TY - JOUR
T1 - Off-Label Use of an External Hand Fixator for Craniomaxillofacial Fractures-An Anatomical Feasibility Study
AU - Wichlas, Florian
AU - Necchi, Marco
AU - Gruber, Teresa
AU - Hofmann, Valeska
AU - Deininger, Susanne
AU - Deininger, Sebastian Hubertus Markus
AU - Deluca, Amelie
AU - Steidle-Kloc, Eva
AU - Pruszak, Jan
AU - Wittig, Jörn
AU - Deininger, Christian
N1 - Wichlas, Gruber, Deininger: Department of Orthopedics and Traumatology, University Hospital Salzburg, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria. Deininger: Department of Urology and Andrology, University Hospital Salzburg, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria. Deluca, Deininger: Institute of Tendon and Bone Regeneration, Paracelsus Medical University, 5020 Salzburg, Austria.
Steidle-Kloc, Pruszak: Institute of Anatomy and Cell Biology|Salzburg, Paracelsus Medical University, 5020 Salzburg, Austria
PY - 2024/3/15
Y1 - 2024/3/15
N2 - 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.MATERIALS AND 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.
AB - 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.MATERIALS AND 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.
U2 - 10.3390/bioengineering11030279
DO - 10.3390/bioengineering11030279
M3 - Original Article
C2 - 38534553
SN - 2306-5354
VL - 11
JO - BIOENGINEERING-BASEL
JF - BIOENGINEERING-BASEL
IS - 3
M1 - 279
ER -