面中部骨折伴发眶底骨折的临床分析

Clinical Analysis of Midfacial Fractures with Orbital Floor Fractures

目的探讨面中部骨折伴发眶底骨折的诊治方法。方法对136例面中部骨折伴发眶底骨折患者的治疗进行回顾性研究。136例患者均采用切开复位内固定术进行治疗,其中49例行眶底手术治疗,21例有眶底骨缺损的患者采用自体骨、钛网或多孔高分子聚乙烯进行眶底重建。结果136例骨折患者的面部外形和功能显著恢复,术后未发生永久性严重并发症,仅2例出现切口局部感染,1例暂时失明,经及时治疗后痊愈。结论面中部骨折伴发眶底骨折的首选诊断方法是CT;治疗原则是恢复眶底的解剖形态和眶腔容积,还纳疝入上颌窦的眶内容物,植入修复材料重建眶底。

Objective To study the characters of the diagnosis and treatment for midfacial fractures with orbital floor fractures. Methods 136 cases of midfacial fractures with orbital floor fractures were diagnosed and treated. All patients underwent CT scans and accepted surgical intervention. Orbital floor fracture was restituted in 49 cases. Orbital floor defects were reconstructed with autogenous bone, titanium mesh or porous polyethylene implant （Medpor） in 21 cases. Results 136 cases recovered well, their facial appearance and function were improved significantly. There were no severe complications happened postoperatively in all cases. 2 cases had postoperative wounds infection and 1 case had temporary ablepsia, but healed completely. Conclusion CT is the best method for diagnosing orbital floor fractures. The objective of treatment is restoration of normal orbital floor and orbital capacity, the reduction of orbital contents prolapsed and reconstruction of orbital floor fractures with repair materials.