Intracranial Fixation Pin Migration: A Complication of External Le Fort III Distraction Osteogenesis in Apert Syndrome
External distraction osteogenesis has long been used in treatment of congenital midface hypoplasia. Distraction osteogenesis is associated with lower relapse rate and less complications compared with standard Le Fort III osteotomy. General complications in using rigid external distraction include localized infection, loosening of pins, and pin displacement. A 24-year-old female patient with Apert syndrome who underwent Le Fort III distraction osteogenesis is reported. Standard Le Fort III osteotomy was performed, and external distractor was placed. After 7-day latency period, the distractor was activated at the rate of 1 mm/d and finished after 20 days. A mild localized infection was recognized at the eighth week of consolidation period, and debridement was carried out at the left side of pin fixation. Obvious displacement of distractor occurred I week later while the patient was sleeping, and emergency operation was performed to remove the distractor and depress the left temporal skull bone fracture after clinical evaluation. The patient was asymptomatic clinically, and the advancement of the midface was stable. Le Fort I osteotomy was performed 3 years later to obtain a normal occlusion, and the patient was satisfied with the final outcome. We concluded that an unwanted trauma might cause severe complications such as skull bone fracture secondary to related local infection, and close follow-up and management are necessary for those cases.
Le Fort III distraction osteogenesis complication intracranial fixation pin migration Apert syndrome craniosynostosis syndrome
Ming Cai Guofang Shen Xudong Wang Bing Fang
Department of Oral and Maxillofacial Surgery. Shanghai Ninth Peoples Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China
国际会议
上海
英文
447-449
2011-12-28（万方平台首次上网日期，不代表论文的发表时间）