摘要
目的 :探讨颧骨复合体骨折致伤原因、临床特点及治疗方式选择。方法 :通过病案记录研究 79例患者的临床资料 ,复位质量及面部外观评价依据临床观察及影像学检查。随访 3～ 12个月。结果 :79例患者中 87.3 %为男性 ,主要是 2 0～ 4 0岁的青壮年 ,占 73 .5 %。交通伤为主要致伤原因 ,占 5 8.2 % ,其次为暴力伤 ( 15 .2 % )。颧面畸形、眼球内陷、复视、张口受限、咬合错乱发生率分别为 83 .5 %、2 4 .1%、19.0 %、60 .8%、3 5 .4 %。神经损伤以眶下神经为主 ,占 4 1.8% ,其次为面神经 ,占 13 .9%。最常用的手术进路为冠状切口 +前庭沟切口 ( 3 0 .4 % ) ,其次为单纯冠状切口 ( 2 2 .8% )。 4 0 .5 %的患者应用小型钛板坚固内固定 ,2 0 .3 %的患者将小型钛板固定技术与钢丝结扎结合使用。74例患者获得了满意的颧面部外形。3例患者术后仍有轻度复视及眼球内陷。所有咬合错乱的患者均获得功能性咬合。结论 :颧骨复合体骨折有多种治疗方法 ,可根据情况选择使用。应用冠状切口或辅加其它切口进路及小型钛板坚固内固定技术可获得满意的疗效。
砄bjective: To study the cause,clinical characteristics and treatment of zygomatic complex fractres(ZCF). Methods: Medical records of 79 cases with ZCF and followed up for 3 months to 2 years were reviwed and analysed. Reduction and cosmatic outcome were assessed by clinical evaluation and postoperative images. Results: Of the 79 patients, 87.3% were male, with the peak incidence in the age group from 20 to 40 years old(73.5%). 58.2% were due to traffic accidents, 15.2% to assalts. Incidence of malar asymmetry, enophthalmos, diplopia,limited mandiblar movement and malocclusion were 83.5%,24.1%,19.0%, 60.8% and 35.4% respectively. Of the nerve disturbances, 41.8% of the infraorbital and 13.9% of the facial nerve were involved. For the treatment the most freqently used approach was the coronal incision in combination with the maxillary vestibular incision(30.4%), followed by coronal incision alone(22.8%). 40.5% of the patients were treated by rigid internal fixation with titanium miniplates alone or combined with wire fixition(20.3%). All patients but five regained satisfactary facial appearance. Three patients still showed slightly post surgical enophthalmos and diplopia at a 6 month follow up. All of the patients with malocclusion regained their functional occlusion after treatment. Conclsions:A variety of techniques can be used in the treatment of ZCF. Among them the coronal incision in combination with other incisions or alone and rigid internal fixation can produce a satisfactary outcome.
出处
《实用口腔医学杂志》
CAS
CSCD
北大核心
2001年第5期422-424,共3页
Journal of Practical Stomatology
关键词
颧骨复合体
骨折
坚固内固定
冠状切口
Zygomatic complex
Fracture
Rigid internal fixation
Coronal incision
