Table Of Contenthttp://dentalebooks.com
Michael Ehrenfeld | Paul N Manson | Joachim Prein
Principles of Internal Fixation
of the Craniomaxillofacial Skeleton
Trauma and Orthognathic Surgery
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Michael Ehrenfeld | Paul N Manson | Joachim Prein
Principles of Internal Fixation
of the Craniomaxillofacial Skeleton
Trauma and Orthognathic Surgery
275 Illustrations, 13 tables
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Principles of Internal Fixation of the Craniomaxillofacial Skeleton—Trauma and Orthognathic Surgery Michael Ehrenfeld, Paul N Manson, Joachim Prein
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Preface
Michael Ehrenfeld, MD, DDS, PhD Paul N Manson, MD Joachim Prein, MD, DDS, PhD
There are no facial fracture textbooks in any of the involved Having spent our lives developing and teaching algorithms
specialties that deal with introductory principles in the same for the efficient and successful reconstruction of the face
amount of detail as the Principles of Internal Fixation of the following trauma, congenital deformities, and tumor
Craniomaxillofacial Skeleton for Trauma and Orthognathic removal, we are keenly aware of the Manual’s contribu-
Surgery. Traditionally, each specialty has had its own areas tion, and what it represents in terms of work, effort, and
of interest and expertise. This textbook is different in that surgical experience. We cannot help wondering what it
it combines and focuses the expertise and competence of would have meant to have such a textbook at the begin-
different specialties on the entire craniofacial skeleton, ning of our careers!
resulting in a comprehensive work of considerable breadth.
It has been a privilege to serve as editors for this new CMF
It serves as a tribute to the many individuals who have Manual, and to suggest ideas for the masterful artwork
taught as faculty in AO courses and symposia over the last which illustrates this textbook. We hope it will enrich the
50 years. Their efforts and individual hard work are sum- knowledge of the current and future generations of CMF
marized in this volume. They have sought to make operative surgeons and assist them in mastering the intricate
sense of the complexity of the craniofacial skeleton and its anatomical details and techniques that lead to exemplary
related soft tissues by describing the principles of clinical results in surgery.
applied anatomy and surgical technique.
Sincerely,
Michael Ehrenfeld
Paul N Manson
Joachim Prein
V
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Introduction
Fourteen years after the publication of the Manual of In- fixation techniques of standard osteotomies of the facial
ternal Fixation in the Cranio-Facial Skeleton*, an update is skeleton. The principles described in this textbook represent
now available. Representing the multidisciplinary spirit of the evolution of CMF buttress reconstruction over the last
AOCMF, the Principles of Internal Fixation of the Cranio- 60 years. In addition to standard procedures, techniques
maxillofacial Skeleton for Trauma and Orthognathic Surgery representing recent surgical advances and new developments
includes contributions from oral and maxillofacial surgeons, are presented as well.
plastic surgeons, otolaryngologists, as well as researchers:
The 41 chapter authors represent a truly international au- Principles and techniques are highlighted by clear, accurate
thorship spanning three continents. illustrations, images, and tables. The combination of text and
figures helps the reader to understand the relationship be-
This Manual is not only meant to provide an overview on tween the anatomy and the principles of surgical reconstruc-
current concepts of craniomaxillofacial trauma care and tion, and to appreciate the difficult challenge of obtaining
orthognathic surgery, but also to serve as a resource textbook consistently superior results. Key references and suggested
for AOCMF Principles Courses, which are an important part readings are provided for each section.
of the education of residents and fellows around the world.
Much effort was made to make the new CMF Manual a
The Manual is divided into seven sections. The first section consistent book and to avoid overlapping content across the
covers general aspects of bone, types and materials of im- chapters. It is now up to the readers to judge whether this
plants, and principles of CMF trauma care. Sections two to task has been accomplished.
six describe the treatment of fractures in all areas of the
craniomaxillofacial skeleton and section seven presents Zürich, April 2012
*Prein J (1998) Manual of Internal Fixation in the Cranio-Facial
Skeleton. 1st ed. Berlin Heidelberg New York: Springer-Verlag.
VI Principles of Internal Fixation of the Craniomaxillofacial Skeleton—Trauma and Orthognathic Surgery Michael Ehrenfeld, Paul N Manson, Joachim Prein
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Acknowledgement
The editors wish to express their gratitude to the 38 authors the incorporation of changes and corrections. Carl Lau,
for contributing chapters to this book and sharing their Vidula Bhoyroo, and Claire Jackson helped with language
knowledge and experience with the reader. We are convinced editing and proofreading.
that this effort will contribute significantly to the education
of craniomaxillofacial residents and fellows. We also thank Thanks go to all illustrators, in particular Stefan Auf der
the authors for understanding that the editors needed to Maur from nougat GmbH, Basel, as the main illustrator and
make changes to the original manuscripts in order to pro- Jecca Reichmuth. Stefan Auf der Maur also did a tremendous
hibit overlap and ensure consistency throughout the book. job in typesetting the book.
We would also like to thank all surgeons who provided
additional ideas and material such as images or photographs. Samuel Leuenberger from Synthes Switzerland proved tire-
less in providing details about instrumentation and a number
Special thanks go to Almuth Nussbaumer who has been of of graphics for the illustration of chapter 1.4.3 Design and
invaluable help to the editors in the coordination of this function of implants. We thank Synthes for their kind per-
book project. Over the last 5 years she has very patiently mission to include this illustrative material in our textbook.
been in constant contact with the chapter authors.
Further thanks go to Börje Müller, Basel, for the excellent
The AO Education team has provided resources and exper- photographs of a number of implants and instruments dis-
tise without which this book would not have been possible. played in chapter 1.4.3 Design and function of implants.
We thank Urs Rüetschi, Kathrin Lüssi, and Renate Huter
for the overall planning and management of this project. Finally, we thank our families for their help and support
Kathrin also provided invaluable assistance in overseeing during the production of this book.
Michael Ehrenfeld
Paul N Manson
Joachim Prein
VII
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Contributors
Editors
Michael Ehrenfeld, MD, DDS, PhD
Professor and Chairperson
Department of Oral and Maxillofacial Surgery
Ludwig-Maximilians University
Lindwurmstr. 2a
80337 München
Germany
Paul N Manson, MD
Professor
Department of Plastic Surgery
Johns Hopkins University School of Medicine
8152 R. McElderry Wing
601 North Caroline Str
Baltimore, MD 21287-0981
USA
Joachim Prein, MD, DDS, PhD
Professor emeritus
Department of Oral and Cranio-Maxillofacial Surgery
University Hospital Basel
Spitalstr. 21
4031 Basel
Switzerland
VIII Principles of Internal Fixation of the Craniomaxillofacial Skeleton—Trauma and Orthognathic Surgery Michael Ehrenfeld, Paul N Manson, Joachim Prein
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Authors Rudolf RM Bos, DMD, PhD John A Disegi, FASTM
Professor and Deputy Head Group Manager Materials Development
Brian Alpert, DDS Department of Oral and Maxillofacial Surgery Synthes USA
Professor and Chairperson University Medical Center Groningen Synthes Technical Center
Department of Oral and Maxillofacial Surgery PO Box 30.001 1301 Goshen Park Way
University of Louisville School of Dentistry 9700 RB Groningen West Chester, PA 19380
Preston Str, Suite 334 The Netherlands USA
Louisville, KY 40292
USA Jon B Chadwell, MD Edward Ellis III, DDS, MS,
Chadwell Facial Plastic Surgery Professor and Chairperson
Oleh Antonyshyn, MD, FRCSC 6301 University Commons Department of Oral and Maxillofacial Surgery
Professor Suite 380 University of Texas Health Science Center at San Antonio
Plastic Surgery, Head Adult Craniofacial Program South Bend, IN 46635 7703 Floyd Curl Dr, MC 7908
University of Toronto USA San Antonio, TX 78229-3900
M1-520 Sunnybrook Health Sciences Centre USA
2075 Bayview Ave Ricardo Cienfuegos, MD, FACS
Toronto, Ontario M4N 3M5 Head Marcelo F Figari, MD, FACS
Canada Department of Plastic, Reconstructive and Head Section of Head and Neck Surgery
Maxillofacial Surgery Department of General Surgery
Leon A Assael, DMD Plastic and Reconstructive Surgeon, American British Hospital Italiano
Professor and Chairperson Cowdray Medical Center Perón 4199
Department of Oral and Maxillofacial Surgery Hospital de Traumatología y Ortopedia Lomas Verdes 1181 Buenos Aires
Oregon Health & Science University, School of Dentistry IMMS Argentina
611 SW Campus Dr Tlacotalpan 59-310, Colonía Roma
Portland, OR 97239 Mexico, D.F., 06760 Nils-Claudius Gellrich, MD, DDS, PhD
USA Mexico Professor and Chairperson
Department of Oral and Maxillofacial Surgery
Laurent Audigé, DVM, PhD Douglas J Colson, MD Medical University Hannover
Methodology and Statistics Manager Clinical Instructor Brown University Carl-Neuberg-Str. 1
AO Foundation Rhode Island Ear, Nose, and Throat Physicians 30625 Hannover
AO Clinical Investigation and Documentation 333 School Str Germany
Stettbachstr. 6 Suite 302
8600 Dübendorf Pawtucket, RI 02860 Beate Hanson, MD, MPH
Switzerland USA Clinical Epidemiologist, Assistant Professor
Director AO Clinical Investigation and Documentation
Robert Bentley, BDS,FDS, RCS, MB BCh, FRCS, Carl-Peter Cornelius, MD, DDS, PhD AO Foundation
FRCS (OMFS) Professor Stettbachstr. 6
Consultant Cranio-Oral and Maxillofacial Surgery Department of Oral and Maxillofacial Surgery 8600 Dübendorf
Kings College Hospital Ludwig-Maximilians University Switzerland
Denmark Hill, Camberwell Lindwurmstr. 2a
SE5 9RS London 80337 München Richard H Haug, DDS
United Kingdom Germany Section Head
Oral and Maxillofacial Surgery
Carolinas Medical Center
1601 Abbey Place
Suite 220
Charlotte, NC 28209
USA
IX
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