Scolozzi Paolo, Imholz Benoît
From the Service of Oral and Maxillofacial Surgery, Department of Surgery, Hôpitaux Universitaires de Genève, Faculty of Medicine, Geneva, Switzerland.
J Craniofac Surg. 2015 Jan;26(1):e59-61. doi: 10.1097/SCS.0000000000001178.
The aim of this study was to prospectively evaluate the use of a simultaneous Le Fort I osteotomy for completion of nonreducible Le Fort fractures. We analyzed the clinical and radiological data of 44 patients with Le Fort fractures, 9 of whom presented with a nonreducible type. Seven patients with an incomplete Le Fort I fracture had a contralateral Le Fort I osteotomy, and 2 patients with an incomplete Le Fort III fracture had a true bilateral Le Fort I-type osteotomy. We recorded age and sex, mechanism of injury, level of Le Fort fracture, concomitant mandibular fractures, concomitant maxillomandibular fixation (MMF) and its duration, surgical approach, status of healing, and complications. Follow-ups were at 1 week and 1, 3, 6, and 12 months.All patients recovered their normal pretrauma occlusion without the need for postoperative elastic guidance, except for 1 patient who required light class III traction elastics for 3 weeks to achieve the correct occlusion. None of the patients presented with intraoperative or postoperative complications.The present study has demonstrated that completion of nonreducible Le Fort fractures by Le Fort I osteotomy results in a high rate of success.
本研究的目的是前瞻性评估采用同期勒福Ⅰ型截骨术完成不可复位性勒福骨折的情况。我们分析了44例勒福骨折患者的临床和影像学资料，其中9例为不可复位型。7例不完全性勒福Ⅰ型骨折患者进行了对侧勒福Ⅰ型截骨术，2例不完全性勒福Ⅲ型骨折患者进行了真正的双侧勒福Ⅰ型截骨术。我们记录了患者的年龄、性别、损伤机制、勒福骨折的水平、合并的下颌骨骨折、合并的颌间固定（MMF）及其持续时间、手术入路、愈合情况和并发症。随访时间为术后1周以及1、3,、6和12个月。除1例患者需要佩戴轻Ⅲ类牵引弹力线3周以达到正确的咬合关系外，所有患者均恢复了创伤前的正常咬合关系，无需术后弹性引导。所有患者均未出现术中或术后并发症。本研究表明，采用勒福Ⅰ型截骨术完成不可复位性勒福骨折的成功率很高。
