拼接式人工骨板在微创眶壁骨折修复手术的初步应用研究

Preliminary Study on the Application of Mosaic Type Artificial Bone Plate in Repair of Minimally Invasive Orbital Wall Fracture

目的探讨将片状人工骨板拆分为条形骨板,从而使眶壁骨折骨板植入切口缩小达到微创化的可行性。方法随机选择18例眼眶骨折患者实行常规骨折修补手术组(对照组);10例经内窥镜行拼接式人工骨板骨折修复手术组(观察组),比较分析两组手术皮肤切口长度。结果拼接式人工骨板骨折修复手术组(观察组)患者皮肤切口平均为(1.30±0.32)cm,常规骨折修补手术组(对照组)患者皮肤切口平均为(3.6±1.0)cm,两组间比较差异有统计学意义(P<0.05)。两组患者骨壁修复良好,双眼突出度对称,骨板位置无移位,无眶内容坎顿,无排斥及感染发生。结论拼接式人工骨板植入是眶壁骨折的有效修复方式,可以成为眶壁骨折修复手术微创化的有力支持技术,尤其是为经鼻入路和经结膜入路的修复提供了新的思路。

Objective The artificial bone plate was split into lamellar bone plates to make the incision of bone plate implantation of orbital wall fractures as small as possible to be minimally invasive. The feasibility is to be investigated.Methods 18 cases of orbital fracture patients were randomly selected to undergo conventional fracture repair surgery（ control group）; 10 cases needed to have mosaic typeartificial bone plate fracture repair surgery through endoscope.（ observation group）. Comparative analysis between the lengths of skin incisions of the two groups was made to assess if they have significant difference.Results The patients in mosaic typeartificial bone plate fracture repair surgery group（ observation group） had skin incision on average of（ 1. 30±0. 32） cm,the patients in conventional fracture repair surgery group（ control group） had skin incision on average of（ 3. 6±1. 0）cm,there were significant differences between the two groups（ P〈0. 05）. Two groups of patients had good bone wall repair,prominent symmetry of eyes. Bone plate position had no displacement. Orbital contents were tidy and had no rejection and infection.Conclusion The mosaic type artificial bone plate implantation is an effective way to repair orbital wall fracture. It can be a powerful technique for the minimally invasive repair of orbital wall fracture. In special,it provides a new idea for the repair of orbital wall fracture through the nasal approach and the approach of the conjunctiva.