Polley J W, Hung K F, Figueroa A, Lakars T, Heiberger H
Heckton Institute, Cook County Hospital, Chicago, IL USA.
J Craniofac Surg. 1998 May;9(3):249-53. doi: 10.1097/00001665-199805000-00014.
Rigid fixation techniques in pediatric craniofacial surgery have enhanced our clinical results by offering greater stabilization and control of bone grafts and osteotomized free segments of the craniofacial skeleton. A potential disadvantage of rigid fixation techniques in the growing craniofacial skeleton includes possible long-term growth restrictions, which have been demonstrated in various animal models. Our goal was to evaluate alternative fixation techniques in the growing craniofacial skeleton of the rabbit to study how altering fixation techniques affects craniofacial development. Eighty New Zealand White rabbits were used in this study. Rabbits were divided into eight groups of 10 each, and seven variant fixation techniques were used to stabilize the frontal bones after bifrontal craniectomies. In all groups except Group 1, the animals underwent a bifrontal craniectomy with orthotopic replacement of the frontal bones. Fixation for each group was as follows: Group 2, wire; Group 3, full microplate; Group 4, suture; Group 5, microplate removal at 4 weeks; Group 6, anterior plate; Group 7, posterior plate; Group 8, soft plate. It was demonstrated that long-term effects on craniofacial development in this animal model are significantly influenced by the type and location of rigid fixation hardware. Significant differences in growth of the craniofacial skeleton for the different fixation groups are presented and discussed.
小儿颅面外科手术中的坚固内固定技术通过为颅面骨骼的骨移植和截骨游离段提供更强的稳定性和控制，改善了我们的临床效果。在生长中的颅面骨骼中，坚固内固定技术的一个潜在缺点是可能存在长期生长限制，这已在各种动物模型中得到证实。我们的目标是评估在生长中的兔颅面骨骼中使用替代固定技术，以研究改变固定技术如何影响颅面发育。本研究使用了80只新西兰白兔。兔子被分成八组，每组10只，采用七种不同的固定技术在双侧额骨切除术后固定额骨。除第1组外，所有组的动物均接受双侧额骨切除术并原位置换额骨。每组的固定方式如下：第2组，钢丝；第3组，全微型钢板；第4组，缝线；第5组，4周时取出微型钢板；第6组，前板；第7组，后板；第8组，软板。结果表明，在该动物模型中，坚固内固定器械的类型和位置对颅面发育的长期影响有显著影响。文中展示并讨论了不同固定组颅面骨骼生长的显著差异。
