Kim Chang Yeon, Kim Kee Woong
Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea.
J Craniofac Surg. 2011 Jul;22(4):1215-8. doi: 10.1097/SCS.0b013e31821c0d84.
A resorbable fixation system has many advantages, but there are complicated procedures to be accomplished to fix a resorbable plate. The complicated procedures in the fixation of a resorbable plate make the operation for facial fractures more difficult and can result in extended operation time and incomplete reduction or fixation. For these reasons, we suggest a new way of using a tapper that can make the surgery more simple and accurate than before. After the resorbable plate is properly located above the fractured site, a hole on the fracture fragment is made by drill, and the tapper is inserted into the hole. When the tapper is inserted at the proper depth, the fracture fragment can be reduced to right place by handling the inserted tapper. Then, the tapper is inserted to the end, and the handle is split. While the inserted tapper acting as a temporary metal screw is placed, another hole is made at nearby site and the screw is inserted. Next, the inserted tapper acting as a temporary metal screw is removed, and another screw is inserted into the hole from which the tapper was removed. From October 2006 to April 2008, we applied this procedure to 106 facial bone fractures in 68 patients, and no major complications were noted. In conclusion, we tried to make the operation more simple and accurate by using the tapper as an instrument for reduction and fixation of fracture fragment.
可吸收固定系统有许多优点,但固定可吸收接骨板需要完成复杂的步骤。可吸收接骨板固定过程中的复杂步骤使得面部骨折手术更加困难,可能导致手术时间延长以及复位或固定不完全。基于这些原因,我们提出一种使用攻丝器的新方法,它能使手术比以前更简单、更精确。在将可吸收接骨板正确放置在骨折部位上方后,用钻头在骨折碎片上钻孔,然后将攻丝器插入孔中。当攻丝器插入到合适深度时,通过操作插入的攻丝器可将骨折碎片复位到正确位置。然后,将攻丝器插入到底部并将手柄劈开。在插入的攻丝器作为临时金属螺钉放置时,在附近位置再钻一个孔并插入螺钉。接下来,将作为临时金属螺钉的插入攻丝器取出,再将另一枚螺钉插入攻丝器取出的孔中。从2006年10月至2008年4月,我们将此方法应用于68例患者的106处面部骨折,未发现重大并发症。总之,我们试图通过使用攻丝器作为骨折碎片复位和固定的器械,使手术更简单、更精确。