PDF(Pubmed)
Abstract：
BACKGROUND: The lack of resources limits the treatment of craniomaxillofacial fractures (CMF) in low-income countries (LIC). Therefore, Barton bandages and/or interdental wiring are considered in these regions. Fracture reduction is maintained by permanent occlusion for 6 weeks, which often leads to limited compliance and dissatisfying results. The aim of this cadaver-based study is to evaluate the feasibility of the use of an external face fixator (EFF) for the treatment of CMF, its biomechanical values and to define the optimal pin insertion points and angles.
METHODS: An AO hand fixator was used. CMF of types Le Fort 1-3 with split fractures of the hard palate were treated with EFF on 13 anatomical specimens. Fractures were created using a chisel, and pins were placed in specific anatomical regions. The maximal pull-out force [N] of pins was analysed by a tensile force gauge, and Fmax of the mandibular pins was evaluated. Computer tomography scans were performed on the healthy, fractured and EFF-treated skulls.
RESULTS: The pull-out forces for the single pins were mandibular pins (n = 15, median 488.0 N), supraorbital pins (n = 15, median 455.0 N), zygomatic pins (n = 14, median 269.1 N), medial hard palate pins (n = 12, median 208.4 N) and lateral hard palate pins (n = 8, median 49.6 N).
CONCLUSIONS: The results indicate that the operation technique is feasible, and the stability of the EFF is sufficient for maintaining the reduction. The required pins can safely be inserted into the described areas with good reduction results. Using EFF offers a feasible alternative to the non-surgical treatment of CMF in LIC.
METHODS: An AO hand fixator was used. CMF of types Le Fort 1-3 with split fractures of the hard palate were treated with EFF on 13 anatomical specimens. Fractures were created using a chisel, and pins were placed in specific anatomical regions. The maximal pull-out force [N] of pins was analysed by a tensile force gauge, and Fmax of the mandibular pins was evaluated. Computer tomography scans were performed on the healthy, fractured and EFF-treated skulls.
RESULTS: The pull-out forces for the single pins were mandibular pins (n = 15, median 488.0 N), supraorbital pins (n = 15, median 455.0 N), zygomatic pins (n = 14, median 269.1 N), medial hard palate pins (n = 12, median 208.4 N) and lateral hard palate pins (n = 8, median 49.6 N).
CONCLUSIONS: The results indicate that the operation technique is feasible, and the stability of the EFF is sufficient for maintaining the reduction. The required pins can safely be inserted into the described areas with good reduction results. Using EFF offers a feasible alternative to the non-surgical treatment of CMF in LIC.
摘要：
背景：在低收入国家（LIC），资源的缺乏限制了颅颌面骨折（CMF）的治疗。因此,在这些区域中考虑巴顿绷带和/或齿间布线。骨折复位通过永久闭塞维持6周，这往往导致依从性有限和不满意的结果。这项基于尸体的研究的目的是评估使用外部面部固定器（EFF）治疗CMF的可行性，其生物力学值，并定义最佳的针插入点和角度。
方法：使用AO手固定器。在13个解剖标本上，用EFF治疗了LeFort1-3型硬腭骨折的CMF。骨折是用凿子制造的,和销被放置在特定的解剖区域。通过拉力计分析了销钉的最大拔出力[N]。并评估了下颌钉的Fmax。对健康的人进行计算机断层扫描，骨折和EFF处理的头骨。
结果：单销的拔出力为下颌销（n=15，中位数488.0N），眶上钉（n=15，中位数455.0N），the针（n=14，中位数269.1N），内侧硬腭针（n=12，中位数208.4N）和外侧硬腭针（n=8，中位数49.6N）。
结论：结果表明该手术技术是可行的，并且EFF的稳定性足以维持还原。所需的销可以安全地插入到所描述的区域中,具有良好的减小结果。使用EFF为LIC中CMF的非手术治疗提供了可行的替代方案。
方法：使用AO手固定器。在13个解剖标本上，用EFF治疗了LeFort1-3型硬腭骨折的CMF。骨折是用凿子制造的,和销被放置在特定的解剖区域。通过拉力计分析了销钉的最大拔出力[N]。并评估了下颌钉的Fmax。对健康的人进行计算机断层扫描，骨折和EFF处理的头骨。
结果：单销的拔出力为下颌销（n=15，中位数488.0N），眶上钉（n=15，中位数455.0N），the针（n=14，中位数269.1N），内侧硬腭针（n=12，中位数208.4N）和外侧硬腭针（n=8，中位数49.6N）。
结论：结果表明该手术技术是可行的，并且EFF的稳定性足以维持还原。所需的销可以安全地插入到所描述的区域中,具有良好的减小结果。使用EFF为LIC中CMF的非手术治疗提供了可行的替代方案。
