开放性眼眶骨折沿原创口Ⅰ期微钛板坚固内固定术的临床观察

Clinical observe of internal fixation with titanic micro-plates along with original wound in stage-Ⅰ of opening orbital fractures

目的探讨开放性眼眶骨折沿原创口Ⅰ期微钛板坚固内固定术的手术方法并评价其临床效果。方法除外严重的眶颅复合伤,对21例(21眼)开放性眼眶骨折,先行眼眶螺旋CT检查并行螺旋三维CT成像重建眼眶及眶周影像及明确骨折处。术中以充分暴露骨折线为原则,在清创的同时,将原外伤创口顺延扩大或不扩大,术中植入微钛板并坚固内固定。其中一例合并下眶壁塌陷,术中植入羟基磷灰石骨板。结果21例均达到Ⅰ期愈合,观察3个月,并行CT检查,未发现感染或微钛板排斥、脱落,眼眶成形效果好、无明显眼功能障碍。结论微钛板坚固内固定眼眶骨折手术简便,固定效果可靠,是眼眶骨折的一种理想治疗方法。开放性眼眶骨折Ⅰ期手术沿原创口入路是可行的同时也是经济的。

Objective To evaluate the operation using internal fixation with titanic micro-plates along the original wound in stage-I to cure the opening orbital fractures and its the clinical effect.Methods Except for severe trauma of orbitocranium,examination were performed on the 21 opening orbital fractures patients at first by using the orbital helical CT scan,and used 3D CT to reconstruct the orbital and periorbital images to make clear the place of fracture.The surgery operated on the principle of fully exposing the fracture lines with the wound expanding or not.The titanic micro-plates would be interal fixation inside in the operation.Results While performing the debridement,21 cases were treated with interal fixation with titanic micro-plates along with original wound in stage-I,one of whose inferior wall of orbit was implanted hydroxyapatite block.Conclusions 1.The interal fixation with titanicmicro-plates in orbital fractures which is simple and reliable,is an ideal method to cure the orbital fractures.2.It is feasible and economical to perform the operation through the original wound in stage-I of opening orbital fractures.