C臂机导向下颧弓骨折复位术

Reduction of Zygomatic Arch Fracture under C-arm X-ray Machine

目的:为了使颧弓骨折复位术能在X线透视下进行,增加复位成功率及即刻评价复位效果,避免矫枉过正现象,拟将该手术在C臂机导向下进行,本文探索该方法的优缺点并评价其疗效。方法:自2003年以来,共对68例单纯颧弓骨折患者,局麻下经口内进路在C臂机导向下进行复位操作。所有患者术前拍颧弓切线位片或CT,明确颧弓骨折的类型,手术当天详细记录病史、张口度和颧面部畸形程度,术后评价即刻效果;3个月后复查,进行临床和影像学(颧弓切线位或CT)评价。结果:术后即刻影像学复查,67例患者复位优,1例患者复位失败,改为开放性手术。术后3个月随访,所有患者创口均Ⅰ期愈合;术后颧面部外形完全对称者占89.55%(60/67),基本对称者占10.45%(7/67);术前平均张口度(2.36±0.25)cm,术后平均张口度(3.7±0.32)cm;CT显示骨折段对位对线好。结论:C臂机导向直视下颧弓骨折复位术,能使骨折段复位更准确,但应选择好适应证和手术时机,并应做好术中X射线的防护。

Objective： To evaluate the effectiveness of C-arm X-ray machine for treating zygomatic arch fracture. Methods： 68 patients from March 1st, 2003 to June 1st, 2007 were retrospectively reviewed. Operative reduction of zygomatic arch fractures were guided under C-arm X-ray machine concomitantly. Results： 67 patients achieved excellent repositioning, one patient failed due to a past injury traumatized 19 days ago. The average operating time was 15 min, and the width of mouth opening increased from （2.36±0.25）cm preoperatively to （3.7±0.32）cm postoperatively. Conclusion： It is concluded that the operation for treating zygomatic arch fracture under C-arm X-ray machine was an ideal method.