新型薄平板型生物可吸收接骨装置用于颧骨骨折内固定的临床可行性：生物可吸收材料与钛接骨术在愈合方面是否存在差异？
The Clinical Feasibility of Newly Developed Thin Flat-Type Bioresorbable Osteosynthesis Devices for the Internal Fixation of Zygomatic Fractures: Is There a Difference in Healing Between Bioresorbable Materials and Titanium Osteosynthesis?
作者信息
Sukegawa Shintaro, Kanno Takahiro, Nagano Daiki, Shibata Akane, Sukegawa-Takahashi Yuka, Furuki Yoshihiko
机构信息
*Division of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital, Takamatsu, Kagawa†Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Shimane‡Cariology and Operative Dentistry, Department of Restorative Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo§Division of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital, Kagawa, Japan.
出版信息
J Craniofac Surg. 2016 Nov;27(8):2124-2129. doi: 10.1097/SCS.0000000000003147.
INTRODUCTION
In recent years, bioresorbable plates have undergone remarkable development. However, there has been no attendant improvement in their strength, because strength requires thickness, and complications such as palpability are related to the thickness of bioresorbable plate systems. In this clinical study, we compared the surgical management of zygomatic fractures using newly developed thinner bioresorbable materials or conventional titanium miniplates.
METHODS
Twelve patients with zygomatic fractures were randomly divided equally into 2 groups (6 with new bioresorbable osteosynthesis materials and 6 with standard titanium miniplates). Using computed tomography, we evaluated the thickness of the soft tissue and plate at the zygomaticofrontal sutures in each patient with the help of detailed radiographic computed tomography data at 6 months postoperatively. We compared the amount of soft-tissue volume increase between the uninjured healthy and injured operated sides in each patient.
RESULTS
Both groups eventually achieved satisfactory healing, with a favorable restoration of form and function and without any complications, including palpability. The amount of soft-tissue volume increase at the operated side relative to the uninjured healthy side using new thin bioresorbable plates was 131.1% (range: 101.5-165.8). On the other hand, that of titanium miniplates was 126.4% (range: 102.2-167.6). There was no statistically significant difference (P > 0.05).
CONCLUSION
This newly developed thinner flat-type bioresorbable plate system could be considered clinically useful in the treatment of zygomatic fractures even in easily palpated areas, such as the infraorbital rim or zygomaticofrontal sutures, without any healing differences in skeleton as compared with conventional titanium miniplates.
引言
近年来，可生物吸收接骨板有了显著发展。然而，其强度并未随之提高，因为强度需要厚度来保证，而诸如可触及性等并发症与可生物吸收接骨板系统的厚度有关。在本临床研究中，我们比较了使用新开发的更薄可生物吸收材料或传统钛微型接骨板治疗颧骨骨折的手术管理方法。
方法
12例颧骨骨折患者被随机平均分为2组（6例使用新型可生物吸收骨固定材料，6例使用标准钛微型接骨板）。借助术后6个月详细的X线计算机断层扫描数据，我们通过计算机断层扫描评估了每位患者颧骨额缝处的软组织和接骨板厚度。我们比较了每位患者未受伤的健康侧与受伤手术侧之间软组织体积增加量。
结果
两组最终均实现了满意的愈合，形态和功能得到良好恢复，且无任何并发症，包括可触及性问题。使用新型薄可生物吸收接骨板时，手术侧相对于未受伤健康侧的软组织体积增加量为131.1%（范围：101.5 - 165.8）。另一方面，钛微型接骨板的增加量为126.4%（范围：102.2 - 167.6）。差异无统计学意义（P>0.05）。
结论
这种新开发的更薄的扁平型可生物吸收接骨板系统在治疗颧骨骨折时，即使在诸如眶下缘或颧骨额缝等容易触及的区域，临床上也可被认为是有用的，与传统钛微型接骨板相比，骨骼愈合方面没有差异。
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