眼眶骨折200例临床分析

目的探讨眼眶骨折的病因、伤情和临床治疗方法。方法对200例眼眶骨折病因、损伤部位、伤情和治疗进行分析。认为在软组织裂伤缝合时尽可能早期行眼眶骨折整复。眶上壁骨折若视功能和眼位无明显改变者,不必行骨折整复。视神经孔骨折者,可以经筛窦进路行视神经探查。重度颜面凹陷畸形,需要行颧骨、上颌骨复位后钛板固定。内直肌嵌入筛窦,下直肌嵌入上颌窦,在眶内容还纳复位后分别用天然珊瑚人造骨板修复骨孔。结果眶壁重度粉碎性骨折51例行Ⅱ期骨折整复,其余均在软组织清创缝合时行I期整复,视功能均得到不同程度的恢复。结论眼眶骨折经早期和恰当方法整复,完全可以修复颜面畸形,并恢复眼球运动和视觉功能。

Clinical analysis of 200 cases of orbital fracture

Aim To investigate into the causes of, injury condition of and treatment of orbital fractures. Methods A total of 200 cases of orbital fracture were treated. If possible, fracture reduction was performed as early as the broken soft tissue was sutured. However, reduction was not performed in those who had supraorbital wall fracture which did not cause remarkable change in visual function or ocular position. Visual nerve examination was conducted through ethnoidal sinus in cases of visual neuropore fracture. In serious depressed facial fractures, zygomatic bone and maxillary bone were reduced and then fixed with tilanic plates. For those who had medial rectus muscle impacted into the ethmoid sinus or inferior rectus muscle impacted into the maxillary sinus, the bone was repaired with hydroxyapatite bone plates. Results Stage-II reduction was performed on 51 cases of serious comminuted orbital fracture. For the rest, stage-I reduction was performed after the soft tissue was cleaned and sutured. Conclusion In orbital fracture, early and proper plastic surgery can repair facial deformity and restore ocular movement and visual function.