CAJ | 학술논문

目的：观察联合面部小切口穿皮内固定微创治疗颌面部骨折的效果，总结经验。方法：对2011-03—2014-04期间收治的87例颌面部骨折病例，采用口内切口或颞部发际内切口显露骨折，并联合面部皮肤小切口，应用穿皮技术进行内固定治疗。观察穿皮操作技术的可行性。观察术后有无面神经损伤、腮腺导管损伤和涎瘘，并评价手术治疗效果。结果：87例病例中，81例采用口内切口，6例采用颞部发际内切口显露骨折，经面部小切口穿皮内固定手术均顺利完成。穿皮操作未发现有面神经分支损伤、腮腺导管损伤和涎瘘等症状。采用口内切口中有5例术后伤口有渗出，伤口延期愈合，其中3例术后反复感染。术后1~3个月复查，X线检查发现1例髁颈下部骨折错位固定，87例患者面部外形对称，面部小切口瘢痕不明显，张口和咬合功能恢复正常。结论：联合面部小切口穿皮内固定技术为颌面部某些骨折内固定提供了可行的垂直手术通道，该方法手术创伤小，骨折固定可靠，术后并发症少，不影响面部皮肤美观。
목적：관찰연합면부소절구천피내고정미창치료합면부골절적효과，총결경험。방법：대2011-03—2014-04기간수치적87례합면부골절병례，채용구내절구혹섭부발제내절구현로골절，병연합면부피부소절구，응용천피기술진행내고정치료。관찰천피조작기술적가행성。관찰술후유무면신경손상、시선도관손상화연루，병평개수술치료효과。결과：87례병례중，81례채용구내절구，6례채용섭부발제내절구현로골절，경면부소절구천피내고정수술균순리완성。천피조작미발현유면신경분지손상、시선도관손상화연루등증상。채용구내절구중유5례술후상구유삼출，상구연기유합，기중3례술후반복감염。술후1~3개월복사，X선검사발현1례과경하부골절착위고정，87례환자면부외형대칭，면부소절구반흔불명현，장구화교합공능회복정상。결론：연합면부소절구천피내고정기술위합면부모사골절내고정제공료가행적수직수술통도，해방법수술창상소，골절고정가고，술후병발증소，불영향면부피부미관。
Objective: To observe the effects of minimally invasive approaches with percutaneous internal fixation in the treatment of maxillofacial fractures. Methods: From 2011-01—2014-04, 87 cases of maxillofacial fracture patients were undergone intraoral or temporal intra-hairline incision to expose the fracture sites and combined with percutaneous inter-nal fixation through small facial incisions. After reduction, the feasibility and postoperative effects, the incidence of facial nerve injury, parotid duct injury, and salivary fistula complications were observed.and recorded. Results: In order to ex-pose fracture site, intraoral incision approach was used in 81 patients, and temporal intra-hairline incision approach was used in 6 patients. At the same time, through small facial incision and by using percutaneous internal fixation technique, the operations of all 87 cases were successfully completed. Percutaneous internal fixation technique did not cause facial nerve branch injury and parotid duct injury, did not cause salivary fistula. In patients of intraoral incision, 5 cases under-gone infection, and the wound healing was delayed. Postoperative examination by X-ray, a misplaced fixation of fracture was found in 1 patient. After 1-3 months follow-up, the facial appearance of 87 patients was symmetrical, the scar of small facial incision was not obvious. The mouth opening and occlusion function returned to normal. Conclusion:The method of percutaneous internal fixation through small facial incision provides a feasible vertical fixation channel for operative treat-ment of some maxillofacial fractures.