眶上颌颧骨骨折78例临床分析

目的探讨眶上颌颧骨骨折的诊断方法与治疗特点。方法回顾性总结2004年1月～2008年4月因眶上颌颧骨骨折住院并治疗的78例患者的临床资料，术前均行CT扫描和三维重建，术中采用头皮冠状切口或半冠状切口切开复位加钛板坚固内固定术，对有眶缺损畸形的患者应用Medpor、颅骨外板或钛网进行眼眶缺损修复和眼球内陷的复位。结果随防3～12月，除面部畸形1例、咬合不正1例、张口受限2例外，余病例治疗效果均较满意。结论CT三维重建技术为眶上颌颧骨骨折的手术设计和实施提供了新的可靠的手段；头皮冠状切口开放复位内固定是合适的手术径路；对有眶缺损的患者应用Medpor、颅骨外板或钛网进行整复是安全有效的治疗方法。

A Clinical Analysis of 78 Cases with Orbital Maxillary Zygomatic Fractures

objective To study the diagnosis and treatment of orbital maxillary zygomatic fracture. Methods 78 patients with orbital maxillary zygomatic fractures from Jan 2004 to Apr 2008 were reviewed and summarized, CT and CT three-dimensional reconstruction were performed preoperative. coronal or hemicoronal incision open reduction plus solid titanium plate fixation were adopted for surgery. As for orbital defect in these patients, medpor,outside of the skull or titanium mesh were applied to repair defects and the reduction of enophthalmos. Results All these cases were followed up 3 to 12 months, one of them had facial deformity, one had malocclusion, two had restriction of mouth opening, the treatment results of the rest appeared to be reasonably satisfactory. Conclusion 3D CT provides a new reliable method for designing and practicing operation in orbital maxillary zygomatie fracture, coronal incision is the appropriate approach for surgery. Medpor implant, outside of the skull plate or titanium mesh was safe and effective material for orbital defects.