Breakage of internal maxillary distractor: considerable complication of maxillary distraction osteogenesis
Breakage of internal maxillary distractor: considerable complication of maxillary distraction osteogenesis
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DOI：
10.1016/j.tripleo.2008.03.035
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发表时间：
2008-07-01
期刊：
影响因子：
--
通讯作者：
Takigawa, Yoko
中科院分区：
文献类型：
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作者：
Aikawa, Tomonao;Iida, Seiji;Takigawa, Yoko
使用口内牵引器进行上颌牵引成骨现在是上颌后缩的标准治疗方法之一。本报告展示了唇腭裂患者内上颌牵引器断裂的 2 例；一个是在分散注意力期间观察到的，另一个是在保留期间观察到的。第一种情况需要牵引节段的旋转运动，这种运动导致牵引器后部横向脱位，牵引器在张口时受到一些机械力。在后一种情况下，在牵引后3个月拍摄的X光片上观察到牵引器断裂，这种并发症可能是由咬合和咀嚼的机械力引起的。两次破损均发生在锚定板和延长杆的连接处，该连接处具有一定的灵活性，可以将锚定板调整到骨表面。因此，外科医生不仅在推进期间，而且在保留期间都应特别注意该牵引器的机械薄弱区域，并应避免不必要的频繁弯曲以采用骨表面，这直接削弱了关节。
Maxillary distraction osteogenesis using intraoral distractors is now one of the standard treatments of maxillary retrusion. This report shows 2 cases of breakage of this internal maxillary distractor in patients with cleft lip and palate; one was observed during the distraction period and the other was during the retention period. The first case required a rotational movement of the distraction segment, and this movement caused the laterally dislocation of the posterior part of the distractor, where the distractor suffered some mechanical forces by mouth opening. In the latter case, breakage of distractor was observed on the radiographs taken 3 months after distraction and this complication may have been caused by mechanical force by occlusion and mastication. Both breakages were found at the joint of the anchorage plate and the extension rod, which has some flexibility for adjusting the plate to the bone surface. Therefore, surgeons should pay special attention for this mechanical weak area in this distractor not only during the advancement period, but also during the retention period and should avoid unnecessary frequent bending for adopting the bone surface, which directly weakens the joint.