经美容小切口治疗颧上颌复合体骨折21例疗效分析  

Effect Analysis on Treatment of Zygomaticomaxillary Complex Fractures through Minimally Larvated Incisions: 21 Cases Report

作　　者：王卓为[1] 

机构地区：[1]中国医科大学北京顺义区医院口腔科,北京101300

出　　处：《中国现代手术学杂志》2014年第2期156-158,共3页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨采用小切口手术入路治疗颧骨复合体骨折的临床效果。方法选择21例颧骨复合体骨折患者，术前经放射影像检查确诊后，采用经眶外侧缘、睑下缘、口内前庭沟等隐蔽部位小切口，暴露颧骨复合体骨折段，复位后采用微型接骨板行坚强内固定。通过面形、开口度、切口愈合情况，并结合x线摄影后三维重建影像评价手术效果。结果本组21例患者均顺利完成手术，术后1周手术切口均Ⅰ级愈合，颜面部正常解剖外形均得到满意恢复，咬合关系正常。本组21例均获随访，随访时间平均3（1～6）个月。患侧颧凸度略低2例，术后轻度开口受限（不足3．5cm）2例，经过2个月开闭口功能锻炼后，开口度均恢复满意；术后出现暂时性面瘫1例，术后3个月面神经功能恢复满意；术前眶下区神经挫伤所致的眶下区麻木1例，术后已逐渐恢复。术后6个月所有病例都经x线检查，骨折对位良好，钛板放置位置正常，无螺钉松脱或钛板断裂、脱落。结论采用隐蔽小切口手术入路，并联合微型钛板行坚强内固定治疗颧骨复合体骨折，能尽可能地减少了患者的手术损伤，而且操作简便，手术耗时短，符合现代外科治疗理念，值得临床推广。Objective To explore the effect of the treatment for zygomaticomaxillary complex fractures through minimally larvated incision. Methods 21 cases of zygomaticomaxillary complex fracture were diagnosed by pre-operative radioscopy, and were treated by reduction and internal fixation. All the fractures were exposed through minimally larvated incisions on the lateral orbital margin, margo infraorbitalis and intraoral vestibule. When diaplasis was completed, micro bone plates were applied to rigid internal fixation. Afterward the assessment of the operation was conducted by 3-digital reconstruction of X-ray imaging and taking factors including profile, opening degree, the incision healing level into consideration, Results All fractures were successful in 21 cases. The incisions were achieved healing and anatomy of the faces was restored to normal with satisfied occluding relation. All cases were followed up for l to 6 months with an average of 3 months. The zygomatic convexity was lightly collapsed in 2 cases, and the opening degree was limited within 3.5 cm in 2 cases. All of them were restored after functional training. The transient facial palsy was appeared in 1 case and recovered 3 months after the operation. The numbness of infraorbital region associated with infraorbital nerve contusion was restored in 1 case. The X-ray ＇ examination showed all fractures were obtained good alignment, satisfied internal fixation of titanium plate without fixator loosen or broken. Conclusion The rigid internal fixation of micro-titanium plate through larvated incisions is a simple and effective treatment for zygomaticomaxillary complex fractures with less operative injury and short duration, and it deserves to be popularized.

关 键 词：颧骨复合体骨折 骨折固定术 内 内固定器 

分 类 号：R782.4[医药卫生—口腔医学]