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Rigid External Distractors in Midface Fractures: A Review of Relevant and Related Literature

Introduction: Literature discussing the use of rigid external distraction devices in midfacial trauma is limited. Rigid external distraction devices have been described for use in craniofacial surgery, allowing for distraction and stabilization of bony segments. In complex facial trauma, bony fragme...

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Autores principales: Gala, Zachary, Halsey, Jordan, Kogan, Samuel, Hoppe, Ian, Ciminello, Frank S., Granick, Mark S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Open Science Company, LLC 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7656155/
https://www.ncbi.nlm.nih.gov/pubmed/33214802
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author Gala, Zachary
Halsey, Jordan
Kogan, Samuel
Hoppe, Ian
Ciminello, Frank S.
Granick, Mark S.
author_facet Gala, Zachary
Halsey, Jordan
Kogan, Samuel
Hoppe, Ian
Ciminello, Frank S.
Granick, Mark S.
author_sort Gala, Zachary
collection PubMed
description Introduction: Literature discussing the use of rigid external distraction devices in midfacial trauma is limited. Rigid external distraction devices have been described for use in craniofacial surgery, allowing for distraction and stabilization of bony segments. In complex facial trauma, bony fragments are often comminuted and unstable, making traditional approaches with internal fixation difficult. Moreover, these approaches require subperiosteal dissection, limiting blood supply that is important for bone healing. Objective: The goal of this study was to evaluate the role of rigid external distraction devices for the treatment of complex facial trauma. Methods: We performed a literature review of rigid external distraction devices, as relevant both for facial trauma and for other craniofacial indications, to better elucidate their use and efficacy in complex facial fractures. Results: The review revealed only 2 articles explicitly describing rigid external distraction devices for facial trauma, while 6 other articles describing its use for other craniofacial cases. An important benefit associated with the use of rigid external distraction devices is their ability to provide controlled traction of bony segments while also allowing for movement as needed for fracture reduction. Various articles describe performing internal fixation following rigid external distraction device usage, while others emphasize that internal fixation is not necessarily indicated if the rigid external distraction device is left intact long enough to ensure bony healing. One potential setback described is unfamiliarity with using the rigid external distraction device, which can preclude its use by many surgeons. In addition, the literature review did not provide any uniform guidelines or recommendations about how long rigid external distraction devices should remain intact. Conclusion: Based on relevant literature, rigid external distraction devices have been shown to be useful in the stabilization and treatment of complex facial fractures. Further studies should be conducted to better elucidate the specific indications for rigid external distraction devices in complex facial trauma.
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spelling pubmed-76561552020-11-18 Rigid External Distractors in Midface Fractures: A Review of Relevant and Related Literature Gala, Zachary Halsey, Jordan Kogan, Samuel Hoppe, Ian Ciminello, Frank S. Granick, Mark S. Eplasty Review Introduction: Literature discussing the use of rigid external distraction devices in midfacial trauma is limited. Rigid external distraction devices have been described for use in craniofacial surgery, allowing for distraction and stabilization of bony segments. In complex facial trauma, bony fragments are often comminuted and unstable, making traditional approaches with internal fixation difficult. Moreover, these approaches require subperiosteal dissection, limiting blood supply that is important for bone healing. Objective: The goal of this study was to evaluate the role of rigid external distraction devices for the treatment of complex facial trauma. Methods: We performed a literature review of rigid external distraction devices, as relevant both for facial trauma and for other craniofacial indications, to better elucidate their use and efficacy in complex facial fractures. Results: The review revealed only 2 articles explicitly describing rigid external distraction devices for facial trauma, while 6 other articles describing its use for other craniofacial cases. An important benefit associated with the use of rigid external distraction devices is their ability to provide controlled traction of bony segments while also allowing for movement as needed for fracture reduction. Various articles describe performing internal fixation following rigid external distraction device usage, while others emphasize that internal fixation is not necessarily indicated if the rigid external distraction device is left intact long enough to ensure bony healing. One potential setback described is unfamiliarity with using the rigid external distraction device, which can preclude its use by many surgeons. In addition, the literature review did not provide any uniform guidelines or recommendations about how long rigid external distraction devices should remain intact. Conclusion: Based on relevant literature, rigid external distraction devices have been shown to be useful in the stabilization and treatment of complex facial fractures. Further studies should be conducted to better elucidate the specific indications for rigid external distraction devices in complex facial trauma. Open Science Company, LLC 2020-10-19 /pmc/articles/PMC7656155/ /pubmed/33214802 Text en Copyright © 2020 The Author(s) http://creativecommons.org/licenses/by/2.0/ This is an open-access article whereby the authors retain copyright of the work. The article is distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review
Gala, Zachary
Halsey, Jordan
Kogan, Samuel
Hoppe, Ian
Ciminello, Frank S.
Granick, Mark S.
Rigid External Distractors in Midface Fractures: A Review of Relevant and Related Literature
title Rigid External Distractors in Midface Fractures: A Review of Relevant and Related Literature
title_full Rigid External Distractors in Midface Fractures: A Review of Relevant and Related Literature
title_fullStr Rigid External Distractors in Midface Fractures: A Review of Relevant and Related Literature
title_full_unstemmed Rigid External Distractors in Midface Fractures: A Review of Relevant and Related Literature
title_short Rigid External Distractors in Midface Fractures: A Review of Relevant and Related Literature
title_sort rigid external distractors in midface fractures: a review of relevant and related literature
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7656155/
https://www.ncbi.nlm.nih.gov/pubmed/33214802
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