Obimakinde Obitade Sunday, Popoola Sunday Ogunsuyi, Ojo Kehinde Olubukola, Yusuf Moruf Babatunde, Omotayo John Adetunji, Akinbade Akinwale Olaleye
Oral and Maxillofacial Surgery Department, College of Medicine, Ekiti State University/ Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria.
Orthopaedic and Trauma Surgery, Department of Surgery, College of Medicine, Ekiti State University/ Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria.
Niger Med J. 2025 Apr 3;66(1):91-98. doi: 10.71480/nmj.v66i1.581. eCollection 2025 Jan-Feb.
Reconstruction of the mandible following tumor resection or trauma can be challenging due to associated functional and esthetic problems. Various options have been described in the literature, but non-vascularized bone graft remain a viable option in middle- and low-income countries, Nigeria inclusive. We hereby report our experience with the use of non-vascularized bone graft with mandibular reconstruction plates in a double bridging technique for mandibular reconstruction in our institution.
Patients who had mandibular defect reconstruction with non-vascularized bone graft between January 2012 and December 2021 were included in this study. Grafts were harvested from either the rib or contralateral iliac crest and secured with mandibular reconstruction plate and screws in a double bridging technique. Patients were followed for a minimum of 12 months and outcomes such as the level of patients' satisfaction with appearance, graft take, bony continuity and complications were assessed and analyzed.
Twenty eight patients comprising 18 males and 10 females [M:F 1.8:1] had mandibular defect reconstruction with double bridging technique during the study period. Donor site distribution revealed that 64.3% [n=18] had their grafts harvested from the iliac crest while the remaining 10 [35.7%] were taken from the rib. Ameloblastoma [75%, n=21] was the commonest lesion necessitating resection of the mandible amongst the subjects. The follow up result showed that appearance was satisfactory in 25 patients [89%], graft take/ restoration of bony continuity in 27 patients [96%], graft infection occurred in 2 patients [7.1%] while only one case of graft failure was established [3.6%].
A combination of non-vascularized bone graft with reconstruction plate in a bridging technique is a viable option for mandibular reconstruction in a resource-limited setting.
由于相关的功能和美学问题，肿瘤切除或创伤后下颌骨的重建具有挑战性。文献中描述了各种选择，但在包括尼日利亚在内的中低收入国家，非血管化骨移植仍然是一种可行的选择。我们在此报告我们在本机构使用非血管化骨移植联合下颌骨重建钢板采用双桥技术进行下颌骨重建的经验。
纳入2012年1月至2021年12月期间采用非血管化骨移植进行下颌骨缺损重建的患者。骨移植取自肋骨或对侧髂嵴，采用双桥技术用下颌骨重建钢板和螺钉固定。对患者进行至少12个月的随访，评估和分析患者对外观的满意度、移植骨存活、骨连续性和并发症等结果。
在研究期间，28例患者（18例男性和10例女性[男:女1.8:1]）采用双桥技术进行了下颌骨缺损重建。供区分布显示，64.3%（n = 18）的患者骨移植取自髂嵴，其余10例（35.7%）取自肋骨。成釉细胞瘤（75%，n = 21）是受试者中最常见的需要切除下颌骨的病变。随访结果显示，25例患者（89%）外观满意，27例患者（96%）移植骨存活/恢复骨连续性，2例患者（7.1%）发生移植骨感染，仅1例（3.6%）移植骨失败。
在资源有限的情况下，非血管化骨移植联合重建钢板的桥接技术是下颌骨重建的一种可行选择。
