耳前长角形切口在复杂颧骨复合体骨折复位内固定术中的应用

Long-corniform Preauricular Approach to Open Reduction and Internal Fixation of Complicated Zygomatic Complex Fractures

目的:探讨应用耳前长角形切口在复杂颧骨复合体骨折切开复位内固定术中的应用效果。方法:在106例复杂颧骨复合体骨折切开复位内固定术中采用耳前长角形切口,术区皮下肿胀分离后沿皮下翻瓣,在颧弓上方2cm切开颞深筋膜浅层并沿此层深面剥离到颧弓,分离显露骨折部位,直视下行骨折复位内固定术。结果:术后通过临床及影像学检查随访,效果满意,无严重并发症。结论:耳前长角形切口结合皮下肿胀分离技术不但为复杂颧骨复合体骨折复位内固定术提供良好的视野,方便骨折复位固定,而且与头皮冠状切口相比大大减少了损伤和出血,值得临床推广。

Objective：To evaluate the clinical results of open reduction and internal fixation of complicated zygomatic complex fractures using a long-corniform preauricular access.Methods：106 cases with complicated zygomatic complex fracture were underwent open reduction and internal fixation through a long-corniform preauricular access.The subcutaneous tissue flap was dissected and elevated after the surgical field was infiltrated with tumescent solution,then the superficial temporal fascia was incised on 2cm above the zygomatic arch and dissection was performed under the superficial temporal fascia downward to the zygomatic arch.When the fracture stumps were separated and appeared,straightforward reduction and internal fixation were performed.Results：Through clinical and radiologic postoperative examinations,satisfactory results were obtained with few complications.Conclusion：Combined with subcutaneous tumescent solution infiltration technique,not only the long-corniform preauricular access can provide an excellent view of the surgical field,facilitating handling of the fracture,but also it can reduce injury and hemorrhage dramatically compared with scalp coronal incision.