Use of bilateral segmental ostectomy to correct malocclusion in the reconstructed mandible with a free fibular bone flap.
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Adult↗
Biomedical subjects
Muhitdin Eski
Publications and source records attributed to Muhitdin Eski.
Correction of thumb deformities after burn: versatility of first dorsal metacarpal artery flap.
In the management of a debilitated burned hand due to contractures, thumb reconstruction constitutes the most crucial part for a beneficial functional outcome. Among the limited local flap alternatives for the thumb, the first dorsal metacarpal artery flap, harvested from the dorsal aspect of the index finger can provide elastic, durable and sensate coverage for soft tissue defects after contracture release. In a 3-year period, neurovascular island first dorsal metacarpal artery flap was used in 14 patients suffering thumb deformities. The time elapsed after the underlying injury until reconstruction ranged from 5 months to 17 years. Follow-up revealed that all deformities were successfully treated with satisfactory functional recovery and cosmetic results. Donor site morbidity was minimal with an acceptable scar on the dorsum of the index finger and adequate tendon gliding without producing extension deficit. Our experience with management of deformities involving the thumb and/or adjacent thenar area revealed that the first dorsal metacarpal artery flap is a reliable local neurovascular island flap option, offering acceptable functional and cosmetic outcomes in respect to sensation, elasticity, durability and skin-match.
Adult↗
Unusual facial impalement injury with wooden material.
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Accidental Falls↗
Vertical distraction osteogenesis of fibular bone flap in reconstructed mandible.
Excellent functional and aesthetic results can be achieved in mandibular reconstructions with using free fibular bone flap. However, the vertical deficiency between the reconstructed segment and the occlusal plane made dental rehabilitation impossible in some cases. We encountered this problem in our 3 patients who had mandibular reconstruction with fibular flap due to extensive bone defect result from gunshot injury. To overcome this segmental vertical distraction of the reconstructed mandible was performed. Fibular bone segments (40-70 mm) were distracted with using extraoral distraction device after a latency period of 5-7 days. The rate of distraction was 1 mm/day, and the rhythm was 4 times (4 x 0.25 mm). Distraction was continued until the desired height was achieved, and the distractor left in place for 12 weeks for bony consolidation. No minor or major complications were encountered. The increase of vertical height was between 9 and 13 mm, and it was stable during the follow-up period (7-22 months). Following the vertical distraction and vestibuloplasty operations, the dental restoration of the patients was performed with mandibular removable partial dentures.
Adult↗
A retrospective analysis of 101 zygomatico-orbital fractures.
A 5-year review of 101 cases of zygomatico-orbital fractures is presented. The epidemiology, fracture patterns, treatment modalities, and complications were evaluated in this retrospective study. A majority of fractures were sustained by males and resulted from trauma inflicted during altercations and traffic accidents. The most common fracture pattern was tripod fracture and the most common associated facial fractures were mandibular fractures. Open reduction and rigid fixation was the most frequently employed treatment modality. Depending on the stability of reduced zygoma, one, two and three-point fixations were applied. Orbital floor exploration was performed in 41 cases. Ten out of 16 orbital floor bone defects required reconstruction. In these cases orbital floor was reconstructed with 1.5-mm porous polyethylene implant. Although we encountered a few complications related to the incisions for open reduction, the rate of complication in which correction was difficult (e.g. facial asymmetry) was lower with this approach when compared with the literature.
Accidental Falls↗
Congenital double lip: review of 5 cases.
Congenital double lip is rare and usually involves the upper lip. Apart from a deformity that interferes with speech and mastication, operation may be indicated for cosmetic reasons. We have operated on five patients with double lip deformities for cosmetic reasons. Although a midline constriction band between two mucosal bulges is thought to be a constant feature, four of our five cases did not have a midline constriction. We used an elliptical excision of the mucosal excess in the four patients. The one with central constriction had an elliptical excision on each side, combined with a vertical midline Z-plasty to release the central constriction. Satisfactory aesthetic results were achieved in all patients.
Adult↗
A custom-made distraction device for experimental mandibular distraction osteogenesis.
Distraction osteogenesis has recently become popular in craniofacial reconstruction, after it was first described for long bones. Despite the widespread clinical use of this technique, currently, lack of an ideal experimental model for small animals hampers investigations focused on its molecular basis, which warrants further elucidation. The authors developed a new device for distraction of the rat mandible and, to asses its effectiveness, practiced on 30 animals assigned to either an acute 3-mm distraction group (n = 7) or a gradual distraction group (0.25 mm twice a day for 6 days; n = 23). The authors applied the devices to a localization that allowed them to perform the ostomies posterior to the molar teeth. Because of a U-shaped plate that the authors used for posterior pin fixation, their device maintained its stability until the end of the study, despite the delicate anatomy of the bone at the posterior part of the mandible. Additionally, the authors described a practical and easy method of transient mandibular stabilization method that facilitates the manipulations while the mouth is open for safer airway control during surgery. This new nutrition technique with enteral feeding solution solved the problem of progressive weight loss after surgery. Application of the device was easy and practical, without demanding complex manipulations. The authors did not observe any device dislodgement or a high rate of accidental fractures during the manipulations. They demonstrated that the device works properly and is able to create ossified regenerate bones that fill the entire distraction gap, which can be used for various investigations during distraction osteogenesis.
Animals↗
Biomechanical analysis of the rigid fixation of zygoma fractures: an experimental study.
In this experimental study, the goal was to test the sufficiency of actual fixation plates in zygomatic complex fractures and the efficiency of a modified plate at the zygomaticofrontal suture in a suitable model, which was designed for biomechanical study. To address this issue, a zygomatic fracture model produced by using a cadaveric cranium was simulated and the fractures were fixed by the actual and modified fixation materials. The force simulating masseter muscle pull was applied with the Lloyd material testing apparatus, and the rotation of the zygoma was determined using displacement transducers. In this study, there were three different experimental groups. Although miniplates at the zygomaticomaxillary buttress and microplates at the infraorbital rim were used in all three groups, three different plates (miniplate, microplate, and modified plate) were used at the frontozygomatic suture in these groups. Rotational displacement of the zygoma with the effects of simulated masseter muscle force was determined. According to the results obtained, microplates are not effective in stabilizing the frontozygomatic suture when the masseter muscle forces are within physiological range. Although miniplates stabilize zygomatic complex fractures, it was shown that modified microplates, which have no ondulation along the plate border, have a higher resistance to rotation than that of the conventional plates. The rotation angle at the instant of fracture with microplates was 4.59 degrees, and that with miniplates was 1.26 degrees. The maximum rotation angle with modified microplates was 0.32 degrees. Modified microplates designed for the fixation of fractures in the zygomatico-orbital region have been shown to be suitable in a well-designed experimental model and might be appropriate for clinical use.
Biomechanical Phenomena↗