颧骨复合体骨折手术治疗临床研究  

Clinical analysis of operations on zygomatic complex fractures

作　　者：张来健[1] 徐伟[1] 王浩[1] 陈志[1] 蒋蕾[1] 郑义诚[1] 

机构地区：[1]连云港市第一人民医院口腔颌面外科,连云港222002

出　　处：《口腔医学》2011年第10期596-599,共4页Stomatology

摘　　要：目的探讨颧骨复合体骨折治疗的手术方式,切口选择、固定部位、固定方式与骨折类型的关系。方法 58例颧骨复合体骨折患者分别采用口内前庭沟切口+头皮冠状切口+睫毛下切口、头皮冠状切口+口内前庭沟切口、口内前庭沟切口+原始创口入路、口内前庭沟切口+眶周小切口、单纯前庭沟切口和颞部切口进行手术复位,复位后采用微型钛板、钛钉行骨折固定,单纯涉及颧弓的粉碎型不稳定骨折采用口内切口复位+个性化外固定模板辅助固定。结果 58例患者过3～6个月的随访,外形满意度95%,无开口受限,无遗留上唇麻木,CT片示骨折对位线良好。结论颧骨复合体骨折的手术方法选择应考虑骨折类型、术者对各种术式适应证的理解、患者的偏好,做好术前与患者充分沟通,在功能和外形双标准的前提下,个性化治疗方案应是最终的目标。Objective To explore the operation method,incision selection,fixed position,fixed mode and fracture types of zygomatic complex fractures.Methods A retrospective review of 58 patients records was conducted.Data regarding surgical methods,imaging,facial material and clinical results were reviewed.Results 8 cases of the 58 patients were type A1,38 cases were type B and 12 cases were type C.16 cases of the 58 patients were used oral vestibule incision＋scalp coronal incision＋eyelash incision on,14 cases were used scalp coronal incision＋oral vestibule incision on,10 cases were used oral vestibule incision＋original wound on,10 cases were used oral vestibule incision＋orbit small incision on,5 cases were used simple oral vestibule incision on,and 3 cases were used temporal incision on.Most patients were fixed by micro titanium plate and titanium nail after fracture restoration.Only 3 cases were treated with incision reset＋personalized fixed template auxiliary fixation,and another five cases involving only the ＂M＂ zygomatic arch were used inside or ipsilateral temporal hairline incision with nulli-fixation on.After 3-6 months,follow-up,almost all of the patients regained normal face appearance and functional occlusion.Conclusions The selection of surgical method of zygomatic complex fracture touches upon various of fracture types,the understanding of various operation methods by operator and patients′ preferences.Under the premise of function and appearance,personalized treatment should be the final goal.

关 键 词：颧骨复合体 骨折 手术 

分 类 号：R782.4[医药卫生—口腔医学]