Agrawal K, Subbarao K S, Nachiappan M, Arumugam A
Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.
Plast Reconstr Surg. 1998 Sep;102(3):839-42. doi: 10.1097/00006534-199809030-00035.
The reconstruction of large skeletal defects of the chest wall is considered complex and difficult. A simple technique for this repair, using polymethylmethacrylate ribs that are prefabricated in a prosthodontic laboratory using heat cure polymer, is presented. These ribs are used as bone substitutes while reconstructing the chest wall defect. The prefabricated polymethylmethacrylate ribs have been used to reconstruct the large chest wall defects after resection of chest wall tumors in three patients. There was risk of severe paradoxical movement of the chest wall without the skeletal defect reconstruction. In all of the cases, there was no need for postoperative mechanical ventilation and there was no paradoxical movement. Cosmetically, it was highly satisfactory. In one patient, the stainless steel wire caused a sinus after 1 year of reconstruction, requiring removal of the wire and the rib, but it did not compromise the stability of the chest wall. We conclude that reconstruction of large chest wall defects with prefabricated polymethylmethacrylate ribs is simple, cost-effective, and easy to plan and execute.
胸壁大的骨骼缺损重建被认为是复杂且困难的。本文介绍一种简单的修复技术，即使用在口腔修复实验室用热固化聚合物预制的聚甲基丙烯酸甲酯肋骨。这些肋骨在重建胸壁缺损时用作骨替代物。预制的聚甲基丙烯酸甲酯肋骨已用于3例胸壁肿瘤切除术后大胸壁缺损的重建。若无骨骼缺损重建，存在胸壁严重反常运动的风险。在所有病例中，术后均无需机械通气，也无反常运动。在外观方面，效果非常令人满意。1例患者在重建1年后不锈钢丝导致窦道形成，需要取出钢丝和肋骨，但这并未影响胸壁的稳定性。我们得出结论，用预制的聚甲基丙烯酸甲酯肋骨重建大胸壁缺损简单、经济有效，且易于规划和实施。
