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A Novel Osteosynthesis Plate Design for Routine Corrective Facial Surgery

Mommaerts, Maurice Y. MD, DMD

Innovation and Techniques
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Plating systems for the osteosynthesis of facial osteotomies have different requirements to those used to treat facial fractures. The aim of fracture treatment is anatomical fragment reduction, functional/rigid immobilization, restoration of occlusion and aesthetics, and occasionally defect bridging. In corrective facial surgery however there is a need for intra-operative adjustments related to changes in occlusion and aesthetics, and defect bridging occurs frequently. Postoperatively, training elastics are used to control temporary neuromuscular imbalance. To accommodate these demands a new plating system is presented, based on five requisites: allowance of occlusal and aesthetic adjustment without hardware removal, plate dimensions that accommodate routine skeletal repositionings, reduced hardware volume compared with trauma plating systems, screws that fit the inter-dental spaces when tension banding, and capability for micro-screw fixation of bone grafts in the osteotomy site. The files of 1000 non-congenital facial deformity patients were analyzed. The sagittal, vertical and transverse movements were drawn and the bridging distances calculated. Slotted plates with double-armed interconnections were designed for maxillary, zygomatic-sandwich, chin and segmental osteotomies. A separate design was made for the sagittal split plate. A pilot study was performed using 20 patients. The system showed great versatility and adaptability, but a multicenter morbidity study is necessary, mainly to study postoperative stability.

Brugge, Belgium

From The Division of Maxillo-Facial Surgery, Department of Surgery and Cleft Palate & Craniofacial Anomalies Team, General Hospital St. Jan, Brugge, Belgium.

Address correspondence to Dr Maurice Mommaerts, Division of Maxillo-Facial Surgery, General Hospital St. Jan, 8000 Brugge, Belgium; E-mail: maurice.mommaerts@azbrugge.be

© 2002 Mutaz B. Habal, MD