Department of Maxillofacial Surgery, Division of Maxillofacial and Neck Reconstruction, Graduate School of Tokyo Medical and Dental University, Tokyo, Japan; Department of Oral and Maxillofacial Surgery, Department of Clinical Sciences, Medical Life Science, Mie University Graduate School of Medicine, Mie, Japan.
Department of Maxillofacial Surgery, Division of Maxillofacial and Neck Reconstruction, Graduate School of Tokyo Medical and Dental University, Tokyo, Japan.
J Stomatol Oral Maxillofac Surg. 2019 Nov;120(5):493-496. doi: 10.1016/j.jormas.2018.11.017. Epub 2018 Dec 4.
Maxillary non-union is a rare complication that occurs after an orthognathic surgery such as Le Fort I osteotomy. Here, we report a case of refractory non-union after maxillary osteotomy, which required a second surgery with bone graft. A 33-year-old man who had undergone bimaxillary osteotomy complained of an abnormal sensation in the right alar part about 1 year after the surgery. The patient was diagnosed as having maxillary non-union. Although surgical stabilization was performed using titanium plates, the non-union remained. The re-fusion surgery was performed about 3 years after the bimaxillary osteotomy with autologous bone graft using a biodegradable fixation system. At the 1-year follow up, the maxillary non-union was healed both clinically and radiographically. Re-fusion surgery using bone graft with biodegradable fixation might be an effective treatment option in cases of prolonged non-union that becomes evident after a long period following the initial maxillary osteotomy.
上颌骨骨不连是一种罕见的并发症，发生于正颌手术后，如 Le Fort I 截骨术。本文报告 1 例上颌骨切开术后难治性骨不连病例，需要进行二次植骨手术。1 名 33 岁男性接受双颌骨切开术后约 1 年出现右侧鼻翼部分异常感觉。诊断为上颌骨骨不连。尽管使用钛板进行了手术固定，但骨不连仍存在。大约在双颌骨切开术后 3 年，使用可吸收固定系统进行了自体骨移植的再融合手术。在 1 年的随访中，上颌骨骨不连在临床和影像学上均愈合。对于初始上颌骨切开术后长时间出现的持续性骨不连，使用骨移植和可吸收固定的再融合手术可能是一种有效的治疗选择。
