改良头皮冠状切口在治疗颧骨复杂性骨折中的临床应用

Clinical application of the modified scalp coronal incision in the treatment of zygomatic complex fractures

目的探讨改良头皮冠状切口入路在治疗颧骨颧弓骨折中的应用并分析其预后情况。方法回顾性分析2008~2016年颧骨颧弓骨折患者236例,均一期完成经改良头皮冠状切口入路颧骨颧弓骨折切开复位坚固内固定术,术后进行康复性张口训练,术后3~6个月随访切口感染、面瘫、咬合关系、张口度、面部畸形和主观满意度等指标,评估预后恢复情况。结果所有患者术后均无切口感染、皮下血肿、颞区凹陷、秃发、永久性面瘫且面容满意恢复,合并有咬合关系紊乱和张口受限的患者,术后均恢复功能性咬合及理想张口度。主观满意度达到97%。结论改良头皮冠状切口在颧骨颧弓三维立体结构重建中,具有术野清晰、复位精确、面容恢复好、瘢痕隐蔽的优点,有助于面神经及血管等结构的保护,降低手术并发症的发生率。

OBJECTIVE To explore the application of the modified scalp coronal incision in the treatment of zygomatic and zygomatic arch fracture, and analyze its prognosis. METHODS A retrospective analysis of 236 cases with zygomatic and zygomatic arch fracture from 2008 to 2016 was performed.They were treated with zygomatic and zygomatic arch fracture open reduction and firm fixation by the modified scalp coronal incision and postoperative mouse rehabilitation. After 3-6 months, the infection of incision, facial paralysis, occlusal, degree of mouth opening, facial deformity and subjective satisfaction index were followed up.The prognosis and recovery were evaluated.RESULTS 1. All of the patients had no postoperative incision infection, subcutaneous hematoma, temporal region sag, bald, and permanent facial paralysis. They all got satisfied face recovery.2.All patients with occlusal disorders and limited mouth opening obtained functional occlusal and ideal degrees of mouth opening. Satisfaction was 97%. CONCLUSION The modified coronal scalp incision in the reconstruction of 3 d structure of zygomatic and zygomatic arch, has the advantages of a clear operation field and accurateresetting, good restoration of face, concealed scar. It contributes to the protection of the facial nerve and vascular structureand reduces the incidence of surgical complications.