Gruss J S
Division of Craniofacial, Plastic and Reconstructive Surgery, Children's Hospital and Medical Center, University of Washington, Seattle, USA.
Scand J Plast Reconstr Surg Hand Surg Suppl. 1995;27:83-95.
Post-traumatic craniofacial deformities may result from failure to diagnose craniomaxillofacial injuries or from less than adequate repair. The skeletal deformities may be corrected by procedures employing extended craniofacial exposure, segmental osteotomies and bony repositioning. A graduated approach to the correction of regional bony post-traumatic deformities has been formulated. Bony depressions are corrected by onlay grafts, rigidly fixed with lag screws. Malposition of anatomically normal bone is corrected by osteotomy and repositioning. Anatomically abnormal bone is replaced with bone grafts. The use of rigid fixation techniques prevents the late skeletal relapse seen with previous techniques. In the established post-traumatic deformity, soft tissue distortion from contracted underlying scar tissue and adherence to bony depressions and defects is the limiting factor in restoring the pre-injury appearance.
创伤后颅面部畸形可能是由于未能诊断颅颌面损伤或修复不充分所致。骨骼畸形可通过采用扩大颅面暴露、节段性截骨术和骨重新定位的手术来矫正。已制定了一种逐步矫正局部创伤后骨畸形的方法。骨凹陷通过贴附植骨矫正，并用拉力螺钉牢固固定。解剖结构正常的骨错位通过截骨术和重新定位来矫正。解剖结构异常的骨用骨移植替代。使用坚固内固定技术可防止出现以往技术中所见的晚期骨骼复发。在已形成的创伤后畸形中，下方瘢痕组织挛缩以及与骨凹陷和缺损的粘连所导致的软组织扭曲是恢复伤前外观的限制因素。
