伴眶周骨折的颌面复合性骨折的临床诊治特点

目的：分析伴眶周骨折的颌面部复合性骨折的临床诊治特点。方法：对收治的38例伴有眶周骨折的颌面部复合性骨折的诊断方法、治疗措施进行分析。其中颧骨、上颌骨伴眶周骨折19例、颧骨颧弓伴眶周骨折9例、上颌骨伴眶周骨折6例、鼻眶筛骨折2例、爆裂性眶眼骨折2例。结果：本组38例中有37例采用手术治疗，除3例视神经损伤出现失明外，其余病例面部外形、眼部症状及口腔功能均恢复良好，10例复视全部消失。结论：在颌面复合性骨折的诊治中，眶周骨折的诊断和处理不容忽视；在诊断上X线检查成为必要的手段，但应合理应用；对眼眶的处理同样需要一个合理、完整的计划。手术的目的应以恢复功能、改善外形为原则；钛板、钛网在眼眶的修复中有良好应用价值。

The Specialities of Diagnosis and Management for the Maxillo-facial Fracture with Orbital Fractures

Objective: To study the characters of the diagnosis and treatment for maxillo-facial complex fracture with orbital fracture. Methods: 38 cases of maxillo-facial complex fracture with orbital fracture were treated between 1995 to 2002.The cases included zygoma-maxilla fracture (19 cases), zygomatic bone fracture (9 cases), maxilla fracture (6 cases), NOE fracture(2 cases) and blown-out fracture(2 cases). Results: Three cases had lost sight in one eye because of injuring of the optic nerve during the accident. 37 cases were treated by operation. 1 case without obvious functional and morphologic change had not received the operation treatment. All of the cases we treated gained a satisfactory result in their oral and maxillo-facial function and appearance. In 10 cases with diplopia got a good sight after operation. Conclusion: The diagnosis and management of the eye and obit are important in mid-face fracture cases. X-ray examination is necessary and it should be used reasonably. A complete plan of the treatment for the orbital fracture should be also made before the operations.