Freudlsperger Christian, Castrillon-Oberndorfer Gregor, Baechli Heidi, Hoffmann Juergen, Mertens Christian, Engel Michael
Department of Oral and Maxillofacial Surgery (Head: Hoffmann Juergen MD, DMD), University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
Department of Neurosurgery (Head: Unterberg Andreas MD), University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
J Craniomaxillofac Surg. 2014 Jul;42(5):503-7. doi: 10.1016/j.jcms.2013.07.016. Epub 2013 Sep 5.
Resorbable osteosynthesis is a widespread tool in craniofacial surgery, however only a limited number of studies have focused on ultrasound-assisted pinned resorbable systems in the treatment of craniosynostosis. Thirty-eight children with various types of craniosynostosis including scaphocephaly, trigonocephaly, anterior and posterior plagiocephaly were treated using the Sonic Welding resorbable osteosynthesis system. All patients were evaluated for operation time, stability of the surgical results, rate of local infections and visibility or palpability of the osteosynthesis material in the follow-up ranging from 15 to 21 month. Mean operation time was not significantly higher compared to conventional osteosynthesis material and all remodelled cranial vaults showed immediate stability. Only one patient showed signs of an inflammatory skin reaction, which recovered spontaneously. The number of palpable or visible plates, respectively, increased during the first months with a maximum at 12 months (34 (89%) plates palpable, 26 (68%) plates visible). After this time point, the number decreased continuously until the end of the follow-up period at 21 months when 3 (20%) plates were palpable, 0 (0%) plates were visible). Ultrasound-assisted pinned resorbable systems seem to be a promising tool in craniofacial surgery providing a timesaving and stable osteosynthesis. An initial swelling of the plates during the first 12 months before the complete degradation might result in a palpable and visible bulge.
可吸收骨固定术是颅面外科中一种广泛应用的工具，然而，仅有有限的研究关注超声辅助的带钉可吸收系统在治疗颅缝早闭中的应用。38例患有各种类型颅缝早闭（包括舟状头畸形、三角头畸形、前后斜头畸形）的儿童接受了超声焊接可吸收骨固定系统治疗。对所有患者在15至21个月的随访期内评估手术时间、手术结果的稳定性、局部感染率以及骨固定材料的可视性或可触知性。与传统骨固定材料相比，平均手术时间并无显著增加，且所有重塑的颅顶均显示出即刻稳定性。仅1例患者出现炎症性皮肤反应迹象，但自行恢复。在最初几个月中，可触及或可见的钢板数量分别增加，在12个月时达到最多（34块（89%）可触及，26块（68%）可见）。在此时间点之后，数量持续减少，直至21个月随访期结束时，3块（20%）可触及，0块（0%）可见。超声辅助的带钉可吸收系统似乎是颅面外科中一种有前景的工具，可提供省时且稳定的骨固定。在完全降解前的最初12个月内，钢板的初始肿胀可能导致可触及和可见的隆起。
