Rimell F, Marentette L J
Department of Otolaryngology, University of Minnesota, Minneapolis.
Otolaryngol Head Neck Surg. 1993 Sep;109(3 Pt 1):499-505. doi: 10.1177/019459989310900319.
Traumatic injuries to the hard palate occurred in 20% of all Le Fort midfacial fractures. The side of a palatal split was directly related to the side that received the highest Le Fort injury. In a symmetric midfacial injury, the palate had a true midline split. Repair of palatal injuries from blunt trauma involved either wire and splinting (eight patients) or miniplate fixation without a splint (11 patients). There were fewer complications in those treated by the miniplate fixation technique (two of 11), as compared to those treated with wire and splinting (four of eight). In miniplate fixation of midfacial fractures, attention is focused on the reconstruction of the supporting buttresses of the midface, both vertical and horizontal. In regard to the palate, this requires union of the inferior horizontal buttress. Gunshot wounds accounted for 21% of the patients and resulted in large bony disruption of the palate, which required free soft tissue and bone grafts for repair of the inferior horizontal buttress.
在所有Le Fort型面中部骨折中，20%发生了硬腭创伤性损伤。腭部裂开的一侧与遭受最高程度Le Fort损伤的一侧直接相关。在对称性面中部损伤中，腭部出现真正的中线裂开。钝性创伤所致腭部损伤的修复方法包括钢丝和夹板固定（8例患者）或无夹板的微型钢板固定（11例患者）。与钢丝和夹板固定治疗的患者（8例中有4例）相比，微型钢板固定技术治疗的患者并发症较少（11例中有2例）。在面中部骨折的微型钢板固定中，注意力集中在面中部垂直和水平支撑支柱的重建上。对于腭部，这需要下水平支撑支柱的愈合。枪伤占患者的21%，导致腭部出现大面积骨破坏，这需要游离软组织和骨移植来修复下水平支撑支柱。
