Colletti Giacomo, Biglioli Federico
Department of Maxillo-Facial Surgery, University of Milan, San Paolo Hospital, Milan, Italy.
J Craniofac Surg. 2012 Sep;23(5):e400-4. doi: 10.1097/SCS.0b013e31825bd004.
Surgical management of panfacial fractures can be extremely challenging. The many fracture lines and lack of landmarks make it difficult to restore the facial skeletal morphology. Extracapsular fractures of the mandibular condyle require open reduction and internal fixation to restore the vertical and sagittal dimensions of the mandible, representing the base for further facial skeleton reconstruction. Six patients with panfacial fractures, including a bilateral extracapsular condylar fracture, were treated between January 2006 and November 2009. One patient underwent surgical procedure 60 days after the injury. The condylar fractures were treated via a mini-retromandibular access. Overall, the bone morphology restoration was good. In particular, all of the condylar fractures were reduced satisfactorily. No complication was detected, and no facial nerve lesion was observed. The literature contains many proposals for surgically accessing panfacial fractures. Open reduction and internal fixation of condylar fractures are crucial for restoring face height. The mini-retromandibular access is especially suitable, because it allows safe, rapid surgical management.
全颜面骨折的外科治疗极具挑战性。众多的骨折线以及缺乏标志性结构使得恢复面部骨骼形态变得困难。下颌骨髁突囊外骨折需要切开复位内固定以恢复下颌骨的垂直和矢状维度，这是进一步面部骨骼重建的基础。2006年1月至2009年11月期间，对6例全颜面骨折患者进行了治疗，其中包括1例双侧髁突囊外骨折。1例患者在受伤60天后接受了手术。髁突骨折通过下颌后入路微型切口进行治疗。总体而言，骨形态恢复良好。特别是，所有髁突骨折均得到满意复位。未检测到并发症，也未观察到面神经损伤。文献中有许多关于全颜面骨折手术入路的建议。髁突骨折的切开复位内固定对于恢复面部高度至关重要。下颌后入路微型切口尤为适用，因为它能实现安全、快速的外科治疗。
