CAJ | 학술논문

目的：：评价三维预成型钛网在单纯性眶壁骨折修复中的精确性和可行性。方法：本研究共包括47例单纯性眶壁骨折患者,骨折部位如下：内下壁联合骨折26例(55%),单纯眶内壁骨折12例(26%),单纯眶下壁骨折9例(19%)。对于眶下壁骨折,采用标准的经下睑结膜入路；而对于眶内壁骨折和内下壁联合骨折,则采用经泪阜、经下睑结膜联合入路,同时暂时切断下斜肌将两切口沟通。所有患者均充分暴露骨折边缘并还纳疝出的眶内组织后,根据术前CT测量的骨折缺损范围,选择对应型号的AO三维预成型钛网并进行适当的修剪和弯制后植入眶内,使用两颗钛钉将钛网固定于眶下缘。通过术后复查眼眶三维CT来评价植入钛网的精确性,通过对患者术前和术后的临床资料的对比来评价预成型钛网临床应用的可行性。结果：术后CT表明,所有患者的眼眶骨折在植入三维预成型钛网后均得到比较精确的解剖修复。所有患者在术中、术后均未出现严重的并发症,40例(87%)患者眼球内陷得以矫正,25例(86%)患者复视消失。结论：AO三维预成型钛网在解剖上可比较精确地修复眶壁骨折；在临床上,可以显著改善眼球内陷和复视。
목적：：평개삼유예성형태망재단순성광벽골절수복중적정학성화가행성。방법：본연구공포괄47례단순성광벽골절환자,골절부위여하：내하벽연합골절26례(55%),단순광내벽골절12례(26%),단순광하벽골절9례(19%)。대우광하벽골절,채용표준적경하검결막입로；이대우광내벽골절화내하벽연합골절,칙채용경루부、경하검결막연합입로,동시잠시절단하사기장량절구구통。소유환자균충분폭로골절변연병환납산출적광내조직후,근거술전CT측량적골절결손범위,선택대응형호적AO삼유예성형태망병진행괄당적수전화만제후식입광내,사용량과태정장태망고정우광하연。통과술후복사안광삼유CT래평개식입태망적정학성,통과대환자술전화술후적림상자료적대비래평개예성형태망림상응용적가행성。결과：술후CT표명,소유환자적안광골절재식입삼유예성형태망후균득도비교정학적해부수복。소유환자재술중、술후균미출현엄중적병발증,40례(87%)환자안구내함득이교정,25례(86%)환자복시소실。결론：AO삼유예성형태망재해부상가비교정학지수복광벽골절；재림상상,가이현저개선안구내함화복시。
Abstract?AlM:To evaluate the accuracy and practicability of three - dimensionally preformed Arbeitsgemeinschaft Osteosynthese AO titanium mesh plates for orbital fractures.?METHODS:Forty-seven patients with isolated blow-out orbital fractures were included in this study. Fracture locations were as follows: floor/medial wall ( n = 26, 55%), medial wall ( n = 12, 26%), and floor ( n = 9, 19%) . The floor fractures were exposed by a standard transconjunctival approach, whereas a combined transcaruncular transconjunctival approach was used in patients with medial wall fractures with temporary dissection of inferior oblique muscle. A three -dimensionally preformed AO titanium mesh plate was selected according to the size of the defect previously measured on the preoperative computed tomographic scan examination and fixed at the inferior orbital rim with 2 screws. The accuracy of plate positioning of the reconstructed orbit was assessed on the postoperative computed tomography ( CT) scan. The practicability of clinical use of AO three - dimensionally preformed titanium mesh plates was assessed on the preoperative and postoperative clinical data.?RESULTS: Postoperative orbital CT scan showed an anatomic three- dimensional placement of the orbital mesh plates in all of the patients. All patients had a successful treatment outcome without clinical complications. 40 patients ( 87%) had a successful enophthalmos correction. 25 patients ( 86%) had a successful recovery from diplopia.?CONCLUSlON: Three- dimensionally preformed AO titanium mesh plates for orbital fracture reconstruction results in an accurate anatomic restoration of the bony orbital contour with a high rate of success to correctenophthalmos and diplopia.