Repair of midfacial fractures with resorbable plates and screws

Abstract

The use of plates and screws composed of a resorbable copolymer of poly L-lactic acid and polyglycolic acid (LactoSorb) for the repair of a variety of midfacial fracture patterns (orbital, zygomatic, and maxillary) was performed in 127 patients. Other than technique variations in application for screw insertion and plate adaptation, no clinical differences were observed in intraoperative bone stability or postoperative long-term results from prior experience with traditional metal devices. No occurrences of postoperative infection; abnormal, prolonged, or delayed soft-tissue swelling; or maxillary sinusitis occurred in this series with a 1- to 7-year follow-up. Resorbable fixation devices work well in the midface when good bone stock is available and extensive comminution of important bony buttresses is not present. Their use requires certain conceptual and technical differences from metal fixation and these issues are highlighted in this clinical review. The use of plates and screws composed of a resorbable copolymer of poly L-lactic acid and polyglycolic acid (LactoSorb) for the repair of a variety of midfacial fracture patterns (orbital, zygomatic, and maxillary) was performed in 127 patients. Other than technique variations in application for screw insertion and plate adaptation, no clinical differences were observed in intraoperative bone stability or postoperative long-term results from prior experience with traditional metal devices. No occurrences of postoperative infection; abnormal, prolonged, or delayed soft-tissue swelling; or maxillary sinusitis occurred in this series with a 1- to 7-year follow-up. Resorbable fixation devices work well in the midface when good bone stock is available and extensive comminution of important bony buttresses is not present. Their use requires certain conceptual and technical differences from metal fixation and these issues are highlighted in this clinical review.