Replica-guided trauma surgery

The aim of this study is to present a new approach to the surgical treatment of fractures of the middle third of the face, based on the use of resorbable materials and stereolithographic models. From 2009 to 2014, we treated 10 cases of orbitozygomatic trauma mostly as secondary surgery. For each case, an anatomical replica had been produced simulating the expected result and was then used to contour the resorbable plates on its surface, even before the beginning of the surgical procedure itself. The plates and meshes already bended act as a guide to bony reduction procedure. No complications occurred: all patients healed well, without inflammatory reactions. The results obtained corresponded to the expected results. This technique has been employed for primary or secondary treatment of fracturesof the middle third facial, where it is not always easy to understand the displacement of bony segments and where the use of resorbables plates could be particularly beneficial, as they do not interfere with the maxillofacial skeleton physiology and avoid the necessity to remove plates and screws. Combined use of stereolithographic model and resorbable materials allow a new surgical approach based on the realization of the surgical procedure on the model, then transferred from the patient to the model, thanks to plates and meshes. This technique helps to overcome many of the limits of the conventional technique: the need of minimal surgical access, in order to minimize facial scarring and the vasculo-nervous structures that cross the head and neck district and the obligation to restore not only the morphology but also the biological functions.