全面部骨折临床诊治

The clinical diagnosis and surgical treatment of panfacial fracture

全面部骨折特指面中1/3和面下1/3的骨骼同时发生的骨折。全面部骨折除有严重的局部损伤外,常伴发颅脑伤以及全身多个器官损伤,救治中不仅要考虑局部因素,更要涉及初期急救时系统损伤救治的相关问题。因此,初期救治中应遵循标准的急诊创伤处理ABCs法,首先救治危及生命的损伤,然后尽早实施专科确定性手术治疗。术前应有明确的影像学诊断,精确了解骨折部位、骨折段移位情况。遵循良好显露,直视下骨折复位,坚强内固定的手术原则。本文根据作者的临床经验,简要评述全面部骨折的治疗原则和方法要点。

Panfacial fracture is a kind of fracture that happens in both the middle and lower face at the same time,which is usually accompanied by cerebral and other important organs damage besides severe facial injury. It needs not only emergency medical treatments for facial damage,but also concerns systemic injury. The ABCs concepts of emergency medical treatments should be used in the primary treatment of panfacial fracture patients,which means the first is to rescue life and then to perform fractures fixation as early as possible. The CT scan and other imageological examinations should be performed to know the positions and movements of fractures before surgery. The good exposure and rigid fixation should be followed in the operation.