面中部陈旧性骨折外科矫治17例

Surgical Correction of Old Midface Fractures

目的:介绍面中部陈旧性骨折的治疗方法。方法:对17例有颜面部畸形与眼、牙合功能障碍的面中部陈旧性骨折行手术矫治。根据螺旋CT诊断结果,采用头皮冠状切口、眶周小切口、口内切口进路行骨折复位固定。行LeFortⅠ型截骨术矫正错牙合畸形6例,眶底骨缺损重建术6例,自体喙突或肋软骨移植矫正鼻根塌陷畸形各1例。结果:全部手术切口一期愈合,眶周与头皮切口无明显瘢痕。面部外形恢复满意14例,显著改善3例。6例错牙合畸形中4例完全矫正,2例改善。6例眼球移位与复视者均恢复正常。结论:螺旋CT对面中部陈旧性骨折的诊治有重要价值。面中部陈旧性骨折的手术矫治应准确恢复面部对称与三维突度,矫正错牙合畸形,重建眶底骨缺损。

Objective： To elaborate the surgical procedures for the correction of old midface fractures. Methods： 17 cases of old midface fractures manifested with facial deformities, eye disfunction, and malocclusions. Operation procedures included Le Fort I ostectomy, orbital floor rehabilitation, autotransplantation of coronoid process or rib cartilage. Results： All the surgical wounds were healing by first intention.14 cases with satisfaction in facial contours, the other 3 significantly improved. Malocclusion was corrected in 4 cases, 2 cases improved. 6 cases with diplopia recovered to normal. Conclusion： Spiral CT technology plays a significant role in the diagnosis of stale midface fractures; The guidelines for the correction of stale midface fractures were mentioned.