Kim Ji Heui, Lee Jun Ho, Hong Seok Min, Park Chan Hum
Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, South Korea.
Acta Otolaryngol. 2013 Jan;133(1):77-81. doi: 10.3109/00016489.2012.712215.
Open reduction through an intercartilaginous incision was useful for treating delayed-diagnosed nasal bone fractures because it resulted in a successful outcome with minimal complications.
Nasal bone fractures are generally managed with closed reduction, which is usually inadequate and results in airway obstruction with a delayed diagnosis of nasal bone fracture when bone healing and fibrotic adhesions around the bone fragment have progressed. This study investigated the surgical outcome of open reduction through an intercartilaginous incision for delayed-diagnosis nasal bone fractures.
The study enrolled 18 patients who underwent open reduction through an intercartilaginous incision to correct delayed-diagnosis nasal bone fractures. Three independent otorhinolaryngologists evaluated the outcomes 4-35 months (average 12.7 months) postoperatively as excellent, fair or poor.
The time from injury to surgery was 11-39 days (20-39 days in adults and 11-30 days in children). The 18 cases included 16 primary repairs and two revisions. A Kirschner wire was inserted in six (33.3%) patients who had unstable reduced nasal bones. Postoperatively, l5 (83%) patients had excellent results, two (11%) had fair, and one (6%) had a poor outcome. No patient experienced any complication.
经软骨间切口切开复位术对于治疗延迟诊断的鼻骨骨折是有效的，因为它能带来成功的治疗效果且并发症极少。
鼻骨骨折一般采用闭合复位治疗，但这种方法通常并不充分，当骨愈合以及骨碎片周围出现纤维性粘连时，会导致气道阻塞以及鼻骨骨折的延迟诊断。本研究探讨经软骨间切口切开复位术治疗延迟诊断鼻骨骨折的手术效果。
该研究纳入了18例接受经软骨间切口切开复位术以矫正延迟诊断鼻骨骨折的患者。三名独立的耳鼻咽喉科医生在术后4至35个月（平均12.7个月）评估治疗效果，分为优、良、差。
受伤至手术的时间为11至39天（成人20至39天，儿童11至30天）。18例病例中，16例为初次修复，2例为再次修复。6例（33.3%）鼻骨复位不稳定的患者插入了克氏针。术后，15例（83%）患者效果为优，2例（11%）为良，1例（6%）为差。没有患者出现任何并发症。
