Associate Professor, Department of Oral and Maxillofacial Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, P.R. China; and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Stomatology, Hangzhou, Zhejiang Province, P.R. China.
Attending Physician, Department of Traditional Chinese Medicine Gynecology, Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, P.R. China.
J Oral Maxillofac Surg. 2021 Jul;79(7):1514-1527. doi: 10.1016/j.joms.2021.02.011. Epub 2021 Feb 23.
The purpose of this study was to evaluate the effectiveness of zygomatic complex fracture reduction by percutaneous bone hook traction as a minimally invasive treatment.
A retrospective case series analysis of 24 patients who underwent unilateral isolated zygomatic complex fracture reduction by percutaneous bone hook traction between June 2014 and June 2019 was performed. Patients who complained of other accompanying maxillofacial fractures or ocular problems were excluded. Postoperative radiographs were used to assess the esthetic appearance and treatment response, including complications, in all patients.
Operation was performed within a mean time of 5.3 days after injury. Closed reduction by percutaneous bone hook traction was performed in 24 patients. At a regular follow-up period of 6 months, postoperative radiographs showed symmetrical outcomes of facial contours and bony union without zygomatic collapse. All patients were satisfied with the symmetrical contours of the zygomatic complex and experienced no complications. Three of the 7 patients had paresthesia in the infraorbital region after injury and regressed postoperatively.
Percutaneous bone hook traction could be an alternative treatment method for simple noncommunicated zygomatic complex fractures without preoperative ocular problems 7 days after injury. Deep understanding of the operative indication, choosing a suitable operation time, and experienced surgeons are keys to effectively using this economical, reliable, and effective approach.
本研究旨在评估经皮骨钩牵引复位颧骨复合体骨折作为微创治疗的有效性。
对 2014 年 6 月至 2019 年 6 月期间接受单侧孤立性颧骨复合体骨折经皮骨钩牵引复位的 24 例患者进行回顾性病例系列分析。排除有其他伴随的颌面骨折或眼部问题的患者。所有患者均通过术后影像学评估评估其美学外观和治疗效果,包括并发症。
手术均在受伤后 5.3 天内进行。24 例患者均行经皮骨钩牵引闭合复位。在 6 个月的常规随访期内,术后影像学显示面部轮廓对称,骨愈合良好,无颧骨塌陷。所有患者均对颧骨复合体的对称轮廓满意,且无并发症发生。7 例患者中有 3 例在受伤后眶下区出现感觉异常,术后缓解。
对于无术前眼部问题的单纯非交通性颧骨复合体骨折,受伤后 7 天内可采用经皮骨钩牵引作为替代治疗方法。深入了解手术适应证、选择合适的手术时机和有经验的外科医生是有效使用这种经济、可靠和有效的方法的关键。