Department of Plastic Surgery, Chang Gung Memorial Hospital at Chiayi, Taiwan.
Craniofacial Center, Department of Plastic Surgery, Chang Gung Memorial Hospital at Linkou, Taiwan.
Asian J Surg. 2018 Jul;41(4):370-376. doi: 10.1016/j.asjsur.2017.03.003. Epub 2017 May 10.
Zygoma fracture is of clinical importance because malar prominence plays an essential role in facial appearance. Traditionally, most maxillofacial surgeons perform osteosynthesis with titanium plates and screws for rigid fixation. However, this procedure has certain disadvantages that include the possibility of implant exposure, palpability or loosening of the screws, painful irritation, temperature sensitization, and radiographic artifacts. In this study, we compared the function and satisfaction outcome between Bonamates bioabsorbable implant and Leibinger titanium implant.
Consecutively 53 patients with isolated unilateral zygomatic fracture that were treated with the Bonamates bioabsorbable plate system, n = 53 were compared to patients with the titanium plate system, n = 55 in the period between 2009 and 2013. All patients were followed-up at least 6 months. Preoperative and postoperative facial computed tomography (CT) scans were performed and scored from 0 to 2 in the 5 areas of zygoma. A score of 2 indicated the most severely displaced fracture in one of the areas. A visual analogue scale ranging from 0 to 10 was used to assess the postoperative aesthetic and functional satisfactions.
The mean ages of the patients in the bioabsorbable and titanium plate groups were 33 years and 30 years, respectively. The male to female ratios were 1.2:1 (bioabsorbable plate group) and 1.1:1 (titanium plate group). The average preoperative CT scan scores of the bioabsorbable and titanium plate groups were 5.7 and 5.1, respectively. The postoperative CT scan scores of the bioabsorbable and titanium plate groups were 1.3 and 1.1, respectively. The implant cost of the bioabsorbable group was approximately 6-fold higher than that of the titanium plate group. The complication rate was similar in both groups and included complications such as palpable implant, skin irritation, and hypersensitive cheek. The patients in both groups attained similar mouth-opening function and a satisfactory score at 6 months after operation.
This study revealed that the bioabsorbable plate outcome was similar to the titanium plate outcome for patients with isolated unilateral zygomatic fracture. The bioabsorbable implant system provides another option for internal fixation devices in the treatment of zygomatic fractures and avoids implant removal surgery; however, the implant cost of bioabsorbable plates is higher than that of titanium plates in Taiwan.
颧骨骨折具有重要的临床意义，因为颧骨突出对面部外观起着至关重要的作用。传统上，大多数颌面外科医生使用钛板和螺钉进行骨内固定以实现刚性固定。然而，该手术存在一定的缺点，包括植入物暴露、螺钉可触及或松动、疼痛刺激、温度敏感、放射伪影等可能性。在这项研究中，我们比较了 Bonamates 可吸收植入物和 Leibinger 钛植入物的功能和满意度结果。
连续选择 2009 年至 2013 年间接受 Bonamates 可吸收板系统治疗的 53 例单侧颧骨骨折患者（n=53）与接受钛板系统治疗的 55 例患者进行比较。所有患者至少随访 6 个月。术前和术后均行面部计算机断层扫描（CT）检查，并在颧骨的 5 个区域内进行 0 至 2 分的评分。2 分表示其中一个区域的骨折移位最严重。采用 0 至 10 分的视觉模拟评分（VAS）评估术后美学和功能满意度。
可吸收板组和钛板组患者的平均年龄分别为 33 岁和 30 岁，男女比例分别为 1.2:1（可吸收板组）和 1.1:1（钛板组）。可吸收板组和钛板组患者术前 CT 扫描评分平均分别为 5.7 和 5.1，术后 CT 扫描评分平均分别为 1.3 和 1.1。可吸收板组的植入物成本约为钛板组的 6 倍。两组的并发症发生率相似，包括可触及植入物、皮肤刺激和面颊敏感等并发症。两组患者术后张口功能相同，术后 6 个月满意度评分相似。
本研究表明，对于单侧颧骨骨折患者，可吸收板的效果与钛板相似。可吸收植入物系统为颧骨骨折的内固定装置提供了另一种选择，避免了植入物取出手术；然而，可吸收板的植入物成本高于台湾的钛板。
