自体阔筋膜修复治疗单纯眼眶下壁爆裂性骨折

Blow-out fracture with orbital floor repaired by auto-fascia

目的评价自体阔筋膜修复治疗单纯眼眶下壁爆裂性骨折的效果。方法将21例(21只眼)单纯性眼眶下壁爆裂性骨折患者根据骨折范围分为2组,骨折范围>2cm2者9例(9只眼),≤2cm2者12例(12只眼),行自体阔筋膜修复术,术后随访3～6个月。观察两组术后复视,眼球突出度情况及视力。结果复视完全消失15例(71.43%),眶下壁骨折>2cm2者眼球内陷矫正2例(22.2%),≤2cm2眼球内陷矫正10例(83.3%),视力提高5例(23.8%)。结论应用自体阔筋膜经下睑缘入路治疗单纯眶下壁爆裂性骨折,能有效地恢复眼球运动。修复眶腔,对于损伤≤2cm2病例效果较好。

Objective To evaluate the therapeutic effects of using auto-fascia in the treatment of blow-out fracture with orbital floor. Methods 21 eases （21eyes） of orbital blow-out fracture with inferior wall were divided into two groups by the orbital floor fracture ranged. Of them ,9 cases suffered the orbital floor fracture ranged 〉 2 cm^2 and 12 cases with the orbital floor fracture ranged ≤2 cm^2 and all were treated with auto-fascia. Follow-up ranged from 3 months to 6 months. Postoperative diplopia , endophthalmose and visual acuity were observed. Results The symptom of diplopia was eliminated completely in 15 cases, and 6 eases remaining diplopia in ambitus. Among those with orbital floor fracture ranged 〉 2 cm^2 , 2 cases （22.2%）had satisfactory Results in correction of endophthalmoses, while 10cases （83.3%） had good Results for orbital floor fracture ranged≤2 cm^2, 5 eases（23.8% ） had satisfactory Results in improving visual acuity. Conclusion The auto-fascia via lower lid subciliary approach repairing blow-out fractures of orbital inferior walls is an effective technique. The Results are good for improving eye movement especially for fracture ranged ≤2 cm^2.