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颧上颌复合体骨折的手术方法

Surgical Methods of Zygomaticomaxillary Complex Fracture.

作者信息

Ji So Young, Kim Seung Soo, Kim Moo Hyun, Yang Wan Suk

机构信息

Department of Plastic and Reconstructive Surgery, Dong Kang General Hospital, Ulsan, Korea.

出版信息

Arch Craniofac Surg. 2016 Dec;17(4):206-210. doi: 10.7181/acfs.2016.17.4.206. Epub 2016 Dec 23.

Abstract

BACKGROUND

Zygoma is a major buttress of the midfacial skeleton, which is frequently injured because of its prominent location. Zygoma fractures are classified according to Knight and North based on the direction of anatomic displacement and the pattern created by the fracture. In zygomaticomaxillary complex (ZMC) fracture many incisions (lateral eyebrow, lateral upper blepharoplasty, transconjunctival, subciliary, subtarsal, intraoral, direct percutaneous approach) are useful. We reviewed various approaches for the treatment of ZMC fractures and discussed about incisions and fixation methods.

METHODS

A retrospective review was conducted of patients with ZMC fracture at a single institution from January 2005 to December 2014. Patients with single zygomatic arch fracture were excluded.

RESULTS

The identified 694 patients who were admitted for zygomatic fractures from which 192 patients with simple arch fractures were excluded. The remaining 502 patients consisted of 439 males and 63 females, and total 532 zygomatic bone was operated. Orbital fracture was the most common associated fracture. According to the Knight and North classification the most frequent fracture was Group IV. Most fractures were fixated at two points (73%).

CONCLUSION

We reviewed our cases over 10 years according to fracture type and fixation methods. In conclusion, minimal incision, familiar approach and fixation methods of the surgeon are recommended.

摘要

背景

颧骨是面中部骨骼的主要支柱,因其位置突出而常受损伤。颧骨骨折根据奈特和诺思的分类方法,依据解剖移位方向和骨折形成的模式进行分类。在颧上颌复合体(ZMC)骨折中,许多切口(外侧眉弓、上睑外侧成形术、经结膜、睑缘下、睑板下、口内、直接经皮入路)都很有用。我们回顾了治疗ZMC骨折的各种方法,并讨论了切口和固定方法。

方法

对2005年1月至2014年12月在单一机构就诊的ZMC骨折患者进行回顾性研究。排除单纯颧弓骨折患者。

结果

共确定694例因颧骨骨折入院的患者,其中192例单纯弓状骨折患者被排除。其余502例患者中,男性439例,女性63例,共手术532处颧骨。眼眶骨折是最常见的合并骨折。根据奈特和诺思分类,最常见的骨折类型为IV型。大多数骨折采用两点固定(73%)。

结论

我们根据骨折类型和固定方法对10年来的病例进行了回顾。总之,建议采用最小切口、术者熟悉的入路和固定方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/068c/5556838/0e5f84645d8f/acfs-17-206-g001.jpg

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