Seattle, Wash. From the Division of Plastic Surgery, Harborview Medical Center.
Plast Reconstr Surg. 2012 Dec;130(6):1296-1304. doi: 10.1097/PRS.0b013e31826d1643.
Zygomaticomaxillary complex fractures associated with ipsilateral naso-orbito-ethmoidal fractures are more complex injuries than isolated zygomaticomaxillary complex fractures. This injury pattern can have significant long-term morbidity if not recognized and treated appropriately during the initial operation. The purpose of this study is to compare mechanisms of injury, treatment, and outcome between patients with zygomaticomaxillary complex fractures and those with zygomaticomaxillary complex and ipsilateral naso-orbito-ethmoidal fractures.
A 5-year retrospective review of all patients treated with zygomaticomaxillary complex fractures at a level I trauma center was performed. Computed tomographic scans were reviewed to divide patients into those with zygomaticomaxillary complex fractures alone and those with zygomaticomaxillary complex and ipsilateral naso-orbito-ethmoidal fractures. Demographics, treatment protocols, outcomes, complications, reoperations, and length of follow-up were identified for both groups and compared to determine differences between these populations.
A total of 245 patients were identified by the Current Procedural Terminology codes for zygomaticomaxillary complex fractures. One hundred eighty-five patients had zygomaticomaxillary complex fractures and 60 patients had zygomaticomaxillary complex/naso-orbito-ethmoidal injuries. The demographics for both populations were similar. There are differences between the groups with regard to mechanism of injury, operative findings, and techniques. The patients with zygomaticomaxillary complex/naso-orbito-ethmoidal fractures had higher rates of postoperative complications and deformities.
Patients who sustain a zygomaticomaxillary complex fracture associated with an ipsilateral naso-orbito-ethmoidal fracture have a higher incidence of postoperative complications and deformities. It is important to recognize this fracture pattern early to help minimize postoperative morbidity.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, II.
与同侧鼻眶筛骨骨折相关的颧骨复合体骨折比单纯颧骨复合体骨折更为复杂。如果在初次手术中不能识别和适当治疗这种损伤模式，可能会导致长期严重的发病率。本研究的目的是比较颧骨复合体骨折患者与颧骨复合体和同侧鼻眶筛骨骨折患者的损伤机制、治疗和结果。
对一级创伤中心治疗的所有颧骨复合体骨折患者进行了 5 年的回顾性研究。对计算机断层扫描进行了回顾，将患者分为单纯颧骨复合体骨折患者和颧骨复合体及同侧鼻眶筛骨骨折患者。确定了两组患者的人口统计学、治疗方案、结果、并发症、再次手术和随访时间，并进行比较，以确定这些人群之间的差异。
根据颧骨复合体骨折的当前操作术语代码，共确定了 245 例患者。185 例患者有颧骨复合体骨折，60 例患者有颧骨复合体/鼻眶筛骨损伤。两组患者的人口统计学特征相似。在损伤机制、手术发现和技术方面，两组之间存在差异。颧骨复合体/鼻眶筛骨骨折患者的术后并发症和畸形发生率较高。
同时发生同侧鼻眶筛骨骨折的颧骨复合体骨折患者术后并发症和畸形发生率较高。早期识别这种骨折模式对于尽量减少术后发病率很重要。
临床问题/证据水平：风险，II。
