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可吸收式下颌骨牵张成骨:技术演变与临床经验

Resorbable distraction of the mandible: technical evolution and clinical experience.

作者信息

Burstein Fernando D

机构信息

Emory University Plastic Surgery Division, Center for Craniofacial Disorders, Children's Healthcare of Atlanta, Atlanta, Georgia, USA.

出版信息

J Craniofac Surg. 2008 May;19(3):637-43. doi: 10.1097/SCS.0b013e31816b6c8f.

Abstract

The author has used various designs of single-stage resorbable distractors to lengthen the mandible in 100 patients aged 7 days to 16 years (mean, 4.24 y; 49 girls, 51 boys) with predictable results and minimal morbidity since 2002. The range of distraction was 15 to 30 mm (mean, 25.4 mm). Indications for surgery included mandibular hypoplasia associated with Pierre Robin sequence, craniofacial microsomia, Treacher Collins, and Nagers syndrome. The history of the development of resorbable polymers for use in craniofacial surgery and the evolution of distraction osteogenesis are reviewed. The melding of these 2 innovative technologies has led to the development of a new class of single-stage resorbable devices. These devices are quite different from the titanium distraction devices that have been used in clinical practice for more than 15 years. Through continued clinical application, the surgical methodology for resorbable distraction has been refined and simplified, although still-evolving continued experience with resorbable distraction has greatly decreased operative time and improved results.

摘要

自2002年以来,作者使用了各种单阶段可吸收牵张器设计,为100例年龄在7天至16岁(平均4.24岁;49名女孩,51名男孩)的患者延长下颌骨,取得了可预测的结果,且发病率极低。牵张范围为15至30毫米(平均25.4毫米)。手术适应症包括与皮埃尔·罗宾序列、颅面短小畸形、特雷彻·柯林斯综合征和纳热尔综合征相关的下颌骨发育不全。本文回顾了用于颅面外科手术的可吸收聚合物的发展历程以及牵张成骨术的演变。这两种创新技术的融合催生了一类新型的单阶段可吸收装置。这些装置与临床应用已超过15年的钛质牵张装置有很大不同。通过持续的临床应用,可吸收牵张的手术方法已得到完善和简化,尽管可吸收牵张的经验仍在不断发展,但已大大缩短了手术时间并改善了效果。

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