Comparison of First and Full Union Rates in Free Fibula Mandible Reconstruction Utilizing Cadcam Vs Non Cadcam

Plastic and Reconstructive Surgery, Global Open

article

Luke Grome¹  Jordan Kaplan¹  Jun Liu¹  Alexander F. Mericli¹  Rene D. Largo¹  Patrick B. Garvey¹ 

[1]Baylor College of Medicine

DOI  :  10.1097/01.GOX.0000696012.00080.ea

学科分类：社会科学、人文和艺术（综合）

来源: Wolters Kluwer

【 摘 要 】

Background: As the complexity of free fibula based mandible reconstruction has increased, modern technology such as virtual surgical planning has become popularizedin hopes of improving outcomes and simplifying surgery.This study represents the largest sample of computer-aideddesign and computer-aided manufacturing (CADCAM)free fibula mandible reconstruction in the plastic surgery.The aim of this study was to evaluate if CADCAM whencompared to standard, non-CADCAM, reconstructionsdemonstrated reduced time to first union and full union.Methods: Following IRB approval, a retrospective databasewas created for all free fibula flap mandible reconstructionsat MD Anderson Cancer Center from April 2005 throughFebruary 2019. Medical records for these consecutive caseswere reviewed and CT scans were analyzed to determinebony union rates. Bony union was defined as the presence ofbi-cortical callous formation and the scan was said to havefull union when this was present at all osteotomy sites.Results/Conclusion: Five hundred and twenty-four patientswere enrolled with average age of 61.6 years (range 14-92,years). Out of 524 patients, 401 had CT scans within oneyear and 377 demonstrated first union. The first union ratewithin one year is significantly higher in the CADCAMgroup than in the non-CADCAM group (CADCAM: 95.9%vs non-CADCAM: 93.07%, p=0.0004). Although at 1-yearfull union rates were statistically significantly higher in theCADCAM group (p=.021), 2-year follow-up showed thatthere was no statistically significant difference in full unionrates when VSP was applied (CADCAM: 85.9% vs nonCADCAM: 86.9%, p=0.312).

【 授权许可】

CC BY-NC-ND