[How to make your own custom cutting guides for both mandibular and fibular stair step osteotomies?] / Ostéotomies fibulaires et mandibulaires en marche d'escalier. Comment réaliser ses propres guides de coupe pour les reconstructions maxillofaciales ?
Ann Chir Plast Esthet
; 62(6): 652-658, 2017 Dec.
Article
em Fr
| MEDLINE
| ID: mdl-28456427
ABSTRACT
INTRODUCTION:
Using tailored cutting guides for osteocutaneous free fibula flap in complex mandibular reconstruction after cancer resection surgery constitutes a substantial improvement. Autonomously conceiving and manufacturing the cutting guides within a plastic surgery department with computer-aided design (CAD) and three-dimensional (3D) printing allows planning more complex osteotomies, such as stair-step osteotomies, in order to achieve more stable internal fixations.METHODS:
For the past three years, we have been producing by ourselves patient-tailored cutting guides using CAD and 3D printing. Osteotomies were virtually planned, making the cutting lines more complex in order to optimize the internal fixation stability. We also printed reconstructed mandible templates and shaped the reconstruction plates on them. We recorded data including manufacturing techniques and surgical outcomes.RESULTS:
Eleven consecutive patients were operated on for an oral cavity cancer. For each patient, we planned the fibular and mandibular stair-step osteotomies and we produced tailored cutting guides. In all patients, we achieved to get immediately stable internal fixations and in 10 patients, a complete bone consolidation after 6 months.CONCLUSION:
Autonomously manufacturing surgical cutting guides for mandibular reconstruction by free fibula flap is a significant improvement, regarding ergonomics and precision. Planning stair-step osteotomies to perform complementary internal fixation increases contact surface and congruence between the bone segments, thus improving the reconstructed mandible stability.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Osteotomia
/
Carcinoma
/
Neoplasias Mandibulares
/
Retalhos de Tecido Biológico
/
Fíbula
/
Reconstrução Mandibular
Tipo de estudo:
Observational_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
Fr
Ano de publicação:
2017
Tipo de documento:
Article