A novel anatomical thin titanium mesh plate with patient-matched bending technique for orbital floor reconstruction

Chih-Hao Chen; Chien-Tzung Chen; Po-Fang Wang; Yu-Tzu Wang; Pin-Hsin Hsu; Chun-Li Lin

doi:10.1016/j.jcms.2018.04.014

A novel anatomical thin titanium mesh plate with patient-matched bending technique for orbital floor reconstruction

J Craniomaxillofac Surg. 2018 Sep;46(9):1526-1532. doi: 10.1016/j.jcms.2018.04.014. Epub 2018 May 2.

Authors

Chih-Hao Chen¹, Chien-Tzung Chen², Po-Fang Wang³, Yu-Tzu Wang⁴, Pin-Hsin Hsu⁵, Chun-Li Lin⁶

Affiliations

¹ Craniofacial Research Center, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Keelung, Taiwan; Chang Gung University, College of Medicine, 5, Fu-Hsin Street, Kwei-Shan, Taoyuan, Taiwan. Electronic address: chchen5027@gmail.com.
² Craniofacial Research Center, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Keelung, Taiwan; Department of Plastic and Reconstruction Surgery, Chang Gung Memorial Hospital, 5, Fu-Hsing Street, Kueishan, Keelung, Taoyuan, 333, Taiwan. Electronic address: ctchenap@cgmh.org.tw.
³ Department of Plastic and Reconstruction Surgery, Chang Gung Memorial Hospital, 5, Fu-Hsing Street, Kueishan, Keelung, Taoyuan, 333, Taiwan. Electronic address: pofang1223@gmail.com.
⁴ Department of Biomedical Engineering, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei, 112, Taiwan. Electronic address: doraemon781227@gmail.com.
⁵ Department of Biomedical Engineering, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei, 112, Taiwan. Electronic address: pinkysyu0624@gmail.com.
⁶ Department of Biomedical Engineering, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei, 112, Taiwan. Electronic address: cllin2@ym.edu.tw.

PMID: 30001884
DOI: 10.1016/j.jcms.2018.04.014

Abstract

This study developed an anatomical thin titanium mesh (ATTM) plate for Asian orbital floor fracture based on the medical image database. The computer aided stamping analysis was performed on four hole/slot patterns included the control type without hole design, circular hole pattern, slot pattern and hole/slot hybrid patterns within the ATTM plate with upper/lower dies of averaged orbital cavity reconstruction models. The curved-fan ATTM plate with 0.4 mm thickness was manufactured and pre-bent using a patient matched stamping process to verify its feasibility and the interfacial fitness between the plate and bone on the orbital floor fracture model. The stamping analysis found that the hole/slot hybrid patterns design resulted in the most favorable performance among all designs owing to the lowest maximum von-Mises stress/strain and spring-back value. The interfacial adaption results test showed that the average patient-matched stamping bending gap size was only 0.821 mm and the operative time was about 8 s. This study concluded that the curved-fan ATTM plate with hole/slot hybrid pattern design and patient-matched pre-bent technique can fit the ATTM plate/orbital cavity interface well, decrease unstable fracture segment mobility and improve the overall reduction efficiency.

Keywords: Bending; Orbital floor fracture; Patient-matched; Plate; Stamping analysis.

MeSH terms

Adolescent
Adult
Bone Plates*
Computer-Aided Design*
Female
Fracture Fixation, Internal / instrumentation*
Humans
Male
Middle Aged
Orbital Fractures / surgery*
Orbital Implants*
Prosthesis Design*
Surgical Mesh*
Taiwan
Titanium
Tomography, X-Ray Computed
Treatment Outcome

Substances

Titanium