Clinical Application of Temporary External Fixator for Immediate Mandibular Reconstruction

Abstract

Immediate mandibular reconstruction is always necessary for the patients receiving segmental mandibulectomy to recover the facial contour and function of occlusion. When 3D modeling is unavailable, temporary external fixator is necessary to maintain the occlusion relationship and facial contour. In this study, we introduce the clinical application of temporary external fixator for immediate mandibular reconstruction in patients receiving segmental mandibulectomy, which consists of 2 anchor claws, 2 all-round retentive arms, and 1 central locking structure. From August 2016 to September 2017, temporary external fixator was applied in 13 patients. Clinical data of gender, age, surgical procedure, duration of operation, and clinical outcomes were recorded and analyzed. Among the 13 patients, there were 4 men and nine women whose ages ranged from 21 to 64 (mean 47.7) years old. There were 9 benign and 4 malignant lesions. All lesions expended at the buccal side of mandible. 12 fibular flaps and 1 vascularized iliac bone graft were used. The mandibular defect ranged from 6 to 14 (mean 10) cm. The operation duration of surgery ranged from 5 to 10 (mean 7) hours. All flaps survived with primary healing. The occlusion and facial contour were good, without significant changes of the length of mandibular body and width of mandible before and after surgery. No functional sequelae were noted at the donor sites. From these results, the temporary external fixator is easy to operate; the surgical procedure is simple and time-saving for surgeon when 3D modeling is unavailable. The indication for temporary external fixator usage is the mandibular lesion growing outward to cheek soft tissue.

Wrist external fixator for treatment of comminuted mandible fracture caused by gunshot wound: A case report

“…At the same time, there are reports using a customized 3D-printed external fixator in cases of septic mandibular pseudarthrosis, a condition that is clinically important, but which allows for more planning time in relation to multiple trauma patients (Louvrier et al, 2020). The ex-fix technique has also been integrated in cases of tumor resection with extensive loss of bone segment (Vural & Yuen, 2007;Yin et al, 2019). In cases of osteoradionecrosis with sequestrotomy there is also an indication, preventing pathological fractures that are difficult to manage.…”

Developing A Temporary External Fixator (TEF) for Mandibular Reconstruction using Two-Phase QFD and TRIZ Approach

“…This meticulous alignment ensures precise intraoperative bone resection and stable fixation during surgery. Following complete tumor resection, the TEF's crucial function is to stabilize the mandible and secure it to the reconstruction plate (Yin et al 2019). These detailed specifications and functionalities, arising directly from the surgical workflow, guided the selection of necessary components and manufacturing specifications.…”

“…It is used before mandibulectomy to prevent the condyle head from shifting out of the neutral zone. The threedimensional position of the lower jaw with the condyle in the glenoid fossa can be recreated using this device (Yin et al 2019). A TEF comprises external rods, fixation pins, and connector rods.…”

Application of Smart Healthcare in Comparative Analysis of Effect of Early External Fixator and Plate Internal Fixation Treatment on Postoperative Complications and Lower Limb Function Recovery of Patients With Unstable Pelvic Fracture

“…Conservative treatment is often selected in clinics to treat unstable pelvic fractures, but the incidence rates of complications such as hypostatic pneumonia and gastrointestinal hemorrhagic stress ulcer are higher (2), which, despite current improvements in medical technology, still affect the prognosis of patients, resulting in a severe reduction in their quality of life (QOL) (3,4). Since the pelvic bone is not stable and relies mainly on soft tissues such as ligaments, so the key to treatment is to provide it with an environment that is mechanically stable throughout its structure, thus aiding the recovery of both the bone and soft tissues (5). With the progress of Internet technology, China proposes to develop the smart health industry and promote the deep integration of cloud computing, big data, mobile Internet, and the health services industry, under which context smart healthcare was born.…”