順序復位固定技術治療顴骨復合體骨折_《中國修復重建外科雜志》

作者：

楊立娟 ¹ , 柳春明 ² , 滑文美 ¹ , 劉衛東 ¹ , 王曦光王凱 ¹¹ , 張占樂 ¹ , 李美芳 ¹ , 段海南 ¹

1廊坊市第四人民醫院口腔科（河北霸州，065700）;;
2解放軍總醫院整形外科;

關鍵詞：

顴骨復合體骨折順序復位固定技術骨折復位

DOI：

10.7507/1002-1892.20130259

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目的探討顴骨復合體骨折的順序復位固定技術及療效。方法2004年3月－2012年2月，收治顴骨復合體骨折32例。男28例，女4例；年齡17～55歲，中位年齡29歲。致傷原因：交通事故傷29例，跌傷3例。新鮮骨折28例，受傷至入院時間1～12 d，平均3 d；陳舊性骨折4例，受傷至入院時間22～60 d，平均40 d。均經臨床和CT檢查確診。采用頭皮冠狀切口、下瞼緣切口和口內前庭溝切口入路，顯露顴面部骨折，以先橫向后縱向順序進行骨折復位固定。橫向由后向前（即顴弓根部→顴弓→顴骨體部→眶下緣）順序，縱向先行顴額縫和眶外壁骨折復位，后轉向口內使顴牙槽嵴骨折復位并固定。結果術后切口均Ⅰ期愈合，無上頜竇瘺、鈦釘及鈦板感染等并發癥發生。18例獲隨訪，隨訪時間6個月～6年，中位時間32個月。患者面形恢復滿意，兩側基本對稱，開、閉口功能正常。無眼球損傷、視力損害發生。術后2例出現額紋消失、眉下垂，6個月有一定程度自行恢復。頭皮冠狀切口遺留2～3 mm脫發痕跡，無瘢痕增生；下眼瞼無明顯瘢痕。6個月復查時，CT及X線片示骨折均愈合。結論順序復位固定技術符合顴骨復雜骨折的力學特點，容易達到精確解剖復位。

引用本文： 楊立娟,柳春明,滑文美,劉衛東,王曦光王凱,張占樂,李美芳,段海南. 順序復位固定技術治療顴骨復合體骨折. 中國修復重建外科雜志, 2013, 27(10): 1181-1184. doi: 10.7507/1002-1892.20130259 復制

1.	Kelley P, Hopper R, Gruss J. Evaluation and treatment of zygomatic fractures. Plast Reconstr Surg, 2007, 120(7 Supp 2): 5S-15S.
2.	Evans GR, Daniels M, Hewell L. An evidence-based approach to zygomatic fractures. Plast Reconstr Surg, 2011, 127(2): 891-897.
3.	Czerwinski M, Martin M, Lee C. Quantitative comparison of open reduction and internal fixation versus the Gillies method in the treatment of orbitozygomatic complex fractures. Plast Reconstr Surg, 2005, 115(7): 1848-1854.
4.	Rohner D, Tay A, Meng CS, et al. The sphenozygomatic suture as a key site for osteosynthesis of the orbitozygomatic complex in panfacial fractures: a biomechanical study in human cadavers based on clinical practice. Plast Reconstr Surg, 2002, 110(6): 1463-1471.
5.	Gruss JS, Van Wyck L, Phillips JH, et al. The importance of the zygomatic arch in complex midfacial fracture repair and correction of posttraumatic orbitozygomatic deformities. Plast Reconstr Surg, 1990, 85(6): 878-890.
6.	馬驍, 柳春明, 柴家科. 顴弓根復位在顴骨復合體骨折治療中的意義. 口腔醫學研究, 2007, 23(4): 414-416.
7.	Evans BG, Evans GR. MOC-PSSM CME article: Zygomatic fractures. Plast Reconstr Surg, 2008, 121(1 Suppl): 1-11.
8.	Zingg M, Laedrach K, Chen J, et al. Classification and treatment of zygomatic fractures: a review of 1025 cases. J Oral Maxillofac Surg, 1992, 50(8): 778-790.
9.	何冬梅, 張益, 張震康. 顴骨復合體骨折的分類研究和治療. 中華口腔醫學雜志, 2004, 39(3): 211-213.
10.	Pribitkin EA, Cognetti DM, Marshall SN, et al. Lag screw fixation in midface fractures. Facial Plast Surg, 2005, 21(3): 165-170.
11.	Mavili ME, Canter HI, Tuncbilek G. Treatment of noncomminuted zygomatic fractures with percutaneous reduction and fixation. J Craniofac Surg, 2007, 18(1): 67-73.
12.	Moon SH, Lee JH, Oh DY, et al. Reduction of zygomatic fracture segment with intermaxillary fixation screw. J Craniofac Surg, 2012, 23(3): 842-844.
13.	de Souza Carvalho AC, Pereira CC, Queiroz TP, et al. Intraoral approach to zygomatic fracture: modified technique for infraorbital rim fixation. J Craniofac Surg, 2012, 23(2): 537-538.
14.	Imai T, Michizawa M, Fujita G, et al. C-arm-guided reduction of zygomatic fractures revisited. J Trauma, 2011, 71(5): 1371-1375.
15.	Ogino A, Onishi K, Maruyama Y. Intraoperative repositioning assessment using navigation system in zygomatic fracture. J Craniofac Surg, 2009, 20(4): 1061-1065.
16.	Becelli R, Quarato D, Matarazzo G, et al. Esthetic positioning of rigid internal fixation in tripod zygomatic fractures: an innovative surgical technique. J Craniofac Surg, 2009, 20(3): 724-725.
17.	Choi KY, Ryu DW, Yang JD, et al. Feasibility of 4-point fixation using the preauricular approach in a zygomaticomaxillary complex fracture. J Craniofac Surg, 2013, 24(2): 557-562.

1. Kelley P, Hopper R, Gruss J. Evaluation and treatment of zygomatic fractures. Plast Reconstr Surg, 2007, 120(7 Supp 2): 5S-15S.
2. Evans GR, Daniels M, Hewell L. An evidence-based approach to zygomatic fractures. Plast Reconstr Surg, 2011, 127(2): 891-897.
3. Czerwinski M, Martin M, Lee C. Quantitative comparison of open reduction and internal fixation versus the Gillies method in the treatment of orbitozygomatic complex fractures. Plast Reconstr Surg, 2005, 115(7): 1848-1854.
4. Rohner D, Tay A, Meng CS, et al. The sphenozygomatic suture as a key site for osteosynthesis of the orbitozygomatic complex in panfacial fractures: a biomechanical study in human cadavers based on clinical practice. Plast Reconstr Surg, 2002, 110(6): 1463-1471.
5. Gruss JS, Van Wyck L, Phillips JH, et al. The importance of the zygomatic arch in complex midfacial fracture repair and correction of posttraumatic orbitozygomatic deformities. Plast Reconstr Surg, 1990, 85(6): 878-890.
6. 馬驍, 柳春明, 柴家科. 顴弓根復位在顴骨復合體骨折治療中的意義. 口腔醫學研究, 2007, 23(4): 414-416.
7. Evans BG, Evans GR. MOC-PSSM CME article: Zygomatic fractures. Plast Reconstr Surg, 2008, 121(1 Suppl): 1-11.
8. Zingg M, Laedrach K, Chen J, et al. Classification and treatment of zygomatic fractures: a review of 1025 cases. J Oral Maxillofac Surg, 1992, 50(8): 778-790.
9. 何冬梅, 張益, 張震康. 顴骨復合體骨折的分類研究和治療. 中華口腔醫學雜志, 2004, 39(3): 211-213.
10. Pribitkin EA, Cognetti DM, Marshall SN, et al. Lag screw fixation in midface fractures. Facial Plast Surg, 2005, 21(3): 165-170.
11. Mavili ME, Canter HI, Tuncbilek G. Treatment of noncomminuted zygomatic fractures with percutaneous reduction and fixation. J Craniofac Surg, 2007, 18(1): 67-73.
12. Moon SH, Lee JH, Oh DY, et al. Reduction of zygomatic fracture segment with intermaxillary fixation screw. J Craniofac Surg, 2012, 23(3): 842-844.
13. de Souza Carvalho AC, Pereira CC, Queiroz TP, et al. Intraoral approach to zygomatic fracture: modified technique for infraorbital rim fixation. J Craniofac Surg, 2012, 23(2): 537-538.
14. Imai T, Michizawa M, Fujita G, et al. C-arm-guided reduction of zygomatic fractures revisited. J Trauma, 2011, 71(5): 1371-1375.
15. Ogino A, Onishi K, Maruyama Y. Intraoperative repositioning assessment using navigation system in zygomatic fracture. J Craniofac Surg, 2009, 20(4): 1061-1065.
16. Becelli R, Quarato D, Matarazzo G, et al. Esthetic positioning of rigid internal fixation in tripod zygomatic fractures: an innovative surgical technique. J Craniofac Surg, 2009, 20(3): 724-725.
17. Choi KY, Ryu DW, Yang JD, et al. Feasibility of 4-point fixation using the preauricular approach in a zygomaticomaxillary complex fracture. J Craniofac Surg, 2013, 24(2): 557-562.

《中國修復重建外科雜志》

順序復位固定技術治療顴骨復合體骨折

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《中國修復重建外科雜志》

順序復位固定技術治療顴骨復合體骨折

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