Matsunaga R S, Simpson W, Toffel P H
Arch Otolaryngol. 1977 Sep;103(9):535-8. doi: 10.1001/archotol.1977.00780260065007.
A simplified protocol of approach has evolved from the treatment of approximately 1,200 malar fractures in an eight-year period in the private practice of one of us (R.S.M.) and at the Los Angeles County/University of Southern California Medical Center. The method begins with the Gillies incison for reduction and routinely uses internal wire pin fixation tailored to the mechanical requirements of the malar fracture. It advances only if necessary to brow and infraorbital incisions, direct wiring, orbital exploration, or Caldwell-Luc. Antrostomy with antral packing. Occasionally, a transcutaneous wire or small bone screw may be inserted for headcap or halo vector traction if indicated by the judgment of the surgeon. The internal wire pin protocol has produced hundreds of satisfactory reductions and fixations of malar fractures in our experience, with shortened operating time and reduced complications. It has been installed as the primary method of treatment for this type of facial fracture in a residency program that has many of these patients.
在我们其中一人（R.S.M.）的私人诊所以及洛杉矶县/南加州大学医学中心八年期间对约1200例颧骨骨折的治疗过程中，逐渐形成了一种简化的治疗方案。该方法首先采用吉利斯切口进行复位，并根据颧骨骨折的力学需求常规使用内钢丝针固定。仅在必要时才进一步采用眉部和眶下切口、直接钢丝固定、眼眶探查或卡尔代尔-卢克手术（上颌窦开窗术并进行上颌窦填塞）。偶尔，如果外科医生判断有必要，可插入经皮钢丝或小骨螺钉用于头帽或头环矢量牵引。根据我们的经验，内钢丝针方案已成功实现了数百例令人满意的颧骨骨折复位和固定，缩短了手术时间并减少了并发症。在一个接收许多此类患者的住院医师培训项目中，它已被确立为这类面部骨折的主要治疗方法。
