Mitsukawa Nobuyuki
Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Showa University, Tokyo, Japan.
J Craniofac Surg. 2011 Jan;22(1):226-9. doi: 10.1097/SCS.0b013e3181f8a4fe.
Titanium plate systems are used frequently for bone fractures and postosteotomy fixation in craniomaxillofacial surgery. However, sometimes the head of the screw for plate fixation is deformed or the screw breaks in the bone. Screw removal can be difficult in these cases. In this study, we examined the utility of the Screw Extraction Set (Synthes Inc) in facilitating the removal of screws broken in craniomaxillofacial bones. In the past, we often encountered screw head sockets that had become deformed. In the removal of such a screw, the extraction screw tip did not engage well with the deformed screw head socket because the extraction screw tip was angled obtusely. Thus, its removal was difficult, and this method was clearly problematic. Using the Screw Extraction Set, the removal method for a screw broken in the bone was relatively easy. In particular, it was very convenient in removing broken screws in the mandibular angle and ramus, where surgery is difficult under direct vision. This system was thought to be useful for craniofacial surgeons if proper patient selection is performed.
钛板系统在颅颌面外科手术中常用于骨折和截骨术后固定。然而，有时用于钢板固定的螺钉头部会变形或螺钉在骨内断裂。在这些情况下，取出螺钉可能会很困难。在本研究中，我们检验了螺钉取出套件（辛迪斯公司）在协助取出颅颌面骨内断裂螺钉方面的效用。过去，我们经常遇到螺钉头部的槽形发生变形的情况。在取出这种螺钉时，由于取出螺钉的尖端角度钝，其尖端与变形的螺钉头部槽形不能很好地啮合。因此，取出它很困难，这种方法显然存在问题。使用螺钉取出套件，取出骨内断裂螺钉的方法相对容易。特别是在直视下手术困难的下颌角和下颌支部位取出断裂螺钉时非常方便。如果进行适当的患者选择，该系统被认为对颅面外科医生有用。
