颧弓颧骨骨折治疗160例临床分析

Investigation of treating zygomatic fracture with minimally invasive surgery

目的分析颧骨颧弓骨折的临床特点,评价其治疗方法。方法将颧弓颧骨骨折分四类(Ⅰ类:颧弓颧骨线型骨折无移位;Ⅱ类:单纯颧弓骨折伴移位;Ⅲ类:颧弓颧骨骨折伴移位;Ⅳ类:颧弓颧骨骨折伴上下颌或鼻骨、颅底骨骨折),采用保守治疗,或在口内切口、头皮冠状切口、下睑缘下切口等前提下复位,利用小型钛板、钢丝固定等方法治疗颧弓颧骨骨折160例。结果Ⅰ类8例均为优(100%);Ⅱ类优27例,占84.4%(27/32),良5例,占15.6%(5/32);Ⅲ类优42例,占58.3%(42/72),良28例,占38.9%(28/72),差2例,占2.8%(2/72);Ⅳ类优18例,占37.5%(18/48),良23例,占47.9%(23/48),差7例,占14.6%(7/48)。结论根据不同的颧弓颧骨骨折类型而选择不同的手术进路,及早手术治疗,采用钛板内固定或钢丝结扎固定,慎重使用假体植入物等,是减少手术创伤、提高疗效的关键。

Objective To investigate the clinical characterisitics and to evaluate the methods in zygomatie fracture with minimally invasive surgery. Methods 160 cases with zygomatic fi＇acture were classified into 4 types-Class Ⅰ to Ⅳ. Conservative treatment and different surgical, approaches and fixatron were applid according to different types. Follow-up was 3 months for all cases, the result for each kind of fractures were analysed. Results 8 cases had excellent result for Class Ⅰ. In Class Ⅱ , 27 cases （84.4%） had excellent result, 5 cases （15.6%） were good. In Class Ⅲ, 42 cases （58. 3% ） were regarded as excellent result, 28 cases （38.9%） were good, 2 cases （2.8%） were poor. In Class Ⅳ, 18 cases （37. 5% ） hadexcellent resuit, 23 cases （47.9%） were good, 7 cases （ 14. 6% ） were poor. Conclusion Different surgical approaches should be selected for different kinds of zygomatic fracture. Patients should he treated in internal fixation with titanium plates or in ligation with steel wires as soon as possible. We should use prosthesis implantation deliberately. All of these factors mainly affect the surgical injury and the effect of treatmen.