颧骨骨折复位径路与固定部位的临床研究

目的　探讨颧骨骨折复位的径路与钛板固定部位。方法　总结 6 5例 (6 5 / 70 )颧骨或颧骨复合体骨折手术复位固定患者的软组织切口、钛板固定部位、钛板数目 ,术后随访 3～ 2 4个月 ,按三级标准评价手术效果 ,其中包括面形和功能的恢复 ,手术切口愈合情况 ;观察术后X线片 ,统计钛板的固定部位、数目及手术并发症。结果　手术软组织切口均一期愈合 ;面形恢复满意、两侧对称、开闭口功能正常 18例 (2 5 7% ) ;面形恢复两侧基本对称 ,开闭口功能正常 4 6例 (6 5 8% ) ;面形恢复两侧不对称 ,开闭口功能基本恢复为 6例 (8 5 % ) ;头皮下血肿 5例 ,钛板外露 1例 ,头皮有不规则瘢痕且宽度 >0 5cm 6例 ,额部和头皮感觉异常 8例。结论　应用冠状切口 (包括口内联合切口 )对 5 1例(5 1/ 6 5 )进行颧骨和颧骨复合体骨折复位固定 ,具有术野显露广泛、在明视下解剖复位、精确固定的优点。 6 5例共用钛板 179块 ,坚固内固定具有精确固位、外形稳定的优点。单纯颧骨骨折下端内陷或外翘移位可做一点固定 ,其他骨折尤其是复杂或陈旧性骨折均应做二点或多点固定

A clinical investigation on the surgical approach and fixation in operative treatment of zygomatic fractures

Objective To investigate the effect of soft tissue incision and rigid internal fixation in the treatment of zygomatic fracture Methods 70 cases with zygomatic fracture were entered into the study The clinical data of 65 patients who were performed operations in the treatment were analyzed The study focused on the incision, number and locations of Titanium plate The facial contour, reduction,fixation, healing of incision, facial bisymmetry and complications of the operation were followed up 3 24 months after surgery Results All the incisions were primary healing Clinical and radiologic assessment of reduction was symmetric and stable in 91 5% of all cases, asymmetric in 8 5% of all cases Subcutaneous hematoma happened in 5 cases,Ti plate exposure 1 in case,scalp scar width was more than 0 5cm in 6 cases,frontal part or scalp paresthesia 8 cases Conclusions Coronal scalp incision has advantages such as good exposure, precise removal of the bone block and good symmetry of both sides. RIF can improve the stability of fracture, promotes fracture healing and guarantes the rehabilitation of zygomatic complex direct reduction and rigid internal fixation with Titanium microplate or miniplate are satisfactory in zygomatic fracture