Jeong Hii-Sun, Moon Min-Seon, Lee Hye-Kyung, Kim Keun-Sik
Department of Plastic and Reconstructive Surgery, Kwandong University College of Medicine, Goyang City, Gyeonggi-do, Republic of Korea.
J Craniofac Surg. 2010 Jan;21(1):75-8. doi: 10.1097/SCS.0b013e3181c3ba30.
Nasal bone fractures are the most common type of facial fracture. Closed reduction has been used as the standard treatment modality for nasal fractures for many years. In cases of nasal fracture with lacerations at the fracture sites, bioabsorbable/metallic plate or interfragment wire fixation can be used with accurate alignment through the openings created by the lacerations. However, in cases of severe comminuted nasal fractures that are difficult to drill and fix, this type of fixation may not be feasible. We performed in 5 patients open reduction with internal fixation through laceration openings using the biomaterial Greenplast (Greencross Corporation, Seoul, Republic of Korea; human plasma fibrinogen, thrombin, aprotinin, and calcium chloride) under general anesthesia. Both structural and aesthetic outcomes were satisfactory. Open reduction through laceration openings and internal fixation with fibrin glue under general anesthesia may be a simpler and more effective method than those currently in general use for the repair of complicated comminuted open nasal fractures.
鼻骨骨折是最常见的面部骨折类型。多年来，闭合复位一直是鼻骨骨折的标准治疗方式。在骨折部位伴有撕裂伤的鼻骨骨折病例中，可通过撕裂伤形成的创口，使用生物可吸收/金属板或骨折片间金属丝固定，并实现精确对线。然而，在严重粉碎性鼻骨骨折且难以钻孔和固定的情况下，这种固定方式可能不可行。我们对5例患者在全身麻醉下，通过撕裂伤创口使用生物材料Greenplast（韩国首尔绿十字公司；人血浆纤维蛋白原、凝血酶、抑肽酶和氯化钙）进行切开复位内固定。结构和美学效果均令人满意。在全身麻醉下通过撕裂伤创口进行切开复位并用纤维蛋白胶进行内固定，可能是一种比目前普遍使用的方法更简单、更有效的修复复杂粉碎性开放性鼻骨骨折的方法。
