Balaji S M, Balaji Preetha
Department of Oral and Maxillofacial Surgery, Balaji Dental and Craniofacial Hospital, Chennai, Tamil Nadu, India.
Ann Maxillofac Surg. 2022 Jan-Jun;12(1):22-26. doi: 10.4103/ams.ams_35_22. Epub 2022 Aug 16.
Rigid plating fixation (RPF) and resorbable plating systems (RPS) advanced the field of reconstruction in craniomaxillofacial region. However, their performance in patients, particularly the effect on bone remodeling at site of hardware placement is not much documented. This manuscript aims to compare the performance of RPF and RPS in a cohort using a retrospective audit of case records.
Archival records were searched for patients who had undergone cranial metal-RPF or RPS or combination for the correction of craniofacial deformities following inclusion-exclusion criteria. From records, data of the quality and quantity of bone formed along the site of plate fixation as compared with the adjacent site, accommodating or facilitating brain growth, and persistence of bone deformity at the site of hardware placement were collected at the end of the follow-up period. A total of 128 sites from 18 individuals (6 with exclusive metal-RPF and 12 with RPS) mean age of 7.45 ± 7.28 (Median 4; IQR of 8.88;2.6-11.5) who underwent cranial bone remodeling surgery formed the study group.
There was a statistically significant difference between the RPF and PRS system at the fronto-orbital suture ( = 0.002) and coronal suture ( = 0.036) with bone quality and quantity.
The RPF system was rigid but had a set of issues, while RPS has advantages and limitations. The qualitative difference in between the two systems is different. Due to inherent dissimilarity, the two systems cannot be interchanged and due diligence has to be exercised while deciding on the system. More prospective studies are needed to validate the findings.
坚固内固定(RPF)和可吸收接骨板系统(RPS)推动了颅颌面区域重建领域的发展。然而,它们在患者中的表现,尤其是对硬件植入部位骨重塑的影响,相关记录并不多。本手稿旨在通过对病例记录的回顾性审核,比较RPF和RPS在一组患者中的表现。
根据纳入-排除标准,在档案记录中搜索接受颅骨金属RPF或RPS或联合治疗以矫正颅面畸形的患者。从记录中,在随访期结束时收集与相邻部位相比,沿接骨板固定部位形成的骨的质量和数量、适应或促进脑生长以及硬件植入部位骨畸形持续存在的数据。共有来自18名个体的128个部位(6名仅接受金属RPF,12名接受RPS)纳入研究组,这些个体平均年龄为7.45±7.28岁(中位数4岁;四分位距8.88;2.6 - 11.5),均接受了颅骨重塑手术。
RPF和PRS系统在额眶缝( = 0.002)和冠状缝( = 0.036)处的骨质量和数量存在统计学显著差异。
RPF系统坚固但存在一系列问题,而RPS有其优点和局限性。这两种系统之间的质量差异不同。由于内在差异,这两种系统不能互换,在选择系统时必须谨慎行事。需要更多前瞻性研究来验证这些发现。