A new method of anatomical reconstruction of extensive defects of the mandible with autogenous cancellous bone.
The mandible and adjacent area is a frequent site of various primary malignant tumours. Therefore resection of this bone is quite often indicated. The main problems associated with defects of the mandible resulting from extensive tumour surgery are: 1. the disadvantage of intermaxillary fixation for immobilization of the stumps of the mandible; 2. the risk of infection; 3. rigid fixation of the stumps of the mandible plus transplant; 4. the different shapes of those regions that have to be replaced (e.g. angle or chin); 5. the poor conditions for revascularisation of the transplant expecially after combined therapy (surgery and radiation). In order to find a way to solve these problems we have developed the three-dimensionally bendable defect bridging plate (3-DBDB plate). Further more we have developed a special technique for the transplantation of compressed cancellous bone. In the first part of the paper the 3-DBDB plate and the principles of transplanting compressed cancellous bone, as well as the specially developed instruments are explained. The second part deals with a typical case and problems of infection.
D000368:Aged; D001860:Bone Plates; D016025:Bone Transplantation; D002277:Carcinoma / Q000601:surgery; D005260:Female; D006801:Humans; D008334:Mandible / Q000601:surgery*; D008339:Mandibular Neoplasms / Q000601:surgery; D010027:Osteotomy / Q000534:rehabilitation; D014182:Transplantation, Autologous