两种入路下颧骨复合体骨折切开复位内固定的临床疗效观察

The study of surgical approach for the reposition and rigid fixation on zygomatic complexfractures

目的:观察两种入路下颧骨复合体骨折切开复位内固定的临床疗效。方法:将40例颧骨复合体骨折需行切开复位内固定患者,分为头皮冠状入路组和局部小切口入路组,每组20例。评价手术完成时间、手术出血量、术后疼痛感受度(VAS)、骨折复位、软组织恢复情况和病人满意度评价。结果:头皮冠状入路组较局部小切口入路组手术时间长、手术出血量多,VAS评分在第12、24、36和48 h时头皮冠状入路组均较局部小切口入路组疼痛程度高;头皮冠状入路组骨折复位优于局部小切口入路组、软组织恢复及病人满意度差于局部小切口入路组,差异均有统计学意义(P<0.05)。结论:局部小切口入路切开复位内固定手术时间短,出血量少,软组织恢复好,患者满意度高,特别适宜耐受性差、美观要求高的患者。

Objective： To observe the clinical effect for the reposition and rigid fixation on zygomatic complexfracture. Methods： Forty patients with zygomatic complexfracture which would be done the reposition and rigid fixation were randomly divided into two groups,that one was done with the surgical approach of coronal scalp incision,the other with the surgical approach of mini-incision. Then,the operation time,bleeding amount,scores of pain（ VAS）,fractures and soft tissue recovery,patient satisfaction were evaluated respectively. Results： The operation time in the coronal scalp-incision group was longer than in the mini-incision group. The bleeding amount in the coronal scalp-incision group was greater than in the miniincision group. The pain of VAS in the mini-incision group was lower than in the coronal scalp-incision group in the 12 th,24 th,36 th,48 th hour respectively. The restoration of fracture in the coronal scalp-incision group was better than in the mini-incision group. The tissue recovery in mini-incision group was better than in the coronal scalp-incision group,and the patient satisfaction score in the mini-incision group was higher than in the coronal scalp-incision group（ P〈0. 05）. Conclusion： There is less operation time and pain,better recovery of soft tissues and higher satisfaction in the mini-incision group.It is a good surgical approach on the reposition and rigid fixation on zygomatic complexfracture on pooer tolerance,higher aesthetic requirements patients.