颧骨复合体骨折复位径路的临床研究

Clinical analysis of reductive approaches of zygomatic complex fractures

目的:回顾性分析颧骨复合体骨折的复位径路。方法:对1990-11～2004-12在我院颌面外科救治的资料完整的152例颧骨复合体骨折手术病例进行回顾性临床研究。结果:交通事故是导致颧骨复合体发生骨折的主要因素之一。在152例患者中,有20例单纯采用头皮冠状切口(全冠状切口8例,一侧冠状切口12例),38例采取头皮冠状切口+口腔前庭切口(全冠状切口12例,一侧冠状切口26例),有32例采取头皮冠状切口+口腔前庭切口+眶周小切口(全冠状切口15例,一侧冠状切口17例),有18例采取头皮冠状切口+口腔前庭切口+眶周小切口+其他小切口(全冠状切口10例,一侧冠状切口8例),44例单纯采取局部小切口;术后随访平均3年(6～72个月),152例患者中得到随访的有129例(84.8%),治疗效果I级45例(占34.8%);II级72例(占55.8%);III级12例(占9.3%)。117例(117/129,90.7%)患者取得了良好的治疗效果。结论:冠状切口(必要时附加小切口)和单纯局部小切口在不同适应证中均可获得满意的治疗效果。

Objective： To analyze the reductive approaches in treatment of zygomatic complex fractures. Methods： The clinical data of 152 patients from November 1990 to December 2004 were investigated and analyzed, which focused on the surgical approaches. Results： Traffic accident was the leading reason for zygomatic complex fractures. Scalp coronal incision in combination with other incisions or alone was applied in 108 patients, the rest were treated by single local incisions. After medical follow-up（ 129 cases） , 117 patients（90.7% ） were satisfactory with the management results. 45 patients belonged to the Ⅰ class ,72 patients belonged to Ⅱ class, and 12 cases belonged to Ⅲ class. Conclusion： Scalp coronal incision in combination with other incisions or alone and local small incisions provide satisfactory outcome in their respective indications.