RESUMEN
Surgical treatment of calvarial defects and deformities has some drawbacks such as donor site morbidity or use of allogenic materials. In this experimental study, we presented a three-dimensional reconstruction of cranial defects by using trifocal biplanar distraction-compression osteosynthesis (TBDCO).Eight sheep with a mean age of 2 years were divided into 2 groups as the control (n = 3) and distraction groups (n = 5). All the animals were operated on under general anesthesia, and 80 x 50-mm full-thickness calvarial defects were created. In the control group, no treatment was performed. In the distraction group, TBDCO was performed with a custom-made distraction device with 2 transport segments. After 5 days of latency period, the anterior transport segment was distracted to a posterior and superior direction (0.7 and 0.3 mm, respectively) and the posterior transport segment was distracted obliquely to an anterior and superior direction (0.7 and 0.3 mm, respectively) with a resulting total vectorial movement of 0.75 mm/d. Active distraction was approximately 29 days, and the consolidation period was 60 days.No major complications were seen during the whole procedure. In the control group, the bone defects remained unhealed. In the distraction group, defects healed and the reconstructed calvarium was dome shaped. Preoperative and postoperative cranial volume measurements of the distraction group animals revealed an increase in cranial volume (P < 0.05). Histologic evaluation showed inductive bone regeneration and mature bone structure development within the distraction zone. Trifocal biplanar distraction-compression osteosynthesis is an effective and safe technique for three-dimensional closure of the cranial defects. In clinical practice, it could provide several advantages over currently available reconstructive procedures.
Asunto(s)
Enfermedades Óseas/cirugía , Craneotomía/métodos , Osteogénesis por Distracción/métodos , Hueso Parietal/cirugía , Procedimientos de Cirugía Plástica/métodos , Anatomía Transversal , Animales , Desarrollo Óseo/fisiología , Clavos Ortopédicos , Placas Óseas , Regeneración Ósea/fisiología , Calcificación Fisiológica/fisiología , Cefalometría/métodos , Diseño de Equipo , Fijadores Externos , Estudios de Factibilidad , Femenino , Procesamiento de Imagen Asistido por Computador , Imagenología Tridimensional/métodos , Osteogénesis por Distracción/instrumentación , Hueso Parietal/patología , Procedimientos de Cirugía Plástica/instrumentación , Ovinos , Tomografía Computarizada por Rayos X , Cicatrización de Heridas/fisiologíaRESUMEN
Soft-tissue defects of the pretibial region constitute a major reconstructive challenge because of the insufficiency of the local tissues. In such cases, a long cross-leg flap may be an alternative option. This study presents a case with an atonic wound in the pretibial region caused by a previous traffic accident, which had received cross-leg flap repair following the excision.