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目的 :探讨颧骨复合体骨折致伤原因、临床特点及治疗方式选择。方法 :通过病案记录研究 79例患者的临床资料 ,复位质量及面部外观评价依据临床观察及影像学检查。随访 3～ 12个月。结果 :79例患者中 87.3 %为男性 ,主要是 2 0～ 4 0岁的青壮年 ,占 73 .5 %。交通伤为主要致伤原因 ,占 5 8.2 % ,其次为暴力伤 ( 15 .2 % )。颧面畸形、眼球内陷、复视、张口受限、咬合错乱发生率分别为 83 .5 %、2 4 .1%、19.0 %、60 .8%、3 5 .4 %。神经损伤以眶下神经为主 ,占 4 1.8% ,其次为面神经 ,占 13 .9%。最常用的手术进路为冠状切口 +前庭沟切口 ( 3 0 .4 % ) ,其次为单纯冠状切口 ( 2 2 .8% )。 4 0 .5 %的患者应用小型钛板坚固内固定 ,2 0 .3 %的患者将小型钛板固定技术与钢丝结扎结合使用。74例患者获得了满意的颧面部外形。3例患者术后仍有轻度复视及眼球内陷。所有咬合错乱的患者均获得功能性咬合。结论 :颧骨复合体骨折有多种治疗方法 ,可根据情况选择使用。应用冠状切口或辅加其它切口进路及小型钛板坚固内固定技术可获得满意的疗效。
Objective: To investigate the causes of fracture of zygomatic complex fracture, clinical features and treatment options. Methods: The clinical data of 79 patients were studied by medical records. The quality of the reset and facial appearance evaluation were based on clinical observation and imaging examination. Follow-up 3 to 12 months. Results: Of the 79 patients, 87.3% were males, mainly males and females aged 20-40 years, accounting for 73.5%. Traffic injuries were the main causes of injuries, accounting for 52.2%, followed by violent injuries (15.2%). Zygomatic deformity, eye retraction, diplopia, limited mouth opening, occlusion disorders were 83.5%, 24.1%, 19.0%, 60.8%, 35.4%. Nerve damage mainly to the infraorbital nerve, accounting for 4 1.8%, followed by the facial nerve, accounting for 13.9%. The most common surgical approach was coronal incision + vestibular incision (30.4%), followed by simple coronary incision (22.8%). Forty-five percent of patients underwent minimal internal fixation with a titanium plate, and 2.03% used a combination of a small titanium plate fixation technique and a steel ligation. 74 patients achieved a satisfactory zygomatic facial appearance. Three patients still had mild diplopia after surgery and eye retraction. All patients with occlusal disorders received functional occlusion. Conclusion: There are many treatments for zygomatic complex fractures, which can be selected according to the situation. The application of coronal incision or other incision plus other small titanium plate fixation technology can get satisfactory results.