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Related Concept Videos

Flail Chest-I01:24

Flail Chest-I

Overview of Flail Chest
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
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The Thoracic Cage: Ribs01:20

The Thoracic Cage: Ribs

Ribs are curved, flattened bones forming the thoracic cavity wall with the thoracic muscles. There are 12 pairs of thoracic ribs. The posterior ends of all the ribs articulate with the T1–T12 thoracic vertebrae. In contrast,the anterior ends of most ribs attach to the sternum via their costal cartilages.
Parts of a Typical Rib
A typical rib has a head, neck, and body. The posterior end of the rib is called the head, followed by a narrow neck. The head articulates primarily with the costal facet...

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Unusual costochondral bone graft complication.

Nathalie Tabchouri1, Natacha Kadlub, Patrick A Diner

  • 1Service de Chirurgie Maxillo-faciale et Plastique Pédiatrique, APHP, Hôpital Necker Enfants Malades, Paris, France; Centre de Référence des Maladie Rares de la Face et de la Cavité Buccale, APHP, Hôpital Necker Enfants Malades, Paris, France.

International Journal of Oral and Maxillofacial Surgery
|August 27, 2013
PubMed
Summary

This report details a rare case of costochondral graft osteolysis and middle cranial fossa osteitis in hemifacial microsomia patients. It highlights an uncommon complication following ramus and condyle reconstruction.

Keywords:
Costochondral bone graftHemifacial microsomiaMiddle crania fossa perforationOtomandibular dysplasia

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Area of Science:

  • Craniofacial surgery
  • Pediatric plastic surgery
  • Orthognathic surgery

Background:

  • Hemifacial microsomia (HFM) involves underdeveloped facial structures, particularly the mandible.
  • Pruzansky type III HFM necessitates ramus and condyle reconstruction, often using costochondral grafts.
  • Standard complications include graft fracture and overgrowth, impacting functional and aesthetic outcomes.

Observation:

  • An extremely rare complication involving osteolysis of a costochondral graft was observed.
  • Concurrent osteitis of the adjacent middle cranial fossa was identified in the same patient.
  • This specific combination of complications has not been previously documented in medical literature.

Findings:

  • The case presents a unique instance of graft osteolysis and cranial bone infection post-reconstruction.
  • Analysis suggests potential contributing factors to this uncommon complication are explored.
  • This finding expands the known spectrum of complications associated with mandibular reconstruction in HFM.

Implications:

  • Understanding these rare complications is crucial for improving surgical techniques and patient management.
  • Highlights the need for vigilance regarding potential infections and graft resorption.
  • Informs future research into the etiology and prevention of severe graft-related complications in craniofacial surgery.