Gunshot wounds: reconstruction of the lower face by osteogenic distraction.
BACKGROUND
Although osteogenic distraction is a well-established technique, the distraction device still needs to be improved, miniaturized, and made lighter, more flexible, and more adaptable for mandibular reconstruction in adults with gunshot wounds. The authors successively used unidirectional and bidirectional devices, followed by a bone transporter with a horseshoe-shaped trammel. The trammel system was then replaced by an endless screw, and finally by a customized endless screw.


METHODS
Eleven adult patients with gunshot injuries underwent mandibular reconstruction using osteogenic distraction with an external device.


RESULTS
An average bone gain of 79 mm was achieved. No infectious complications were observed. The authors encountered equipment problems during the study, requiring a change of material. The mean duration of mandibular distraction was 3.5 months.


CONCLUSIONS
Distraction of bone fragments facilitates the simultaneous expansion of soft tissues, avoiding free or pedicled myocutaneous flaps, for soft-tissue reconstruction. The alveolar ridge with the attached gum is also recreated by distraction, allowing dental reconstruction by osseointegrated implants.
Labbé
D
D
Department of Maxillofacial and Plastic Surgery, University Hospital, Caen, France. dr.labbe@wanadoo.fr
Nicolas
J
J
Kaluzinski
E
E
Soubeyrand
E
E
Sabin
P
P
Compère
J-F
JF
Bénateau
H
H
D000328:Adult; D000368:Aged; D001858:Bone Nails; D001863:Bone Screws; D019094:Dental Prosthesis, Implant-Supported; D004867:Equipment Design; D005151:Facial Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery*; D008875:Middle Aged; D019857:Osteogenesis, Distraction / Q000295:instrumentation; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D013406:Suicide, Attempted; D014948:Wounds, Gunshot / Q000601:surgery*