Gala Zachary, Halsey Jordan, Kogan Samuel, Hoppe Ian, Ciminello Frank S, Granick Mark S
Division of Plastic and Reconstructive Surgery, Rutgers New Jersey Medical School, Newark, NJ.
Division of Plastic and Reconstructive Surgery, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ.
Eplasty. 2020 Oct 19;20:e11. eCollection 2020.
Literature discussing the use of rigid external distraction devices in midfacial trauma is limited. Rigid external distraction devices have been described for use in craniofacial surgery, allowing for distraction and stabilization of bony segments. In complex facial trauma, bony fragments are often comminuted and unstable, making traditional approaches with internal fixation difficult. Moreover, these approaches require subperiosteal dissection, limiting blood supply that is important for bone healing.
The goal of this study was to evaluate the role of rigid external distraction devices for the treatment of complex facial trauma.
We performed a literature review of rigid external distraction devices, as relevant both for facial trauma and for other craniofacial indications, to better elucidate their use and efficacy in complex facial fractures.
The review revealed only 2 articles explicitly describing rigid external distraction devices for facial trauma, while 6 other articles describing its use for other craniofacial cases. An important benefit associated with the use of rigid external distraction devices is their ability to provide controlled traction of bony segments while also allowing for movement as needed for fracture reduction. Various articles describe performing internal fixation following rigid external distraction device usage, while others emphasize that internal fixation is not necessarily indicated if the rigid external distraction device is left intact long enough to ensure bony healing. One potential setback described is unfamiliarity with using the rigid external distraction device, which can preclude its use by many surgeons. In addition, the literature review did not provide any uniform guidelines or recommendations about how long rigid external distraction devices should remain intact.
Based on relevant literature, rigid external distraction devices have been shown to be useful in the stabilization and treatment of complex facial fractures. Further studies should be conducted to better elucidate the specific indications for rigid external distraction devices in complex facial trauma.
关于在面中部创伤中使用坚固外固定牵张装置的文献有限。坚固外固定牵张装置已被描述用于颅面外科手术，可实现骨段的牵张和稳定。在复杂面部创伤中，骨碎片常为粉碎性且不稳定，使得传统的内固定方法难以实施。此外，这些方法需要进行骨膜下剥离，限制了对骨愈合至关重要的血液供应。
本研究的目的是评估坚固外固定牵张装置在治疗复杂面部创伤中的作用。
我们对坚固外固定牵张装置进行了文献综述，这些装置与面部创伤及其他颅面适应症相关，以更好地阐明其在复杂面部骨折中的应用和疗效。
该综述仅发现2篇明确描述坚固外固定牵张装置用于面部创伤的文章，另有6篇文章描述其用于其他颅面病例。使用坚固外固定牵张装置的一个重要益处是其能够对骨段提供可控牵引，同时还能根据骨折复位的需要进行移动。多篇文章描述了在使用坚固外固定牵张装置后进行内固定，而其他文章强调，如果坚固外固定牵张装置保留足够长的时间以确保骨愈合，则不一定需要进行内固定。所描述的一个潜在挫折是对使用坚固外固定牵张装置不熟悉，这可能使许多外科医生无法使用该装置。此外，文献综述未提供关于坚固外固定牵张装置应保留多长时间的统一指南或建议。
基于相关文献，坚固外固定牵张装置已被证明在复杂面部骨折的稳定和治疗中有用。应进行进一步研究以更好地阐明坚固外固定牵张装置在复杂面部创伤中的具体适应症。
