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[钛微型钢板骨合成与一期骨移植治疗颅面骨折]

[Management of craniofacial fractures with titanium mini-plate osteosynthesis and primary bone transplantation].

作者信息

Nemes I, Szabó J, Pácz M, Bobest M

机构信息

Megyei Markusovszky Kórház, Szombathely, Arc-, Allcsont- és Szájsebészeti Osztály.

出版信息

Orv Hetil. 1999 Apr 25;140(17):923-8.

Abstract

The frontobasal traumatic lesions are often combined with several type of midface fractures therefore the authors adopted the craniofacial injury definition. In the years 1995-1997, 534 patients with head trauma were operated on by maxillofacial surgeon and neurosurgeon of which 35 (6.5%) cases showed concomitant combined frontonaso-orbital-skull base involvement. In the complex management of the severe craniofacial lesions the cooperative team-work of maxillofacial surgeon, neurosurgeon, otolaryngologist and ophthalmologist is required. Stabilized midface and the "watertight" dura closure or plasty are basically important conditions for the ceasing of cerebrospinal fluid leak. In the instance of optic nerve lesion the exploration and decompression within the eight hours is mandatory by transcranial-subcranial approach. At their cases authors preferred the early, definitive one-stage management with step-by step titanium miniplate reconstructive osteosynthesis and primary bone grafting correct bony restoration could be achieved. According their experiences of new treatment method with definitive one-stage management of complex craniofacial injuries they decreased the incidence of postoperative complications, the time of hospitalisations obtained optimal functional and cosmetic results.

摘要

额基部创伤性损伤常合并多种类型的面中部骨折,因此作者采用了颅面损伤的定义。1995年至1997年期间,534例头部外伤患者接受了颌面外科医生和神经外科医生的手术治疗,其中35例(6.5%)显示伴有额鼻眶颅底联合受累。在严重颅面损伤的综合治疗中,需要颌面外科医生、神经外科医生、耳鼻喉科医生和眼科医生的团队协作。稳定的面中部和“水密性”硬脑膜闭合或成形术是脑脊液漏停止的基本重要条件。在视神经损伤的情况下,必须在8小时内通过经颅-颅下途径进行探查和减压。在他们的病例中,作者倾向于早期、确定性的一期治疗,采用逐步钛微型钢板重建性骨合成和一期植骨,可以实现正确的骨修复。根据他们对复杂颅面损伤进行确定性一期治疗的新治疗方法的经验,他们降低了术后并发症的发生率,缩短了住院时间,获得了最佳的功能和美容效果。

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