Int J Comput Assist Radiol Surg - Mandible reconstruction using patient-specific pre-bent reconstruction plates: comparison of standard and transfer key methods.

Tópicos

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Resumo

RPOSE: Mandible reconstruction with reconstruction plates requires bending the plates during the operation and fixation using the "standard method" (ST-method). The ST-method is limited when a pathological process has perforated the mandibular outer cortex. A transfer key method (TK-method) was developed where plates are pre-bent using a patient-specific mandible model and positioned on the mandible with the help of transfer keys. The ST-method and TK-method were compared in a clinical trial.METHODS: Mandibular reconstruction was performed on 42 patients in this study: 22 were performed using the TK-method and 20 using the ST-method. Pre- and postoperative CT scans were evaluated by measuring the distances between six corresponding landmarks on the mandibular condyles and rami. The difference between pre- and postoperative distances was used to evaluate reconstruction accuracy.RESULTS: The median deviation of the unsigned/ absolute values of all six distances was 1.07 mm for the TK-method and 1.67 mm for the ST-method. The TK-method showed significantly better results. For the signed values, the median deviation of the six distances was -0.6 mm for the TK-method and -1.47 mm for the ST-method, indicating that the mandibles became narrower with both methods. This width difference was not statistically significant.CONCLUSION: The TK-method was more accurate than the ST-method in a clinical trial. The TK-method was effective and accurate for mandible reconstruction using pre-bent fixation plates.

Resumo Limpo

rpose mandibl reconstruct reconstruct plate requir bend plate oper fixat use standard method stmethod stmethod limit patholog process perfor mandibular outer cortex transfer key method tkmethod develop plate prebent use patientspecif mandibl model posit mandibl help transfer key stmethod tkmethod compar clinic trialmethod mandibular reconstruct perform patient studi perform use tkmethod use stmethod pre postop ct scan evalu measur distanc six correspond landmark mandibular condyl rami differ pre postop distanc use evalu reconstruct accuracyresult median deviat unsign absolut valu six distanc mm tkmethod mm stmethod tkmethod show signific better result sign valu median deviat six distanc mm tkmethod mm stmethod indic mandibl becam narrow method width differ statist significantconclus tkmethod accur stmethod clinic trial tkmethod effect accur mandibl reconstruct use prebent fixat plate

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