皮下双筋膜切口治疗颧弓M型骨折

Treatment of M type zygomatic arch fracture using two subperiosteal access

目的探讨皮下双筋膜切口治疗颧弓M型骨折的治疗效果。方法对48例颧弓M型骨折患者于中间骨折线表面顺皮纹作切口,顺表浅肌肉腱膜系统(SMAS)表面分离,确认M两端骨折线位置后,在SMAS表面作2个小切口,先分离、暴露M两端骨折线后再于2个切口间的SMAS下骨面贯通,形成隧道,再暴露M中间骨折线。直视下对颧弓M型骨折进行复位、固定。结果所有患者手术时间均缩短,均解剖复位,术后无神经损伤。结论皮下双筋膜切口是治疗颧弓M型骨折较好方法,增大了手术视野,方便了医生操作。

Objective To explore treatment effect of M type zygomatic arch fracture using twosubperiosteal accesses. Methods Forty- eight patients of M type zygomatic arch fracture were treatedthrough two subperiosteal accesses. The patient was dissected until the superficial muscular aponeuroticsystem（SMAS）. Two subperiosteal accesses,which were just above the bilateral fracture position of Mtype zygomatic arch fracture,were then performed. The SMAS was dissected to expose the three fracturelines of zygomatic arch,then treated with reduction and rigid internal fixation under sufficient exposure.Results All patients were anatomic reduction and no nerve injury was seen. The average operation timewas also shortened. Conclusion The two subperiosteal accesses is a good approach for treating the M typeof zygomatic arch fracture. This modified surgical technique expands the operation vision.