经眶周小切口治疗颧骨复合体骨折

Repositioning zygomatic complex fractures via peri-orbital mini-incision approach

目的:介绍经眶周小切口复位固定颧骨复合体骨折(ZMC)的方法与疗效。方法:共治疗93例ZMC骨折,其中单纯经眶周(眉弓外侧和下睑缘下)小切口复位58例(62%),眶周小切口+上颌前庭沟切口复位35例(38%)。术后行临床疗效和影像学观察,随访半年。结果:84例(90%)痊愈,面部畸形与眼球功能障碍完全恢复,眶周无明显瘢痕;9例(10%)明显改善。结论:ZMC骨折经眶周小切口入路治疗创伤小,疗效好,可同期进行眶底探查与眶底骨缺损重建,对复杂性骨折还需联合口内切口复位固定。

PURPOSE： To introduce the approach and clinical effects of repositioning zygomatic complex （ZMC） fractures via peri-orbital mini-incision. METHODS： 93 ZMC fractures were treated by open reduction, in which 58 （62%） were repositioned alone via skin incision of lateral orbital and inferior palpebra margin, and the remaining 35 （38%） via both skin incision and oral vestibular mucous incision. Mini or micro Ti-plates were placed along fracture fissures for fixation. Functional and esthetic evaluations by clinical and radiology examination were done at 1 week after operation. All patients were followed up for 6 months postoperatively. RESULTS： 84 cases （90%） recovered well from their facial deformities and ophthalmic dysfunctions, no obvious peri-orbital scar was noticed. 9 cases （10%） achieved remarkable improvement. CONCLUSION： Repositioning of ZMC fractures via peri-orbital approach can get quite satisfactory results. Exploring and reconstructing bony defects of orbital floor can be completed conveniently at the same time. In more complicated ZMC fractures, additional intraoral incision must be used.