Purpose: Resorbable fixation system has an advantage that those can be absorbed safely inside the body after surgery and does not have side effect such as pain, foreign body sensation, restriction of bony growth. But, there are 3 stages to be accomplished to fix a resorbable plate. First, a hole is made by drill, second, the site of the hole is tapped by a tapper, and at last a screw is inserted into tapped hole fixing the plate. Because of these complicated procedures, there is an increased chance that a fracture fragment or a plate is displaced during the procedures. So we suggest a new way of using tapper that can make the surgery more simple and accurate than before.
Methods: After resorbable plate was properly located above fractured site, a hole on fracture fragment was made by drill and the tapper was inserted into that hole. When the tapper was inserted at a certain depth, the fracture fragment could be reduced to right place by handling inserted tapper. Then, tapper was inserted to the end, and handle was split. While the tapper was placed still to act as a metal screw instantly, another hole was made at nearby site and screw was inserted. Then the tapper acting as a screw was removed and a next screw was inserted into that tapper-removed hole. After the plate and fracture fragment were fixed tightly by those screws, extra screws were inserted at other sites if needed.
Results: From October 2006 to April 2008, we applied this procedure to 106 facial bone fractures in 68 patients. There were frontal bone fractures(n=7), zygomatic complex fractures(n=37), maxillary fractures(n=50), blow out fractures(n=15), mandibular fractures(n=7) and no major complications were noted. Proper reduction and fixation of fractured site was observed in follow-up radiologic examination.
Conclusion: The complicated procedures in fixation of resorbable plate makes operation for facial fractures more difficult, and it can result in extended operation time, incomplete reduction or fixation. For that, we tried to make the operation more simple and accurate by using the tapper as an instrument for reduction and fixation of fracture fragment. So in case using resorbable fixation system, we hope that the operator feels more comfort and outcome will be more improved with using this new method of using tapper.