颌面部多发性骨折的临床治疗分析

Clinical analysis of the multiple fracture in maxillofacial region

目的探讨颌面部多发性、复杂性骨折的治疗策略。方法应对非陈旧性的颌面部多发性骨折，联合神经外科、眼科、耳鼻喉科进行会诊，制定合理手术治疗方案。在骨折复位和固定治疗中，联合应用颌间结扎、钛板坚固内固定、皮瓣修复等多种技术，尽可能恢复患者的功能和面容外观。结果本组45例患者均在伤情稳定后进行骨折的整复治疗，对41处上颌骨骨折，33处下颌骨骨折，14处鼻骨骨折，12处髁突骨折，6处眶壁骨折，5处颧骨骨折进行复位和固定。术后随访3～12个月，骨折复位良好，效果满意。结论多临床学科的协同诊治有利于为患者提供更好的治疗，根据骨折的具体情况，合理选择适当的切口入路和结扎、固定方式，是颌面部多发性复杂骨折的有效治疗方法。

Objective To explore the treatment strategy of maxillolaeial multiple complex fracture. Methods An optimal theraputic plan was made based on clinical consultation by surgeon from neurosurgery, ophthalmology, otolaryngology and stomatology, to repair the facial multiple fracture as far as possible. Anatom- ical function and aesthetic outcome were restored via intermaxillary fixation, rigid internal fixation and surgical flap repair. Results All 45 patients received the treatment of fracture at the stable stage after trauma. Among them, 41 maxillary fractures, 33 mandible fractures, 14 nasal bone fractures, 12 condyle fractures, 6 orbital fractures, 5 zygomatic fractures were repaired and reconstructed. Follow-up was performed for 3 to 12 months, and all cases received satisfactory results with good fixtion of the fracture. Conclusion Combined treatment strategy from multiple departments＇ consultation opinion can better serve the patient. Meanwhile, reasonable choice of incision and fixation technique is an effective approach for the treatment of multiple complex maxillofa- cial fracture.