The Journal of craniofacial surgery
-
Comparative Study
Orbital stress analysis, Part IV: Use of a "stiffness-graded" biodegradable implants to repair orbital blow-out fracture.
The purpose of this study was to develop a finite element model (FEM) of a human orbit, of 1 patient, who had an orbital blow-out fracture, to study the effect of using a "stiffness-graded" (SG) biodegradable implant on the biomechanics of bone-fracture repair. ⋯ The use of SG implants induced significant changes in the stress patterns at the fracture interface and at the bone-implant interface. Stiffness-graded biodegradable implants offered less stress shielding to the bone, providing higher compressive stress at the fractured surface, to induce accelerated bone healing, as well as higher tensile stress in the intact portion of the bone. It seems that this is the first reported study, in the literature, on the use of SG biodegradable implants to repair and promote bone healing at the fracture site of the inferior orbital wall bone defect.
-
Some of the most problematic craniofacial injuries in pediatric plastic surgery are large calvarial defects in children who have passed the age of maximal dural osteogenic potential and yet are too young to yield split calvarial grafts. Porous polyethylene (Medpor; Porex) is an alloplastic material that can be customized to precisely match a cranial defect. We present a clinical series that demonstrates successful use of porous polyethylene cranioplasties in large pediatric cranial defects. ⋯ For pediatric large-scale calvarial defects, custom-made porous polyethylene implants can be safely used for cranioplasty. Tissue expansion and acellular dermal matrix were useful tools to help augment the soft tissues of the scalp before cranioplasty to prevent complications of implant extrusion and wound breakdown.