Hihara Masakatsu, Yagura Takuma, Takegawa Masayasu, Kakudo Natsuko, Morimoto Naoki, Kusumoto Kenji
Department of Plastic and Reconstructive Surgery, Kansai Medical University, Osaka, Japan.
Department of Orthopedic Surgery, Kansai Medical University, Osaka, Japan.
Trauma Case Rep. 2019 Jun 22;22:100214. doi: 10.1016/j.tcr.2019.100214. eCollection 2019 Aug.
In general, internal plate fixation is mainly performed in order to reduce multiple facial bone fractures and rarely uses an external fixator. Although it would be ideal to successfully achieve or preserve the occlusal relationship of the upper and lower jaws, it is difficult to successfully manage multiple bone fragments in order to use them to achieve internal fixation, especially when treating a severely comminuted facial fracture. In addition, it is also important to prevent the onset of severe infection after sub-periosteal dissection, due to the presence of avascular bony fragments and an internal fixation implant which thus represents a foreign body. In order to treat extensive comminuted fracture without internal plate fixation, we performed external fixation using an Ilizarov-type external fixator. The Ilizarov-type external fixator is characterized by a few circular external structures and threaded rods. This device can be modified for use in the field of orthopedic surgery to correct three-dimensional deformities caused by fragile complicated fractures and bone defects. The advantages of the Ilizarov-type external fixator for treating panfacial fractures include a low invasiveness, utility in various fracture situations, easy adjustment of threaded rods, and a low potential cost. We herein report the first case of a severe panfacial fracture that was successfully treated using an Ilizarov-type external fixator.
一般来说，内固定主要用于治疗多发性面骨骨折，很少使用外固定器。虽然成功实现或保留上下颌的咬合关系是理想的，但为了进行内固定而成功处理多个骨碎片很困难，尤其是在治疗严重粉碎性面骨骨折时。此外，由于存在无血运的骨碎片和作为异物的内固定植入物，防止骨膜下剥离后严重感染的发生也很重要。为了在不使用内固定板的情况下治疗广泛的粉碎性骨折，我们使用伊利扎罗夫式外固定器进行了外固定。伊利扎罗夫式外固定器的特点是有一些环形外部结构和螺纹杆。该装置可在整形外科领域进行改良，以纠正由脆弱复杂骨折和骨缺损引起的三维畸形。伊利扎罗夫式外固定器治疗全颜面骨折的优点包括低侵袭性、适用于各种骨折情况、螺纹杆易于调整以及潜在成本低。我们在此报告首例使用伊利扎罗夫式外固定器成功治疗的严重全颜面骨折病例。
