25例颧上颌复合体骨折诊治方法的探讨

Treatment of zygomaxillary complex multiple fractures:An analysis of 25 consecutive cases

目的:对颧上颌复合体(ZMC)骨折的致伤原因、三维CT检查及坚强内固定方法进行回顾性分析。方法:25例患者均经三维CT检查、图像重建并行坚强内固定手术治疗,术后随访3～12个月。结果:25例患者中,交通事故伤13例(52%),工业事故伤5例(20%)。局部塌陷畸形21例,咬合紊乱19例,张口受限15例,复视伴眼并发症17例,眶下神经支配区麻木11例,5例伴有上颌矢状骨折。25例患者三维CT重建图像均清晰显示主体解剖图像及周围关系,图像直接显示了颌骨骨折的部位及空间结构关系。所有患者选用微型钛板行坚强内固定手术治疗,22例获得满意效果。结论:对于ZMC骨折患者,通过选择局部切口、冠状切口及前庭沟切口,用微型钛板行坚强内固定术,可以获得满意的疗效。

PURPOSE: This retrospective study was performed to analyze the causes,3D spiral CT examination and the treatment of ZMC fractures. METHODS: Rigid internal fixation was used in 25 patients with ZMC fractures after 3D spiral CT examination and anatomical reduction.The patients were followed up for 3 to 12 months. RESULTS: In the 25 cases,13 cases had traffic accident injury,5 had industrial accident injury.Local collapsed teratism were found in 21 cases,malocclusion was noted in 19 cases,limitation of mouth opening was found in 15 cases,displopia was in 17 cases,infraorbital numbness in 11 cases,5 cases had sagittal maxillary fracture.Spiral 3D CT images showed the steric anatomical images and relationship to the adjacent structures clearly in 25 patients.All patients were treated via rigid internal fixation with titanium plates and pins.22 patients had satisfied maxillofacial appearance. CONCLUSION: Using topical,coronal and vestibular incisions accordingly,and rigid internal fixation with titanium plates,satisfied outcomes can be achieved in patients with ZMC fractures.