自体骨移植整复眶底爆裂骨折的临床研究

A clinical study on resconstruction of the orbital floor blowout fracture with autogenous bone grafts

目的：比较四种自体骨整复眶底爆裂骨折的适用性. 方法：用髂骨、上颌窦前壁、下颌骨颏联合部或喙突移植整复16例眶底爆裂骨折,术后随访1个月和3个月,检查眼球陷没、复视和眼球运动障碍的恢复及供区并发症情况. 结果：15例患者两侧眼球对称,无复视,眼球运动自如；1例有轻度的复视和眼球运动障碍.供骨区均未出现严重的并发症. 结论：四种自体骨均可用于整复眶底爆裂骨折,较小或中等的眶底缺损宜选用上颌窦前臂骨质,较大的缺损宜选用下颌骨颏联合部或喙突的骨质.

Objectives:To compare the usefulness of four sources of b one grafts for the reconstruction of the orbital floor. Methods:A r etrospective study was conducted on 16 patients who had orbital floor blowout fr actures reconstructed with autogenous bone grafts from the ilium,the antral wall , the mandibular symphysis or the coronoid process.Patients were examined at rec all visits for any evidence of unsuccessful reconstructin by checking enophthalm ous,diplopia and extraocular movements. Results:During a three-mont h follow-up,there was a good restoration of the orbital floor,with no clinical e v idence of enophthalmous,diplopia or imperfect extraocular movement in 15 patient s.Slight diplopia and slightly restricted extraocular movement were observed in one patient.The patients with iliac graft had transient(1 to 2 weeks) limp,and t he patients with coronoid process grafts had transient (7 to 10 days) trismus. Conclusions:The ilium, antral wall,mandibular symphysis,and coronoid process make excellent donor graft sites for reconstruction of orbital floor de fects.The antral wall is suitable for the repair of small to moderate-sized orb ital floor defects,and mandibular symphysis and coronoid process are suitable fo r the repair of large-sized orbital floor defects.