眶下进路在颧骨复合体骨折中的应用

目的:寻求颧骨复合体骨折手术治疗减小面部遗留瘢痕的方法。方法:对51例患者采用改良式眶下进路治疗颧骨复合体骨折,对以往眶下缘切口从睑缘改为骨性眶下缘位置即在患者下睑缘下1cm处,相当于眼轮匝肌下方眼袋的位置作同眼轮匝肌方向一致的弧形切口,切开皮肤皮下组织,钝性分离,推眼轮匝肌向上后直达眶下缘,切开骨膜,暴露眶下缘骨折处,其它小切口未做改变。术后均随访2～3个月,对其疗效进行评价。结果:切口隐蔽性好,而且可以充分暴露眶下缘、眶外侧壁、颧弓以及颧牙槽嵴骨折端,所有患者术后均Ⅰ期愈合,患者术后颧骨左右对称性、咬合功能及局部感觉均获得满意效果,除1例由于是疤痕体质面部小切口疤痕比较明显外,其余病例面部疤痕均不明显。结论:该方法创伤小,显露好,路径短,顺皮纹方向,只留下线样切口愈合,疤痕小不影响面部的整体美观。

Infraorbital Approach in the Treatment of Zygomatic Complex Fractures

Objective： To seek a surgical approach which could minimize facial scars in the treatment of zygomatic complex fractures. Methods： 51 fracture cases were applied by a modified surgical approach, incision located at the lower margin of orbieularis palpebrarum muscle. After reduction, all cases were followed up for 3 months. Results： All cases were healed with first intention. Healing scars were obscure and almost hardly to differentiate with nearby Langer＇s skin lines. One case with the exception was an idiopathic collagen fibrous tissue hyperplasia. Conclusion： This modified approach is applicable in the treatment of complex zygomatic fractures with cosmetic demands.