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1、陈旧性眶额骨折合并眼球内陷治疗［摘要］目的：探讨陈旧性眶额骨折后眼球内陷的整复治疗。方法：术前常规行X线检查、眶部轴面及冠状位扫描及三维重建，了解眶颜骨骨折及眶内容物移位嵌顿情况。术中首先暴露骨折部位,将移位的骨折块截骨复位、微型钛板坚强内固定，重建正常的眶缘；用自体或人工材料植入，同时修复眶壁。结果：所有病例眼球内陷均得以明显改善或矫正,额部外形明显改善，眼球运动功能得以恢复，CT显示眶结构恢复良好，内直肌及下直肌位置及形态正常，视神经无受压。结论：陈旧性眶颤骨折所致晚期眼球内陷畸形可通过截骨复位、植入自体或人工材
2、料重建眶缘，修复眶骨各壁的缺损获得有效矫正。［关键词］眶额骨折；眼球内陷；手术治疗［中图分类号1R622［文献标识码］A［文章编号］1008-6455(2009)02-0166-03ThetreatmentoflateorbitozygomaticfracturewithenophthalmosWUGuo-ping,HEXiao-chuan,TENGLi,GUOLi,LIYue-gang,LIAOYi,XIONGAi-bing(DepartmentofPlasticandBurnSurgery,theAffilate
3、dHospitalofLuzhouMedicalCollege,Luzhou646000,Sichuan,China)Abstract：ObjectiveTostudythesurgicaltreatmentofenophthalmosdeformitycausedbyorbitozygomaticfractures.MethodsX-ray,Acoronalandanaxialcomputedtomographyscanoftheorbit,andthree-dimensionalCTreconstructionw
4、ereemployedtodemonstratethestatusoftheorbitozygomaticfractureandthedisplacementandherniatedorbitalcontentsofthepatientspreoperatively.Followingexposedthefracturedarea,thedisplacedorbitalboneswererepositionedafterosteotomyandrigidfixedbymicro-plateandscrewstorec
5、onstmcttheorbitalrim.Thenthefracturedorbitalwallswererepairedpreciselywithautogenousboneandbiomaterialwhichwerefixedtotheareabeneaththeperiosteum.ResultsAllpatientshadtheirenophthalmosdeformitycorrectedandregainedsatisfactoryzygomaticofacialappearancewiththiste
6、chnique・Themovementofthegloberecoveredwell,postoperativeCTscandemonstratingorbitalwallswerereconstruetedwell,thelocationandformationofmedialandinferiorrectusmusclewerenormal,andtherewasnoopticnervecompressed.ConclusionsThelateorbitozygomaticfracturewithenophtha
7、lmosdeformitycanbecorrectedorobviouslyimprovedbythereductionofdisplacedbonefragmentsandprecisereconstructiontheorbitalwallswithautogenousboneandbiomateria1.Keywords：orbitozygomaticfracture；endophthalmos；surgicalprocedures颜骨与眶骨及上颌骨的解剖毗邻关系密切，额骨骨折特别是由高速直接暴力所致，势必导致
8、邻近骨的骨折。眶额骨折造成眶壁破坏、眶周骨移位塌陷、眶内容物疝出或丢失。因各种原因早期未得到及时复位固定或治疗不当，当肿胀消退后，由于骨折段的畸形愈合、吸收、瘢痕挛缩牵拉，造成后期眶额骨以及邻近器官和软组织结构的畸形。而眶额骨折所致后期眼球内陷一直被认为是该区域创伤后畸形矫正的重点和难点。笔者2004年7月〜2008年7月收治额眶骨折伴眼球内陷
