Canady J W, Wayne I, Fellows D R, Zimmerman M B, Laurenzo J F, Thompson S A
Department of Surgery, University of Iowa, Iowa City, USA.
Plast Reconstr Surg. 1996 Sep;98(3):410-7; discussion 418-9. doi: 10.1097/00006534-199609000-00004.
Treatment of craniofacial dysostosis involves complex remodeling of the cranium and facial bones. Maintenance of the newly positioned segments may be achieved by rigid fixation using plates; however, there is concern that, over time, these plates may interfere with normal growth. The purpose of this study was to test a method of "semi-rigid" fixation of an osteotomy of the frontonasal suture in juvenile rabbits by comparing standardized parameters of craniofacial growth after conventional suture plating with the experimental plating method and with growth after sham operation. Forty-five, 6-week-old, weanling rabbits were divided into three groups of 15 each (12 for cephalometry, 3 for histological examination): (group 1) control, sham operated; (group 2) rigid fixation; (group 3) semi-rigid fixation. Rabbits were maintained for 14 weeks. Craniofacial growth was assessed using three-dimensional image analysis techniques. Measurements were subjected to statistical analysis (one-way analysis of variance) to compare the three treatment groups. Pairwise comparison of means between the treatment groups was done using Bonferroni's method at the 0.05 significance level. Semi-rigid fixation permitted significantly more normal growth of the developing rabbit head than rigid fixation in total snout length, total vault length, left and right midface height, and left orbital length. Both semi-rigid and rigid fixation significantly restricted growth compared with sham operated animals in left and right posterior midface height, right orbital length, right and left nasal bone length, and left parietal width. There were no significant differences in the growth of all other parameters measured.
颅面骨发育不全的治疗涉及颅骨和面部骨骼的复杂重塑。使用钢板进行坚固固定可维持新复位节段的位置；然而，人们担心随着时间推移，这些钢板可能会干扰正常生长。本研究的目的是通过比较传统缝线钢板固定、实验性钢板固定后的颅面生长标准化参数以及假手术后的生长情况，来测试一种用于幼年兔额鼻缝截骨术的“半坚固”固定方法。45只6周龄的断奶幼兔被分为三组，每组15只（12只用于头影测量，3只用于组织学检查）：（第1组）对照组，假手术；（第2组）坚固固定；（第3组）半坚固固定。兔子饲养14周。使用三维图像分析技术评估颅面生长情况。对测量结果进行统计分析（单因素方差分析）以比较三个治疗组。治疗组之间的均值两两比较采用Bonferroni法，显著性水平为0.05。与坚固固定相比，半坚固固定使发育中的兔头在总鼻长、总颅顶长度、左右中面部高度和左眶长度方面的生长明显更接近正常。与假手术动物相比，半坚固固定和坚固固定在左右后中面部高度、右眶长度、左右鼻骨长度和左顶骨宽度方面均显著限制了生长。所测量的所有其他参数的生长没有显著差异。
