeleton. It is suggested that the treatment of midfacial hypoplasia in children by the technique of sutural distraction osteogenesis is to be preferred because of its simplicity and relative noninvasiveness. Thus, the authors suggest that midfacial hypoplasia should be treated at a younger age by this technique, potentially eliminating the need for a Le Fort III osteotomy at an older age.
介绍了一种使用骨承载牵引钩进行截骨牵张成骨（ODO）和缝牵张成骨（SDO）的新技术。截骨加牵张成骨技术适用于成年患者。缝牵张成骨技术适用于6至12岁的年轻患者。牵张系统由面弓、正畸弹力线和骨承载牵引钩组成。骨承载牵引钩由钛制成，有两个牵引钩横向或向下延伸。当需要进行Le Fort III截骨时，将骨承载牵引钩通过鼻孔插入在梨状孔外侧下方钻出的骨孔中。当不需要截骨时，仅放置骨承载牵引钩。在成年患者的Le Fort III截骨牵张成骨技术中使用重弹力线，而对于年轻患者则使用轻力，因此使用轻弹力线。分别对3例成年患者和4例儿童进行了截骨牵张和缝牵张治疗。所有7例面中部发育不全的患者均建立了和谐的面部轮廓和正常的咬合关系。影像学检查显示面中部骨骼平衡前移。由于其简单性和相对无创性，建议优先采用缝牵张成骨技术治疗儿童面中部发育不全。因此，作者建议应在较年轻的时候采用该技术治疗面中部发育不全，这可能消除在较年长时进行Le Fort III截骨的必要性。
