额眶区凹陷性骨折整复术式探讨

The applicationo of the dissociate bone flap in treatment of the macrosis depressed skull fracture on the frontal orbit part

目的探索额眶区凹陷性骨折手术修复整形术式。方法在额眶骨折区外周作冠状切口,翻转皮瓣后,在凹陷性骨折旁开约2cm约左右范围钻孔,形成游离骨瓣,在凹陷性骨折碎片周围形成足够的操作空间后,再取下游离的碎骨片,用骨膜剥离子撬起凹陷的眶板复位后用骨胶原位粘合,取下的游离性骨瓣及碎骨片复位后用骨胶粘合形成新的完整的骨瓣,内板不平整处可用骨蜡修复平整,尽可能将骨瓣内的碎骨片整理归位,再将游离性骨瓣还纳固定。结果2000年1月至2004年12月我们为17例颅脑外伤额部及眶区巨大凹陷性骨折患者采用此方法进行了修复,所有病例均取得较好疗效,未见有任何并发症,痊愈后患者容貌恢复正常。结论凹陷性骨折游离骨瓣成型手术整复法可以避免凹陷性骨折撬抬复位的并发症,整复效果好。

Objective To study the reconstructive effect of the dissociate bone flap to repair the macrosis depressed skull fracture on the frontal and orbit part. Methods The coronal scalp flap was elevated and dissociate bone flap was expanding to the 2cm width beside the edge of depressed skull fracture. The first step was to extract the dissociate bone flap and make there is an area for operating . Then extract free bone fragments, and elevate the depressed orbital lamina and use the biological glue to stick it to its position. The free fragments extracted were sticked into a whole one and it to its position in use of the biological glue on the dissociate bone flap. The uneven inner table should was smoothen with bon-wax. The prosthetic dissociate bone flap was put back on its position and fixation. Results From January 2000 to Deeember 2004, 17 cases of the macrosis depressed skull fracture on the frontal and orbit part undertaken plastic surgery by the dissociate bone flap to treat the macrosis depressed skull fracture and obtaiued excellent curative effect. Conclusions Using dissociate bone flap to treat the muerosis depressed skull fracture on the frontal and orbit part can avoid the complication of the traditional operation, and make the method become a plastic surgical operation.