陈旧性眶颧骨折合并眼球内陷的治疗

The treatment of late orbitozygomatic fracture with enophthalmos

目的:探讨陈旧性眶颧骨折后眼球内陷的整复治疗。方法:术前常规行X线检查、眶部轴面及冠状位扫描及三维重建,了解眶颧骨骨折及眶内容物移位嵌顿情况。术中首先暴露骨折部位,将移位的骨折块截骨复位、微型钛板坚强内固定,重建正常的眶缘;用自体或人工材料植入,同时修复眶壁。结果:所有病例眼球内陷均得以明显改善或矫正,颧部外形明显改善,眼球运动功能得以恢复,CT显示眶结构恢复良好,内直肌及下直肌位置及形态正常,视神经无受压。结论:陈旧性眶颧骨折所致晚期眼球内陷畸形可通过截骨复位、植入自体或人工材料重建眶缘,修复眶骨各壁的缺损获得有效矫正。

Objective To study the surgical treatment of enophthalmos deformity caused by orbitozygomatic fractures. Methods X-ray, A coronal and an axial computed tomography scan of the orbit, and three-dimensional CT reconstruction were employed to demonstrate the status of the orbitozygomatic fracture and the displacement and herniated orbital contents of the patients preoperatively. Following exposed the fractured area, the displaced orbital bones were repositioned after osteotomy and rigid fixed by micro-plate and screws to reconstruct the orbital rim. Then the fractured orbital walls were repaired precisely with autogenous bone and biomaterial which were fixed to the area beneath the periosteum. Results All patients had their enophthalmos deformity corrected and regained satisfactory zygomaticofacial appearance with this technique. The movement of the globe recovered well, postoperative CT scan demonstrating orbital walls were reconstructed well, the location and formation of medial and inferior rectus muscle were normal, and there was no optic nerve compressed. Conclusions The late orbitozygomatic fracture with enophthalmos deformity can be corrected or obviously improved by the reduction of displaced bone fragments and precise reconstruction the orbital walls with autogenous bone and biomaterial.