Pin guidance of reconstruction plate contour: an expanded role of external fixation.
This article presents a modification of intraoperative external fixation for mandibular reconstruction with free tissue flaps. This technique is indicated when preregistration of the reconstruction plate is not possible due to transmandibular tumor extension. Once standard external fixation has been carried out and prior to segmental mandibulectomy, additional pins are fixed to the connecting rod that delineate the mandibular contour in three-dimensional (3D) space. Following mandibulectomy, these pins allow accurate contouring of the reconstruction plate and improved restoration of mandibular contour, projection, and dental occlusion. A step-by-step description of the technique using models and intraoperative photos is presented. This method of mandibular reconstruction is a simple and time-effective alternative to intraoperative computer navigation and 3D modeling in select cases of oral carcinoma where tumor infiltration of the outer mandibular cortex precludes prebending of the reconstruction plates.
University of Toronto, Department of Otolaryngology, Head and Neck Surgery, Sunnybrook Health Sciences Center, Toronto, Canada. yves.jaquet@chuv.ch
Yves
Y
Jaquet
Kevin M
KM
Higgins
Danny J
DJ
Enepekides
D001858:Bone Nails; D001860:Bone Plates; D001863:Bone Screws; D058752:Free Tissue Flaps; D006801:Humans; D008334:Mandible / Q000601:surgery*; D009984:Orthopedic Fixation Devices; D019651:Plastic Surgery Procedures / Q000295:instrumentation* / Q000379:methods*