Department of Oral and Maxillofacial Surgery, First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, China; Department of Oral and Maxillofacial Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, China.
Department of Anesthesiology, Anesthesiology Research Institute, First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, China.
J Craniomaxillofac Surg. 2024 May;52(5):606-611. doi: 10.1016/j.jcms.2024.02.021. Epub 2024 Feb 12.
Our study aimed to evaluate modified patient-specific surgical-guide-assisted precise treatment of unilateral comminuted zygomaticomaxillary complex (ZMC) fractures. The retrospective non-randomized study was conducted in a single hospital in China. All patients diagnosed with unilateral comminuted ZMC fractures between January 1, 2018 and December 31, 2022 were retrospectively reviewed. All patients underwent preoperative spiral computed tomography (CT). CT data were processed using software to DICOM format and transferred to Proplan CMF3.0 for preoperative virtual surgical planning and postoperative evaluation. All data were extracted from standardized electronic medical records. All statistical analyses were performed using SPSS version 20.0. The chi-square test and t-test were used for statistical analyses. The 54 included patients were divided into two comparable, equal cohorts of 27 patients, and followed up for at least 6 months. Fracture reduction was assisted using the modified patient-specific surgical guides in the guide group (23 males, four females; mean age 37.74 ± 12.07 years) and without the modified patient-specific surgical guides in the control group (20 males, seven females; mean age 37.44 ± 13.58 years). In the guide group, the mean eminence deviation between the affected and unaffected sides was 1.01 ± 0.92 mm, and the mean width deviation between the affected and unaffected sides was 1.29 ± 1.32 mm. In the control group, the mean eminence deviation between the affected and unaffected sides was 1.99 ± 1.69 mm, and the mean width deviation between the affected and unaffected sides was 2.68 ± 2.01 mm. The differences in facial protrusion (p = 0.001) and width (p = 0.003) symmetry between the affected and healthy sides of the two groups were statistically significant (p < 0.05). In conclusion, applying the modified patient-specific surgical guides to unilateral comminuted zygomaticomaxillary complex fracture reduction has the advantages of greater predictability and effectiveness, and improved bilateral ZMC symmetry. It should be noted that this approach would be especially beneficial for less-experienced surgeons.
我们的研究旨在评估改良的个体化手术导板辅助精确治疗单侧粉碎性颧骨-上颌复合体（ZMC）骨折。本研究为回顾性、非随机研究，在中国的一家医院进行。回顾性分析 2018 年 1 月 1 日至 2022 年 12 月 31 日期间诊断为单侧粉碎性 ZMC 骨折的所有患者。所有患者均行术前螺旋 CT（CT）检查。将 CT 数据以 DICOM 格式处理并传输至 Proplan CMF3.0 进行术前虚拟手术规划和术后评估。所有数据均从标准化电子病历中提取。采用 SPSS 20.0 进行统计学分析。采用卡方检验和 t 检验进行统计学分析。54 例患者被分为两组，每组 27 例，至少随访 6 个月。在导板组（23 例男性，4 例女性；平均年龄 37.74±12.07 岁）中使用改良的个体化手术导板辅助骨折复位，而在对照组（20 例男性，7 例女性；平均年龄 37.44±13.58 岁）中则不使用改良的个体化手术导板。在导板组中，患侧和健侧颧骨突出度的平均偏差为 1.01±0.92mm，患侧和健侧颧骨宽度的平均偏差为 1.29±1.32mm。在对照组中，患侧和健侧颧骨突出度的平均偏差为 1.99±1.69mm，患侧和健侧颧骨宽度的平均偏差为 2.68±2.01mm。两组患侧和健侧面部突出度（p=0.001）和宽度（p=0.003）对称性的差异有统计学意义（p<0.05）。结论：应用改良的个体化手术导板辅助单侧粉碎性颧骨-上颌复合体骨折复位具有可预测性和有效性更高、双侧 ZMC 对称性更好的优点。需要注意的是，对于经验较少的外科医生来说，这种方法尤其有益。
