Kreshanti Prasetyanugraheni, Kekalih Aria, Rahyussalim Ahmad Jabir, Supriadi Sugeng, Priosoeryanto Bambang Pontjo, Noviana Deni, Oley Mendy Hatibie, Sukasah Chaula Luthfia
Doctoral Program in Medical Sciences, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
Division of Plastic Reconstructive and Aesthetic Surgery, Department of Surgery, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
Arch Craniofac Surg. 2024 Aug;25(4):171-178. doi: 10.7181/acfs.2024.00290. Epub 2024 Aug 20.
We developed a novel interlocking three-dimensional (3D) miniplate design with an adjustable configuration. As this device is new, surgeons must become familiar with its application. This study evaluated the usability and learning curves associated with the novel interlocking 3D miniplate for mandibular fracture fixation.
The study participants, nine plastic surgeons, were asked to apply an interlocking 3D miniplate and a standard miniplate to polyurethane mandible models. The participants had completed the Basic Craniomaxillofacial Osteosynthesis course during residency and had operated on craniomaxillofacial fractures within the past 5 years. They were instructed to place the interlocking 3D miniplate three times and the standard miniplate once. We assessed the time required for implant placement, the comfort level of the surgeons, and the biomechanical stability of the plates. Biomechanical testing was conducted by subjecting the mandible to forces ranging from 10 to 90 N and the displacement was measured.
The results indicate increasing comfort with each attempt at placing the interlocking 3D miniplate, with a significant difference between the first and third attempts. Additionally, a reduction in application time was noted with repeated attempts, suggesting improved efficiency. Biomechanical tests showed comparable stability between the tested plates.
Multiple attempts at applying the interlocking 3D miniplate resulted in increased comfort and reduced application time. These findings indicate that, despite its novelty, the interlocking 3D miniplate is relatively straightforward to apply and has a short learning curve. However, surgeons must have specific qualifications to ensure proper training and minimize errors during placement.
我们开发了一种具有可调节结构的新型三维(3D)锁定微型钢板设计。由于该装置是新的,外科医生必须熟悉其应用。本研究评估了与用于下颌骨骨折固定的新型3D锁定微型钢板相关的可用性和学习曲线。
研究参与者为9名整形外科医生,要求他们将3D锁定微型钢板和标准微型钢板应用于聚氨酯下颌骨模型。参与者在住院期间完成了颅颌面骨固定基础课程,并在过去5年内对颅颌面骨折进行过手术。他们被要求放置3D锁定微型钢板3次,标准微型钢板1次。我们评估了植入物放置所需的时间、外科医生的舒适度以及钢板的生物力学稳定性。通过对下颌骨施加10至90 N的力并测量位移来进行生物力学测试。
结果表明,每次尝试放置3D锁定微型钢板时舒适度都在增加,第一次和第三次尝试之间存在显著差异。此外,随着重复尝试,应用时间有所减少,表明效率有所提高。生物力学测试显示测试钢板之间具有可比的稳定性。
多次尝试应用3D锁定微型钢板可提高舒适度并减少应用时间。这些发现表明,尽管3D锁定微型钢板新颖,但应用相对简单,学习曲线较短。然而,外科医生必须具备特定资质,以确保进行适当培训并在放置过程中尽量减少错误。