计算机辅助手术导航在单侧复杂颧骨复合体骨折复位与固定中的应用  

Use of computer-assisted surgical navigation in the reduction and fixation of unilateral zygomatic complex fractures

作　　者：李智 程谷 杨荣涛 吕坤 周海华 李祖兵 Li Zhi;Cheng Gu;Yang Rongtao;Lyu Kun;Zhou Haihua;Li Zubing(Department of Oral and Maxillofacial Surgery,School and Hospital of Stomatology,Wuhan University,Wuhan 430079,China)

机构地区：[1]武汉大学口腔医院口腔颌面外科,430079

出　　处：《中华整形外科杂志》2021年第1期29-34,共6页Chinese Journal of Plastic Surgery

基　　金：湖北省卫计委科研项目(WJ2017M047)。

摘　　要：目的评价计算机辅助手术导航在单侧复杂颧骨复合体骨折复位与固定中的应用效果。方法回顾分析2013年1月至2017年12月在武汉大学口腔医院口腔颌面外科应用计算机辅助导航技术完成的单侧复杂颧骨复合体骨折复位与固定治疗患者的临床资料。术前拍摄螺旋CT,将数据导入BrainLAB导航系统或AccuNavi-A导航系统工作站设计手术方案,然后将手术方案导入术中导航工作站,辅助完成颧骨复合体骨折的复位与固定。术后1周内拍摄三维CT,测量健侧和患侧的颧骨突度值,并采用配对t检验比较双侧的差异;同时以双侧颧骨突度值的差值评价颧骨复合体骨折的复位情况,差值的绝对值小于2 mm为达到了理想的复位标准。术后常规复查,评价伤口愈合情况、面形和功能恢复程度。结果共纳入45例患者,其中男性39例,女性6例,年龄21~68岁。患者术后健侧和患侧的颧骨突度值分别为(80.78±6.14) mm和(80.85±6.10) mm,双侧比较差异无统计学意义(t=0.362,P=0.719)。患者术后健、患双侧颧骨突度差值的绝对值为 (0.92±0.68) mm。43例骨折达到理想复位程度,另外2例颧骨突度差值的绝对值分别为2.3 mm和2.2 mm。术后所有患者手术切口愈合良好,未出现感染等并发症,外形及功能恢复均满意。结论在单侧复杂颧骨复合体骨折手术中应用计算机辅助手术导航可以有效确保骨折复位的精确性,获得较好的临床效果。Objective The purpose of this study was to evaluate the effect of computer-assisted surgical navigation in the reduction and fixation of unilateral zygomatic complex fractures.Methods A retrospective analysis was performed on the patients suffering from unilateral zygomatic complex fractures treated by computer-aided surgical navigation technology in the Department of Oral and Maxillofacial Surgery,Hospital of Stomatology,Wuhan University from January 2013 to December 2017.Spiral CT was used before surgery,the data was imported into BrainLAB navigation workstation or AccuNavi—a navigation workstation to design the surgery plan,and then the surgery plan was imported into the surgical navigation workstation to assist the reduction and fixation of the zygomatic complex fracture.Three-dimensional CT was used within 1 week after surgery to measure the reference values of the postoperative healthy and affected zygomatic prominence,which were analyzed by the paired t-test.At the same time,the reduction of the fracture was evaluated by the difference of the bilateral reference values of the zygomatic prominence,and the absolute value of the difference less than 2 mm was judged as exact reduction.All patients underwent postoperative follow-up,and wound healing and facial appearance and functional recovery were evaluated.Results A total of 45 patients were involved in this study,including 39 males and 6 females,aged 21-68 years old.The postoperative zygomatic prominence values of the healthy side and affected side were(80.78±6.14)mm and(80.85±6.10)mm,respectively.There was no statistical significance(t=0.362,P=0.719)between the reference values of the bilateral zygomatic prominence after operation.The absolute value of the difference between the zygomatic prominence of the healthy and the affected sides after operation was(0.92±0.68)mm.Fourty-three cases achieved exact reduction of the fracture.In the other 2 cases,the absolute value of the zygomatic prominence difference was 2.3 mm and 2.2 mm,respectively.The surgica

关 键 词：外科手术 计算机辅助 颧骨骨折 骨折闭合复位 颧骨突度 

分 类 号：R782.2[医药卫生—口腔医学]