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Outcome of early rigid fixation and removal of rigid external distraction system after distraction osteogenesis of the midface

Authors
 In Sik Yun  ;  Be-Young Yun Park 
Citation
 JOURNAL OF CRANIOFACIAL SURGERY, Vol.22(2) : 576-580, 2011 
Journal Title
JOURNAL OF CRANIOFACIAL SURGERY
ISSN
 1049-2275 
Issue Date
2011
MeSH
Adolescent ; Bone Plates ; Child ; Cleft Lip/surgery* ; Cleft Palate/surgery* ; Craniofacial Dysostosis/surgery* ; Female ; Humans ; Male ; Osteogenesis,Distraction/instrumentation ; Osteogenesis,Distraction/methods* ; Osteotomy, Le Fort/methods* ; Recurrence ; TreatmentOutcome ; Young Adult
Keywords
Distraction osteogenesis ; rigid external distraction ; early rigid fixation ; midface distraction ; orthognathic surgery
Abstract
After distraction osteogenesis of the midface using a rigid external distraction (RED) system, there is a high possibility that a relapse might occur due to an incomplete fixation during the consolidation period, and it is uncomfortable for the patients to wear a head frame for 2 to 3 months. There are also risks of trauma that are developing. To overcome these problems, we suggest the protocol of early rigid fixation, with excellent treatment outcomes and a review of literatures. Of 9 patients, Le Fort III osteotomy was completed in 2 patients with Crouzon disease, and a Le Fort I osteotomy was completed in 7 patients with a cleft lip and palate. Immediately after the distraction with RED was completed, the fixation was done using a miniplate. This was followed by the early removal of the RED system. In patients who underwent the current procedure, an analysis was performed for the degree and the duration of distraction and the period of use of the RED system. Then, the presence of relapse was examined. The mean degree of bone distraction was found to be 18.05 mm (range, 9-31.5 mm). The mean period of wearing RED system was 29.78 days (range, 21-43 days). Thereafter, the mean follow-up period was 13 months (range, 6 months to 3 years). The degree of accumulated relapse was found to be 1.7 mm (10%) on postoperative year 1, 2.4 mm (13.3%) on postoperative year 2, and 2.3 mm (14.6%) on postoperative year 3. With the concept of early rigid fixation, we were able to eliminate the disadvantages of distraction osteogenesis such as the long period of wearing a head frame, the delay of returning to society, and the inconvenience of patients. Moreover, early rigid fixation could decrease the need of overcorrection and the amount of relapses.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00001665-201103000-00045&LSLINK=80&D=ovft
DOI
10.1097/SCS.0b013e318207f26e
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Plastic and Reconstructive Surgery (성형외과학교실) > 1. Journal Papers
Yonsei Authors
Park, Beyoung Yun(박병윤)
Yun, In Sik(윤인식) ORCID logo https://orcid.org/0000-0003-1103-7047
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/94098
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