Kim Youn Hwan, Lee Kyoung Mook, Kim Jeong Tae
Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, Korea.
J Craniofac Surg. 2011 Nov;22(6):2235-7. doi: 10.1097/SCS.0b013e3182320108.
Because chin is a major component of the lower face, underprojection, overprojection, and asymmetry of chin have been addressed via various surgical approaches. Sliding genioplasty is a popular technique to resolve this problem. This technique is rarely known to have postoperative complications, including nonunions. We experienced 1 case of nonunion after sliding genioplasty and treated it successfully.A 25-year-old woman who underwent sliding genioplasty 10 years ago at a local clinic visited our institute owing to displeasing appearance of the chin. Ten months ago, nonunion was diagnosed, and the patient underwent a second operation. We performed a longer incision than the previous operation and removed screws, plate, and an alloplastic material that was inserted previously. Shaving of the nonunion margins, refixation, and recontouring were performed, and bone chips acquired from the recontouring procedure were inserted into the interim space. During follow-up, no complications were observed, and bone union was completed on radiologic examination. Appropriate fixation is very important to prevent nonunion after sliding genioplasty. For appropriate fixation, getting a sufficient surgical field is indispensable, and shaving the nonunion margins, refixation, and bone chip implantation are helpful to address this complication.
由于下巴是下脸部的主要组成部分,下巴的后缩、前突和不对称已通过各种手术方法进行处理。颏部截骨前移术是解决这一问题的常用技术。该技术很少出现术后并发症,包括骨不连。我们遇到1例颏部截骨前移术后骨不连的病例,并成功进行了治疗。
一名25岁女性10年前在当地诊所接受了颏部截骨前移术,因对下巴外观不满意前来我院就诊。10个月前,诊断为骨不连,患者接受了二次手术。我们做了比上次手术更长的切口,取出了螺钉、钢板和先前植入的异体材料。对骨不连边缘进行修整、重新固定和重塑外形,并将重塑过程中获取的骨碎片植入间隙。随访期间未观察到并发症,影像学检查显示骨愈合完成。适当的固定对于预防颏部截骨前移术后骨不连非常重要。为了进行适当的固定,获得足够的手术视野是必不可少的,修整骨不连边缘、重新固定和植入骨碎片有助于处理这一并发症。