Rohrich R J, Watumull D
Department of Surgery, University of Texas Southwestern Medical Center, Dallas, USA.
Plast Reconstr Surg. 1995 Sep;96(3):570-5. doi: 10.1097/00006534-199509000-00008.
We evaluated retrospectively 101 patients to assess clinically the results of fixation methods on isolated unilateral zygoma fractures (mean follow-up 3.2 years). All patients were examined by an investigator who was blinded to the initial fixation method. Ninety-two patients were treated with wire or plate fixation alone. The major clinical parameters assessed were globe position abnormalities (enophthalmus and dystopia), malar projection, and cheek sensation. Rigid plate fixation achieved statistically better long-term malar symmetry (p = 0.002) and approached statistical significance in the achievement of more normal globe position (p = 0.06) compared with wire fixation alone. Cheek sensation showed a nonsignificant trend (p = 0.13) toward improvement with plate fixation. Other parameters that were evaluated were anatomic location of fixation points, number of fixation points, surgical approach and exposure, and breakdown of fixation dates by specialty. None of these factors showed any significant influence on outcome. The present study confirms what we have known to be true from our clinical experience--that rigid internal fixation is superior in minimizing or preventing long-term sequelae of facial fractures.
我们对101例患者进行了回顾性评估，以临床评估孤立性单侧颧骨骨折固定方法的效果（平均随访3.2年）。所有患者均由对初始固定方法不知情的研究者进行检查。92例患者仅接受钢丝或钢板固定治疗。评估的主要临床参数包括眼球位置异常（眼球内陷和异位）、颧骨突出度和面部感觉。与单纯钢丝固定相比，坚固钢板固定在长期颧骨对称性方面取得了统计学上更好的效果（p = 0.002），在实现更正常的眼球位置方面接近统计学意义（p = 0.06）。面部感觉在钢板固定时有改善的趋势，但无统计学意义（p = 0.13）。评估的其他参数包括固定点的解剖位置、固定点的数量、手术入路和暴露情况以及按专业划分的固定日期明细。这些因素均未对结果显示出任何显著影响。本研究证实了我们从临床经验中已知的事实——坚固内固定在最小化或预防面部骨折的长期后遗症方面更具优势。
