Effects of rigid fixation on the growing neurocranium of immature rabbits.
The improved intraoperative long-term skeletal stability achieved with rigid fixation techniques has led to their widespread popularity and application. However, experimental studies have revealed some drawbacks related to metallic implants and long-term results of clinical studies, especially in pediatric patients, has confirmed the results of experimental studies. Our aim in this experimental study using an infant rabbit model is to answer the following question: "Does short-term skeletal stability cause long-term growth inhibition?" Forty, 9-day-old New Zealand white albino rabbits were divided into four groups: 1) experimental, n=6: plated across the right coronal suture and two screws on each side of the left coronal suture; 2) re-operation, n=6: the same materials as group I were placed, and only the plate was removed at the end of 1 month; 3) sham, n=6: sham control with simulated surgery and two screws on each side of the left coronal suture; 4) control, n=2: no operation. The animals were killed 6 months after microplate application, and the skulls were evaluated both grossly and cephalometrically. Gross examination showed that the plates and the screws were covered by bony overgrowth and caused bony irregularity and regional bone degeneration. The parietal bones on the plated sides became striated and lost their concave shape. Cephalometric analysis demonstrated overt mastoid tip deviation toward, or shortening of cranionasal length on, the side with rigid fixation. We conclude from our study that rigid fixation during skeletal development causes growth retardation and should not be used in the growing child.
Sanus
Galip Zihni
GZ
Istanbul University, Cerrahpasa Medical Faculty, Department of Neurosurgery, Istanbul, Turkey, and Institute for Craniofacial and Reconstructive Surgery, Providence Hospital, Michigan, USA.
Tanriverdi
Taner
T
Kacira
Tibet
T
Jackson
Ian T
IT
D000704:Analysis of Variance; D000818:Animals; D001846:Bone Development; D001860:Bone Plates / Q000009:adverse effects*; D002508:Cephalometry; D003393:Cranial Sutures / Q000601:surgery*; D003398:Craniosynostoses / Q000209:etiology*; D003399:Craniotomy / Q000009:adverse effects*; D016268:Internal Fixators / Q000009:adverse effects*; D011817:Rabbits; D018709:Statistics, Nonparametric