应用计算机辅助手术导航系统经口内径路复位颧弓M型骨折临床观察

Reduction of zygomatic arch M-shaped fracture with computer-assisted navigation system by intraoral approach

目的探讨应用计算机辅助手术导航系统经口内径路复位颧弓M型骨折的技巧及经验。方法 2012年1月至2014年12月武汉大学口腔医学院47例颧弓M型骨折分为非导航组（26例）和导航组（21例）。非导航组患者20例经口内径路,6例经颞部小切口,26例中低年资医师开展3例。导航组患者均应用计算机辅助手术导航系统经口内径路进行开放复位,其中7例由低年资医师完成。术后随访3~6个月。结果非导航组1例经口内径路复位效果不佳,另1例术后复查X线片显示颧弓骨段塌陷,其他病例以及导航组全部病例均复位效果满意。结论应用计算机辅助手术导航系统经口内径路复位颧弓M型骨折是一种安全、高效、易于掌握的方法,尤其有利于低年资医师快速掌握手术技巧。

Objective To analyze surgical reduction of zygomatic arch M-shaped fractures, and to summarize experi- ence of the application of navigation. Methods Forty-seven zygomatic arch M-shaped fractures were divided into two groups：group without navigation（26 cases）and group with navigation （21）. In group without navigation, 20 cases were re- duced by intraoral incision, and 6 by temporal incision;junior surgeons conducted the reduction in 3 cases. In group with navigation, all the cases were treated by intraoral reduction with navigation ;junior surgeons conducted the reduction in 7 cases. The duration of follow-up ranged from 3 to 6 months. Results In group without navigation, one case failed to be restored by intraoral incision, and another case was identified fracture fragment collapse postoperatively. All other frac- tures healed without complications in both groups. Conclusion Intraoral reduction of zygomatic arch M-shaped frac- ture with computer-assisted navigation system is an effective and useful way to achieve better treatment effects, and espe- cially easy for junior surgeons to master.