两种方法治疗颧骨骨折的临床分析

Clinical analysis of two methods in surgical treatment of zygomatic fracture

目的:探讨面部小切口联合口内切口配合单齿勾治疗颧骨骨折与经头皮冠状切口联合口内切口治疗颧骨骨折的临床疗效。方法:根据Kni ght和Nort h的分类方法[1](简称KN分类),回顾性总结了42例颧骨颧弓骨折,手术入路分别采用面部小切口配合单齿勾联合口内切口复位、固定颧骨及经头皮冠状切口联合口内切口复位、固定颧骨,通过术后临床检查、X线检查和CT评价不同术式的治疗效果,分析出现的并发症。结果:两种术式均可取得满意效果,并发症在一定时期内消失。结论:面部小切口配合单齿勾治疗颧骨骨折KN分类Ⅲ、Ⅳ、Ⅴ型效果良好,创伤小,单齿勾的应用能有效使移位的骨折块复位,缩短复位时间;经头皮冠状切口治疗颧骨骨折KN分类第Ⅵ型能充分暴露骨折区,联合口内切口利于解剖复位及内固定,是治疗KN分类第Ⅵ型骨折的有效方法。

ObjectiveTo assess the small facial incision with Dan Chi Gou and coronal scalp incision treatments for patients with zygomatic fracture.Methods42 cases with zygomatic fracture （KN type III, IV,V,VI） were reviewed retrospectively.The surgical approaches were combination incisions through small facial incision with Dan Chi Gou, zygomatic fixation, and combination incisions through coronal scalp incision,zygomatic fixation. The curative effect was evaluated by clinical examination and radiography and CT results.Complications were analyzed.ResultsBoth of the two methods had successful results. Complications were cured in a period of time.ConclusionSmall facial incision with Dan Chi Gou in surgical treatment is a good solution in dealing with type III,IV and V zygomatic fracture;it can effective reset the fracture with application of Dan Chi Gou, less wound and less reset time are another advantage. Coronal scalp incision in surgical treatment is a good solution in dealing with type VI zygomatic fracture. It can fully expose fracture zone, and the combination incision is good for anatomic and internal fixation.