Free skeletal muscle transplantation

Use the body or others to free skeletal muscles to repair the defect. Precautions for free skeletal muscle transplantation: 1. The general condition must be good, oral hygiene should be maintained before surgery, tooth roots should be removed, caries should be treated, and calculus and tartar should be cleaned. 2. Select the appropriate bone donor area, when bone defects are less, consider taking materials in situ, and using healthy adjacent mandibular margin bone restoration. The zygomatic bone is mainly used for mandibular body defects; ribs and costal cartilage are mainly used in the case of semi-mandibular bone defects; in the case of full mandibular defects, when the simple ribs are still insufficient, it can also be combined with the sacrum, that is, the sacrum is used for the sacrum. Branches and ribs. If the use of deformable cancellous bone transplantation, the indications are wide and can not be limited by the defect site. 3. The ipsilateral condyle is generally used for sacral bone graft transplantation, because its shape and curvature are generally similar to the defect site. When taking ribs, cut at 7 to 9 ribs. If it is necessary to cut the costal cartilage at the same time to form the ascending branch of the mandible, since the costal cartilage must be used as the mandibular branch, it should generally be taken from the opposite side so that the shape, curvature and defect can be approximated. 4. Bone grafts and jawbone fixation methods are: bone fixation, intermaxillary fixation, and external fixation. The methods of bone fixation with bevel guides or intermaxillary fixation are better, and external fixators are less effective. If the intermaxillary fixator is used after bone transplantation, it can usually be removed within 4 weeks. The small splint or metal wire fixed between bones can be placed for a long time if there is no infection or foreign body reaction, otherwise it can be cut out and removed after 8-10 weeks of bone grafting. 5. The formation of mandibular condyle defect is clinically unsatisfactory. Although the bone graft can be sawed into a few gaps (patellas) with bone saws or the inner plate can be formed by V-shaped resection (ribs) to assist in forming, sometimes the intended purpose is still not achieved. In this case, a plastic bone cancellous graft may be a better method.