scholarly journals Shaping of comminuted midface fractures with stock Titanium mesh: a technical note

2021 ◽  
Vol 27 (4) ◽  
pp. 51
Author(s):  
Ashutosh Kumar Singh ◽  
Safal Dhungel ◽  
Sanad Dulal ◽  
Manish Yadav
Keyword(s):  
Three Dimensional ◽  
Case Series ◽  
Technical Note ◽  
Titanium Mesh ◽  
Facial Bones ◽  
Maxillofacial Region ◽  
Midface Fractures ◽  
Midfacial Fractures ◽  
Thin Bone ◽  
Miniplate Osteosynthesis

Multiply fragmented fractures of the maxillofacial region are difficult to fix with traditional miniplate osteosynthesis because of the extremely small size of fragments, complex three-dimensional anatomy, thin bone unable to hold screws and multidirectional pull of muscles. We intend to present a technical note on a case series of extremely comminuted midfacial fractures reconstructed with stock Titanium mesh, cut to shape and used to mold the small fragmented segments into the shape of the facial bones. Severe fragmentation of midface leads to facial hollowing, tissue prolapse and asymmetry even after major facial buttresses are fixed and reconstructed. Simple stock Titanium mesh can be used to reconstruct these severe fragmentations of thin bones of the midface as shown in the series and avoid late and unsightly complications.

An innovative prone positioning system for advanced deformity and frailty in complex spine surgery

2020 ◽  
Vol 32 (2) ◽  
pp. 229-234
Author(s):  
Benjamin Kolb ◽  
John Large ◽  
Stuart Watson ◽  
Glyn Smurthwaite
Keyword(s):  
Ankylosing Spondylitis ◽  
Three Dimensional ◽  
Technical Note ◽  
Positioning System ◽  
Prone Positioning ◽  
Economic Implications ◽  
Potential Safety ◽  
Chest Deformity ◽  
Positioning Device ◽  
Skin Quality

The authors present a technical note for a prone positioning system developed to facilitate cervical extension osteotomy for ankylosing spondylitis in the presence of severe deformity and frailty. Chin-on-chest deformity represents one of the most debilitating changes of ankylosing spondylitis. Where the chin-brow angle approaches or exceeds 90°, prone positioning becomes problematic due to the fixed position of the head. Furthermore, the challenge is compounded where physiological deconditioning leads to frailty, and the side effects of medical therapies decrease muscle mass and skin quality. Conventional prone positioning equipment is not able to cater to all patients. A versatile system was developed using a 3D reconstruction to enable a positioning simulation and verification tool. The tool was used to comprehensively plan the perioperative episode, including spatial orientation and associated equipment. Three-dimensional printing was used to manufacture a bespoke positioning device that precisely matched the contours of the patient, reducing contact pressure and risk of skin injury. The authors were able to safely facilitate surgery for a patient whose deformity and frailty may otherwise have precluded this possibility. The system has potential safety and economic implications that may be of significant utility to other institutions engaging in complex spinal surgery.

scholarly journals Intraoperative O-arm Navigation Guided Anterior Cervical Surgery; A technical note and case series

2021 ◽  
pp. 101288
Author(s):  
Masato Tanaka ◽  
Hardik Suthar ◽  
Yoshihiro Fujiwara ◽  
Yoshiaki Oda ◽  
Koji Uotani ◽  
...  
Keyword(s):  
Case Series ◽  
Technical Note ◽  
Cervical Surgery ◽  
Anterior Cervical Surgery

scholarly journals A novel anatomic titanium mesh cage for reducing the subsidence rate after anterior cervical corpectomy: a finite element study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yuhang Wang ◽  
Yi Zhan ◽  
Huiming Yang ◽  
Hua Guo ◽  
Haiping Zhang ◽  
...  
Keyword(s):  
Finite Element ◽  
Three Dimensional ◽  
Titanium Mesh ◽  
Titanium Mesh Cage ◽  
Element Analysis ◽  
Cervical Corpectomy ◽  
Subsidence Rate ◽  
Anterior Corpectomy ◽  
Mesh Cage ◽  
Anterior Cervical Corpectomy

AbstractFusion with a titanium mesh cage (TMC) has become popular as a conventional method after cervical anterior corpectomy, but postoperative TMC subsidence has often been reported in the literature. We designed a novel anatomic cervical TMC to reduce the postoperative subsidence rate. According to the test process specified in the American Society of Testing Materials (ASTM) F2267 standard, three-dimensional finite element analysis was used to compare the anti-subsidence characteristics of a traditional TMC (TTMC) and novel TMC (NTMC). Through analysis, the relative propensity values of a device to subside (Kp) of the TTMC and NTMC were 665.5 N/mm and 1007.2 N/mm, respectively. A higher Kp measurement is generally expected to indicate that the device is more resistant to subsidence into a vertebral body. The results showed that the novel anatomic titanium mesh cage (NTMC) significantly improved the anti-subsidence performance after anterior cervical corpectomy and fusion (ACCF), which was approximately 51.3% higher than that of the traditional titanium mesh cage.

scholarly journals Virtual Surgical Planning, Stereolitographic Models and CAD/CAM Titanium Mesh for Three-Dimensional Reconstruction of Fibula Flap with Iliac Crest Graft and Dental Implants

2021 ◽  
Vol 10 (9) ◽  
pp. 1922
Author(s):  
Carlos Navarro Cuéllar ◽  
Manuel Tousidonis Rial ◽  
Raúl Antúnez-Conde ◽  
Santiago Ochandiano Caicoya ◽  
Ignacio Navarro Cuéllar ◽  
...  
Keyword(s):  
Bone Resorption ◽  
Surgical Planning ◽  
Iliac Crest ◽  
Three Dimensional ◽  
Titanium Mesh ◽  
Iliac Crest Graft ◽  
Virtual Surgical Planning ◽  
Fibula Flap ◽  
Dimensional Reconstruction ◽  
Cad Cam

Mandibular reconstruction with fibula flap shows a 3D discrepancy between the fibula and the remnant mandible. Eight patients underwent three-dimensional reconstruction of the fibula flap with iliac crest graft and dental implants through virtual surgical planning (VSP), stereolitographic models (STL) and CAD/CAM titanium mesh. Vertical ridge augmentation and horizontal dimensions of the fibula, peri-implant bone resorption of the iliac crest graft, implant success rate and functional and aesthetic results were evaluated. Vertical reconstruction ranged from 13.4 mm to 10.1 mm, with an average of 12.22 mm. Iliac crest graft and titanium mesh were able to preserve the width of the fibula, which ranged from 8.9 mm to 11.7 mm, with an average of 10.1 mm. A total of 38 implants were placed in the new mandible, with an average of 4.75 ± 0.4 implants per patient and an osseointegration success rate of 94.7%. Two implants were lost during the osseointegration period (5.3%). Bone resorption was measured as peri-implant bone resorption at the mesial and distal level of each implant, with a variation between 0.5 mm and 2.4 mm, and with a mean of 1.43 mm. All patients were rehabilitated with a fixed implant prosthesis with good aesthetic and functional results.

scholarly journals Recurrent contracted sockets treated with personalized, three-dimensionally printed conformers and buccal grafts

2021 ◽  
pp. 112067212110000
Author(s):  
Annabel LW Groot ◽  
Jelmer S Remmers ◽  
Roel JHM Kloos ◽  
Peerooz Saeed ◽  
Dyonne T Hartong
Keyword(s):  
Three Dimensional ◽  
Case Series ◽  
Secondary Outcome ◽  
Retrospective Case ◽  
Upper Eyelid ◽  
Ocular Prosthesis ◽  
Buccal Mucosal Graft ◽  
Custom Made ◽  
3D Printed

Purpose: Recurrent contracted sockets are complex situations where previous surgeries have failed, disabling the wear of an ocular prosthesis. A combined method of surgery and long-term fixation using custom-made, three-dimensional (3D) printed conformers is evaluated. Methods: Retrospective case series of nine patients with recurrent excessive socket contraction and inability to wear a prosthesis, caused by chemical burns ( n = 3), fireworks ( n = 3), trauma ( n = 2) and enucleation and radiotherapy at childhood due to optic nerve glioma ( n = 1) with three average previous socket surgeries (range 2–6). Treatment consisted of a buccal mucosal graft and personalized 3D-printed conformer designed to be fixated to the periosteum and tarsal plates for minimal 2 months. Primary outcome was the retention of an ocular prosthesis. Secondary outcome was the need for additional surgeries. Results: Outcomes were measured at final follow-up between 7 and 36 months postoperatively (mean 20 months). Eight cases were able to wear an ocular prosthesis after 2 months. Three cases initially treated for only the upper or only the lower fornix needed subsequent surgery for the opposite fornix for functional reasons. Two cases had later surgery for cosmetic improvement of upper eyelid position. Despite pre-existing lid abnormalities (scar, entropion, lash deficiency), cosmetic outcome was judged highly acceptable in six cases because of symmetric contour and volume, and reasonably acceptable in the remaining two. Conclusions: Buccal mucosal transplant fixated with a personalized 3D-designed conformer enables retention of a well-fitted ocular prosthesis in previously failed socket surgeries. Initial treatment of both upper and lower fornices is recommended to avoid subsequent surgeries for functional reasons.

Design and fabrication of anisotropic textile brace for exerting corrective forces on spinal curvature

2021 ◽  
pp. 152808372110326
Author(s):  
Queenie Fok ◽  
Joanne Yip ◽  
Kit-lun Yick ◽  
Sun-pui Ng
Keyword(s):  
Medical Condition ◽  
Three Dimensional ◽  
Case Series ◽  
The Body ◽  
Spinal Curvature ◽  
Radiographic Examination ◽  
Interface Pressure ◽  
Pressure System ◽  
Case Series Study ◽  
Point Pressure

This study focuses on the fabrication of an anisotropic textile brace that exerts corrective forces based on the three-point pressure system to treat scoliosis, which is a medical condition that involves deformity of the spine. The design and material properties of the proposed anisotropic textile brace are discussed in detail here. A case series study with 5 scoliosis patients has been conducted to investigate the immediate in-brace effect and biomechanics of the proposed brace. Radiographic examination, three-dimensional scanning of the body and interface pressure measurements have been used to evaluate the immediate effect of the proposed brace on reducing the spinal curvature and asymmetry of the body contours and its biomechanics. The results show that the proposed brace on average reduces the spinal curvature by 11.7° and also increases the symmetry of the posterior trunk by 14.1% to 43.2%. The interface pressure at the corrective pad ranges from 6.0 to 24.4 kPa. The measured interface pressure shows that a sufficient amount of pressure has been exerted and a three-point pressure distribution is realized to reduce the spinal curvature. The obtained results indicate the effectiveness of this new approach which uses elastic textile material and a hinged artificial backbone to correct spinal deformity.

scholarly journals Digital Customized Titanium Mesh for Bone Regeneration of Vertical, Horizontal and Combined Defects: A Case Series

Medicina ◽  
2021 ◽  
Vol 57 (1) ◽  
pp. 60
Author(s):  
Daniele De Santis ◽  
Federico Gelpi ◽  
Giuseppe Verlato ◽  
Umberto Luciano ◽  
Lorena Torroni ◽  
...  
Keyword(s):  
Bone Formation ◽  
Bone Regeneration ◽  
Case Series ◽  
Guided Bone Regeneration ◽  
Point Of View ◽  
Significant Gain ◽  
Titanium Mesh ◽  
New Bone Formation ◽  
Correct Method ◽  
Combined Defects

Background and Objective: Guided bone regeneration allows new bone formation in anatomical sites showing defects preventing implant rehabilitation. Material and Methods: The present case series reported the outcomes of five patients treated with customized titanium meshes manufactured with a digital workflow for achieving bone regeneration at future implant sites. A significant gain in both width and thickness was achieved for all patients. Results: From a radiographic point of view (CBTC), satisfactory results were reached both in horizontal and vertical defects. An average horizontal gain of 3.6 ± 0.8 mm and a vertical gain of 5.2 ± 1.1 mm. Conclusions: The findings from this study suggest that customized titanium meshes represent a valid method to pursue guided bone regeneration in horizontal, vertical or combined defects. Particular attention must be paid by the surgeon in the packaging of the flap according to a correct method called the “poncho” technique in order to reduce the most frequent complication that is the exposure of the mesh even if a partial exposure of one mesh does not compromise the final outcome of both the reconstruction and the healing of the implants.

scholarly journals Minimally invasive spinopelvic “crab-shaped fixation” for unstable pelvic ring fractures: technical note and 16 case series

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Akinori Okuda ◽  
Naoki Maegawa ◽  
Hiroaki Matsumori ◽  
Tomohiko Kura ◽  
Yasushi Mizutani ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Pelvic Ring ◽  
Case Series ◽  
Technical Note ◽  
Pelvic Ring Fractures
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