Eine Plattform für die Wissenschaft: Bauingenieurwesen, Architektur und Urbanistik
Eine Plattform für die Wissenschaft: Bauingenieurwesen, Architektur und Urbanistik
The development and validation of titanium cranioplasty.
The work reviews in detail the history of cranioplasty including the origin of the calvarial defects and their means of repair in particular the use of autogenous bone, methyl methacrylate and titanium. Morbidity is reviewed as published and the properties of titanium as a valuable alloplastic material are discussed. The role of the CT image and its application in cranioplasty is described. A novel hydraulic bench top press was designed with the capability of 4,500 psi which facilitated further development and investigation of the dye compressed plate. From 1986 to 1991 plates were made from the external impression technique. Two retrospective reviews were carried out to audit the outcome and problems which included inaccurate bone margin detail where fitting required the use of bent flanges which took 40–70 minutes often with poor aesthetics. Incorrect investment and compression produced metal strain and distortion with incorrect plate insertion. The first review 40/66 patients returned their questionnaires. 18 were finally reviewed at 8–10 years, 11 had died, 11 were lost to follow up. 31 had been symptom free. 2 had severe headache, in the final cohort, 8 had mild headaches and 12 local pain. Only 4 were known to have been infected. One within 6 months and 3 after 6.5 years. 59% of the frontal cases were regarded as aesthetically satisfactory. Sixty five percent of the defects were large (>100cm2), 16/45 were to repair previous bone repairs, 5 were for infected acrylic plates In view of the poor fit and aesthetics a protocol for 8 anterior cases was carried out prospectively which included the fabrication of a wax frontal template and detailed planning with the surgeon. The aesthetic results were significantly improved 7 out of 8 were excellent and the 8th good. This protocol improved the outcome of the second study with 82% satisfactory aesthetically, but marginal fit and operating time remained a problem. The introduction of the CADCAM system revolutionized, the detection of the site and thickness of ...
The development and validation of titanium cranioplasty.
The work reviews in detail the history of cranioplasty including the origin of the calvarial defects and their means of repair in particular the use of autogenous bone, methyl methacrylate and titanium. Morbidity is reviewed as published and the properties of titanium as a valuable alloplastic material are discussed. The role of the CT image and its application in cranioplasty is described. A novel hydraulic bench top press was designed with the capability of 4,500 psi which facilitated further development and investigation of the dye compressed plate. From 1986 to 1991 plates were made from the external impression technique. Two retrospective reviews were carried out to audit the outcome and problems which included inaccurate bone margin detail where fitting required the use of bent flanges which took 40–70 minutes often with poor aesthetics. Incorrect investment and compression produced metal strain and distortion with incorrect plate insertion. The first review 40/66 patients returned their questionnaires. 18 were finally reviewed at 8–10 years, 11 had died, 11 were lost to follow up. 31 had been symptom free. 2 had severe headache, in the final cohort, 8 had mild headaches and 12 local pain. Only 4 were known to have been infected. One within 6 months and 3 after 6.5 years. 59% of the frontal cases were regarded as aesthetically satisfactory. Sixty five percent of the defects were large (>100cm2), 16/45 were to repair previous bone repairs, 5 were for infected acrylic plates In view of the poor fit and aesthetics a protocol for 8 anterior cases was carried out prospectively which included the fabrication of a wax frontal template and detailed planning with the surgeon. The aesthetic results were significantly improved 7 out of 8 were excellent and the 8th good. This protocol improved the outcome of the second study with 82% satisfactory aesthetically, but marginal fit and operating time remained a problem. The introduction of the CADCAM system revolutionized, the detection of the site and thickness of ...
The development and validation of titanium cranioplasty.
Joffe, Jack Mayor (Autor:in)
01.01.2000
Doctoral thesis, UCL (University College London).
Hochschulschrift
Elektronische Ressource
Englisch
DDC:
690
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