局部小切口内固定治疗颧骨复合体骨折93例临床分析

Treatment of zygomatic complex fracture with local small incision fixation:clinical analysis of 93 cases

目的 通过临床回顾性研究,探讨局部小切口在颧骨复合体骨折治疗过程中的临床应用及效果.方法 对93例颧骨复合体骨折患者在全身麻醉下行颧弓表面、眉尾、眶下缘及口内前庭沟等部位切口,将骨折复位后用微型钛板坚固内固定.结果 所有患者的伤口均Ⅰ期愈合,瘢痕微小,无面神经损伤发生.随访6 ～15个月,其中2例出现术后张口困难,经功能锻炼后张口度恢复正常;5例患者自觉双侧面形不对称,取出内固定后自觉面形对称满意.结论 局部小切口手术进路可以通过微小创口获得清晰的术野,减少了术中出血;其精确的复位和微小的瘢痕使颧骨复合体骨折复位后能得到令人满意的效果.

Objective To discuss the clinical application and effect of a local small incision in the treatment of zygomatic complex fractures by clinical retrospective study. Methods Ninety-three patients with zygomatic complex fractures underwent zygomatic arch surface, amygdala, infraorbital rim and intraoral vestibular incision under general anesthesia. The fractures were fixed with micro titanium plate after reduction. Results All the patients healed primarily with less scarring without facial nerve injury. Postoperative follow-up was performed for 6 to 15 months. Two cases with postoperative open mouth difficulty recovered after functional exercises. Five patients were with asymmetric facial shape by self-judgment, which improved by removing the internal fixation. Conclusion Through a tiny incision, the local small incision surgical approach can achieve a satisfactory effect on the fracture reduction of simple and moderate zygomatic complex fractures owing to a clear operative field with less intraoperative bleeding, accurate reduction and concealed scar.