颧蝶缝在颧骨骨折复位中的作用  

Function of sphenozygomatic suture as a guide in reduction of zygomatic fracture

作　　者：张清彬[1] 东耀峻[2] 李祖兵[2] 赵吉宏[2] ABILE 

机构地区：[1]河北医科大学口腔医学院颌面外科,石家庄050017 [2]武汉大学口腔医学院颌面外科 [3]民主刚果金沙萨中刚友谊医院口腔颌面外科

出　　处：《实用口腔医学杂志》2010年第5期615-617,共3页Journal of Practical Stomatology

摘　　要：目的:探讨以颧蝶缝作为术中颧骨骨折复位标准的可靠性和临床效果。方法:对2004-12～2007-12在我院就诊、以颧蝶缝为复位标准的66例资料完整的颧骨骨折病例进行回顾性分析。结果:66例中有男性45例,女性21例,年龄17～59岁,平均37.5岁;术后初期(1月之内)66例患者均取得了满意的面型。随访6～72个月,平均22个月。在66例患者中得到随访的有62例(93.9%),失访的有4例(6.1%)。按四级评定,治疗效果I级20例(占32.3%);II级40例(占64.5%);III级1例(占1.6%);IV级1例(占1.6%)。在III和IV级2例患者中,X线检查1例为眶外缘与颧弓连线形成的弧度较对侧变小,而颧上颌突与颧弓下缘连线形成的弧度变大;1例眶外缘外侧的颞部塌陷,颧弓处扁平,颧骨发生外转移位。2例患者行CT扫描显示颧蝶缝处仍有错位。结论:颧骨骨折手术复位时,以颧蝶缝为复位标准,在此基础上再复位其他骨折断端,可获得较精准的解剖复位,从而恢复患者三维立体的正常面型。Objective：To analyze the function and reliability of sphenozygomatic suture as a guide in the reduction of zygomatic fracture.Methods：From Dec 2004 to Dec 2007.66 patients who were operated with sphenozygomatic suture as the first guide in the reduction were chosen.The clinical data of 66 patients were investigated and analyzed.Results：All the patients were restored to satisfactory facial contour at early period after operation（within 1 month）.After a follow-up of 6~72 months（mean time 22 months）,4 cases were lost.20 patients belonged to type I,40 patients to type II,1 case to type III and 1 case to type IV.Radiographically,precise anatomic reduction was acquired in 60 patients,and there was slightly discontinued reduction in 2 cases.There was small dislocation at sphenozygomatic suture,which led to facial malformation or asymmetry.Conclusion：In the surgical treatment of zygomatic fractures,reduction of sphenozygomatic suture as guide combined with reduction of other fracture lines can get precise zygomatic reconstruction and normal aesthetic outcome.

关 键 词：创伤 颧骨骨折 手术复位 颧蝶缝 

分 类 号：R782.4[医药卫生—口腔医学]