Elimination of mandibular defects with dosed distraction. Part III. Use of dosed distraction for restricted osteoplasty in subtotal and end defects of the mandible

摘要

Two variants (3(rd) and 4(th)) of non-free mandible osteoplasty with the use of compression-distraction apparatus (CDA) elaborated during the war in Afghanistan are described by the author. The 3(rd) variant was used in cases of vast combined defects of lower part of the face when two-sided osteotomy of both mandible stumps in order to create mobile mandible fragments of the length of 2.5 cm and their follow-up shift to the middle line of the face with the help of CDA is made. Distraction of callosity and soft tissues stimulated histogenesis that led to substitution of big osseous-soft tissue defect of lower part of the face. The 4(th) variant had two stages: 1(st) stage resulted in reconstruction of mandible branch, the 2(nd) -- in reconstruction of mandible head. In such a way the new temporomandibular joint using own tissues of the patient was created without application of allotransplant or titanium explant.