Aragón de Castro I, Hanafee W
Rev Interam Radiol. 1979 Jan;4(1):1-10.
The radiologist is in the unique position of reviewing the management of facial fractures when interpreting the post reduction films. Many of these patients have other more life threatening injuries so that their facial fractures may have been neglected or treated by individuals unfamiliar with the problem of facial injury. Immobilization following reduction is the key to satisfactory healing. The bony calvarium is the pivotal point and all free fragments should be immobilized to the frontal zygomatic area. Mandibular fractures should be immobilized to the upper alveolar ridge. If the upper alveolar ridge is also a free fragment due to a LeFort type fracture the entire complex of mandible and midface after being wired together should be wired to the stable bony calvarium. Midface fractures (LeFort type fractures) require the same type of treatment as one would apply to a forearm fracture; i.e., the joints proximal and distal must be immobilized. In the midface fracture the mandible is immobilized through the teeth to the upper alveolar ridge and the entire complex to the bony calvarium. The more specific problems associated with individual factors require high quality radiographic techniques for diagnosis and management.
放射科医生在解读复位后的片子时，处于审查面部骨折治疗情况的独特位置。这些患者中有许多人还有其他更危及生命的损伤，以至于他们的面部骨折可能被忽视，或者由不熟悉面部损伤问题的人进行治疗。复位后的固定是实现满意愈合的关键。颅骨是关键点，所有游离碎片都应固定到额颧区域。下颌骨骨折应固定到上牙槽嵴。如果由于勒福氏骨折导致上牙槽嵴也是游离碎片，那么在下颌骨和中面部整体用金属丝固定在一起后，应将其与稳定的颅骨固定。中面部骨折（勒福氏骨折）需要与治疗前臂骨折相同类型的处理方法，即近端和远端关节都必须固定。在中面部骨折中，下颌骨通过牙齿固定到上牙槽嵴，整个复合体固定到颅骨。与个体因素相关的更具体问题需要高质量的放射学技术来进行诊断和处理。
