An experimental study of a novel external fixator based on universal joints for the rapid initial stabilization of mandibular comminuted fractures

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外文摘要：Purpose:Shaping and assembling contemporary external fixators rapidly for the severe mandibular fractures remains a challenge,especially in emergency circumstance.We designed a novel external fixator that incorporates universal joints to provide the stabilization for mandibular comminuted frac-tures.This study aims to confirm the efficacy of this novel external fixator through biomechanical tests in vitro and animal experiments.Methods:In vitro biomechanical tests were conducted using 6 fresh canine with mandibular defect to simulate critical comminuted fractures.Three mandibles were stabilized by the novel external fixator and other mandibles were fixed by 2.5 mm reconstruction plates.All fixed mandibles were subjected to loads of 350 N on the anterior regions of teeth and 550 N on the first molar of the unaffected side.The stability was evaluated based on the maximum displacement and the slope of the load-displacement curve.In animal experiments,9 beagles with comminuted mandibular fractures were divided into 3 groups,which were treated with the novel external fixation,reconstruction plate,and dental arch bar,respectively.The general observation,the changes in animals'weight,and the surgical duration were recorded and compared among 3 groups.The CT scans were performed at various intervals of 0 day(immediately after the surgery),3 days,7 days,14 days,21 days,and 28 days to analyze the displacement of feature points on the canine mandible and situation of fracture healing at 28 days.The statistical significance was assessed by the two-way analysis of variance test followed by the Bonferroni test,enabling multiple comparisons for all tests using GraphPad Prism10.1.0(GraphPad Inc,USA).Results:The outcomes of the biomechanical tests indicated that no statistically significant differences were found in terms of the maximum displacement(p=0.496,0.079)and the slope of load displacement curves(p=0.374,0.349)under 2 load modes between the external and internal fixation groups.The animal experiment data showed that there were minor displacements of feature points between the external and internal fixation groups without statistic difference,while the arch bar group demonstrated inferior stability.The CT analysis revealed that the best fracture healing happened in the internal fixation group,followed by the external fixation and arch baring at 28 days after fixation.The external fixation group had the shortest fixation duration(25.67±3.79)min compared to internal fixation((70.67±4.51)min,p＜0.001)and arch baring((42.00±3.00)min,p=0.046).Conclusion:The conclusion of this study highlighted the efficacy and reliability of this novel external fixator in managing mandibular fractures rapidly,offering a viable option for the initial stabilization of comminuted mandibular fractures in the setting of emergency rescue.

外文关键词：

External fixationMandibular fractureBattle injuriesDamage control

作者：

Zhi-Qiang Hu、Tai-Qiang Dai、Lu Zhao、Xun Li、Xu Gong、Hao Jia、Hai-Tao Kong、Bo-Lei Cai、Shi-Ping Chang、Lei Tian

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作者单位：

State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration,National Clinical Research Center for Oral Diseases,Shaanxi Clinical Research Center for Oral Diseases,Department of Oral and Maxillofacial,School of Stomatology,The Fourth Military Medical University,Xi'an,710032,China

The 80th Group Army Hospital of PLA,Weifang,261000,Shandong province,China

The Third Affiliated Hospital,The Air Force Military Medical University,Xi'an,710038,China

State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration,National Clinical Research Center for Oral Diseases,Shaanxi Clinical Research Center for Oral Diseases,Department of Dental Materials,School of Stomatology,The Fourth Military Medical University,Xi'an,710032,China

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基金：

Research projects of State Key Laboratory of Oral & Maxillofacial Reconstruction and RegenerationResearch projects of State Key Laboratory of Oral & Maxillofacial Reconstruction and RegenerationKey research and development program of Shaanxi Province

项目编号：

2020ZB03LX2021-1012024SF-YBXM-264

出版年：

2024

DOI：

10.1016/j.cjtee.2024.06.002

中华创伤杂志(英文版)

中华医学会

中华创伤杂志(英文版)

CSTPCD

影响因子：0.608

ISSN：1008-1275

年,卷(期)：2024.27(5)