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Fixation of vascularized bone grafts
R Schmelzeisen1, B A Rahn, J Brennwald
1Clinic of Oral and Maxillofacial Surgery, Medical University of Hannover, Germany.
Summary
Miniplates are effective for bone grafting fixation in most patients. However, THORP plates may reduce complications in specific vascularized bone graft cases, particularly for extensive mandibular reconstructions.
Area of Science:
- Oral and Maxillofacial Surgery
- Biomaterials in Medicine
- Surgical Techniques
Background:
- Bone grafting is crucial for reconstructing mandibular defects.
- Miniplates have been the standard fixation method for bone grafts.
- Vascularized bone grafts offer advantages but require secure fixation.
Purpose of the Study:
- To evaluate the efficacy and complication rates of miniplate fixation for bone grafts.
- To compare miniplate fixation with THORP plates for vascularized bone grafts in animal models.
- To identify patient-specific factors influencing the choice of fixation system.
Main Methods:
- Retrospective analysis of 24 patients undergoing bone grafting with miniplates.
- Animal experiment comparing miniplate and THORP plate fixation for vascularized bone grafts in guinea pig mandibular defects.
Main Results:
- Miniplate fixation showed a low complication rate in clinical cases, with one instance of graft displacement.
- Animal experiments indicated fewer complications with THORP plates compared to miniplates for vascularized bone grafts.
- THORP plates demonstrated superior stability in the animal model for mandibular angle defects.
Conclusions:
- Miniplate fixation is generally suitable for bone grafting, serving as the method of choice in many scenarios.
- THORP plates may offer a more stable fixation alternative for vascularized bone grafts, especially in complex reconstructions or cases with high expected mobility.
- Patient-specific factors and the extent of mandibular reconstruction should guide the selection of fixation systems.