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Spectrum of primary bone grafting in cranio maxillofacial trauma at a tertiary care centre in India.

Singh AK, Mohapatra DP, Kumar V - Indian J Plast Surg (2011)

Bottom Line: In past several years, traumas following road traffic accidents and other causes have increased, owing to an increase in mechanization and pace of life.Patients with a history of acute trauma resulting in facial skeletal injuries with or without bone loss were included in the study.Olecranon, Iliac crest, ribs, Vascularized as well as nonvascularized outer table calvarial grafts and nonvascularized inner table calvarial grafts were used in this study.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic and reconstructive surgery, Chattrapati Shahuji Maharaj Medical University, Lucknow , Uttar Pradesh, India.

ABSTRACT

Background: In past several years, traumas following road traffic accidents and other causes have increased, owing to an increase in mechanization and pace of life. These patients frequently have complicated injuries involving soft tissue and the craniofacial skeleton. Assessment of bony injuries and loss of portions of facial skeleton and their management has proved to be a challenge to the reconstructive surgeon.

Aims: Primary bone grafting of craniofacial skeletal injuries provides an opportunity for one stage correction of bony defects. The varied spectrum of primary bone grafts for management of craniomaxillofacial injuries are evaluated in this study.

Materials and methods: Patients with a history of acute trauma resulting in facial skeletal injuries with or without bone loss were included in the study. Primary bone grafting was undertaken in situations requiring contour correction, replacement of skeletal losses and for rigid fixation of fracture segments. Olecranon, Iliac crest, ribs, Vascularized as well as nonvascularized outer table calvarial grafts and nonvascularized inner table calvarial grafts were used in this study.

Results: Sixty two patients of craniomaxillofacial injury following trauma requiring primary bone grafting were considered in this study. Fifty seven percent of patients (n=32) required primary bone grafting for replacement of bone loss while bone grafting for contour correction was done in twenty three patients. The parietal calvaria overlying the non-dominant hemisphere was used as a source of bone graft in forty-nine patients. Nearly ninety-two percent of the patients were satisfied with the results of primary bone grafting.

Conclusions: Functional and aesthetic assessment of each of these patients, managed with primary bone grafting revealed a low rate of disabilities and high percentage of satisfaction in this study.

No MeSH data available.


Related in: MedlinePlus

A parietotemporal skeletal defect in an eight-year-old female child resurfaced with split rib grafts
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Figure 9: A parietotemporal skeletal defect in an eight-year-old female child resurfaced with split rib grafts

Mentions: Defects over the frontal region following comminuted fractures or bone loss in compounding injuries were replaced with calvarial outer table grafts [Figure 8]. Smaller parietotemporal defects were resurfaced with calvarial outer table non-vascularised grafts. In two patients, larger defects were replaced with split rib grafts [Figure 9]. In twelve patients, blowout fractures of the orbit were resurfaced with calvarial outer table non-vascularised grafts. The outer table of the ilium was used as a plate to resurface the orbital floor defect in one patient. Six calvarial outer table grafts were used to resurface contour defects of the zygoma, following impacted zygomatic fractures in patients presenting late. Of these, two were vascularised grafts based on the superficial temporal artery. Olecranon grafts were used in fractures involving the nasal dorsum. The outer table of the parietal calvaria was used for improving the dorsal nasal contour in two patients and for replacement of bone loss over the maxillary anterior wall in one. Mandible body and parasymphseal fractures were fixed with contoured bone plates designed from the calvarial outer table and screws. Five calvarial outer table non-vascularised grafts were used for this purpose.


Spectrum of primary bone grafting in cranio maxillofacial trauma at a tertiary care centre in India.

Singh AK, Mohapatra DP, Kumar V - Indian J Plast Surg (2011)

A parietotemporal skeletal defect in an eight-year-old female child resurfaced with split rib grafts
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3111118&req=5

Figure 9: A parietotemporal skeletal defect in an eight-year-old female child resurfaced with split rib grafts
Mentions: Defects over the frontal region following comminuted fractures or bone loss in compounding injuries were replaced with calvarial outer table grafts [Figure 8]. Smaller parietotemporal defects were resurfaced with calvarial outer table non-vascularised grafts. In two patients, larger defects were replaced with split rib grafts [Figure 9]. In twelve patients, blowout fractures of the orbit were resurfaced with calvarial outer table non-vascularised grafts. The outer table of the ilium was used as a plate to resurface the orbital floor defect in one patient. Six calvarial outer table grafts were used to resurface contour defects of the zygoma, following impacted zygomatic fractures in patients presenting late. Of these, two were vascularised grafts based on the superficial temporal artery. Olecranon grafts were used in fractures involving the nasal dorsum. The outer table of the parietal calvaria was used for improving the dorsal nasal contour in two patients and for replacement of bone loss over the maxillary anterior wall in one. Mandible body and parasymphseal fractures were fixed with contoured bone plates designed from the calvarial outer table and screws. Five calvarial outer table non-vascularised grafts were used for this purpose.

Bottom Line: In past several years, traumas following road traffic accidents and other causes have increased, owing to an increase in mechanization and pace of life.Patients with a history of acute trauma resulting in facial skeletal injuries with or without bone loss were included in the study.Olecranon, Iliac crest, ribs, Vascularized as well as nonvascularized outer table calvarial grafts and nonvascularized inner table calvarial grafts were used in this study.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic and reconstructive surgery, Chattrapati Shahuji Maharaj Medical University, Lucknow , Uttar Pradesh, India.

ABSTRACT

Background: In past several years, traumas following road traffic accidents and other causes have increased, owing to an increase in mechanization and pace of life. These patients frequently have complicated injuries involving soft tissue and the craniofacial skeleton. Assessment of bony injuries and loss of portions of facial skeleton and their management has proved to be a challenge to the reconstructive surgeon.

Aims: Primary bone grafting of craniofacial skeletal injuries provides an opportunity for one stage correction of bony defects. The varied spectrum of primary bone grafts for management of craniomaxillofacial injuries are evaluated in this study.

Materials and methods: Patients with a history of acute trauma resulting in facial skeletal injuries with or without bone loss were included in the study. Primary bone grafting was undertaken in situations requiring contour correction, replacement of skeletal losses and for rigid fixation of fracture segments. Olecranon, Iliac crest, ribs, Vascularized as well as nonvascularized outer table calvarial grafts and nonvascularized inner table calvarial grafts were used in this study.

Results: Sixty two patients of craniomaxillofacial injury following trauma requiring primary bone grafting were considered in this study. Fifty seven percent of patients (n=32) required primary bone grafting for replacement of bone loss while bone grafting for contour correction was done in twenty three patients. The parietal calvaria overlying the non-dominant hemisphere was used as a source of bone graft in forty-nine patients. Nearly ninety-two percent of the patients were satisfied with the results of primary bone grafting.

Conclusions: Functional and aesthetic assessment of each of these patients, managed with primary bone grafting revealed a low rate of disabilities and high percentage of satisfaction in this study.

No MeSH data available.


Related in: MedlinePlus