定向两次牵引成骨术在下颌骨肿瘤术后缺损修复中的应用

Double-step distraction osteogenesis in the reconstruction of unilateral mandibular segmental defects after tumor resection

目的探讨定向两次牵引成骨术在下颌骨肿瘤术后缺损修复中的应用。方法2002年1月至2006年12月，对6例因肿瘤术后致下颌骨缺损患者，先牵引下颌骨体部，再牵引下颌骨升支部。结果手术过程顺利，外形恢复良好，局部成骨满意，无感染等并发症。下颌骨最大体部单侧牵引幅度为5．5cm，平均5．2cm，升支部最大4．2cm，平均3．4cm。咬合及张口度恢复良好。结论定向两次牵引成骨术用于修复肿瘤术后下颌骨缺损，创伤小、手术时间短、操作简单，并可避免植骨及由此带来的供、受区并发症，效果稳定可靠；缺点是整个治疗时间长，需3次手术。

Objective To investigate the application of double-step distraction osteogenesis in the reconstruction of mandibular segmental defects after tumor resection. Methods From January 2002 to December 2006, six eases of post-tumor unilateral mandibular segmental defects were reconstructed using distraction osteogenesis. The mandibular body was lengthened first, following by mandibular ramus distraction. Results No infection or other complication was observed. The maximal distraction length reached 55 millimeter in the mandibular body, and 42 millimeter in the mandibular ramus. The average distraction length was 52 millimeter in the mandibular body, and 34 millimeter in the mandibular ramus. Both the aesthetic and functional result was excellent in all eases. Conclusions Double-step distraction osteogenesis is effective and easily performed in the reconstruction of unilateral mandibular segmental defects with less morbidities and complications. There is no need for donor site. However, the treatment period is relatively long with three staged operations.