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correct surgery
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     Conclusion: It's essential for the anatomic reduction that proper surgical incision and correct surgery sequence be selected for complex fractures;
     结论 :选择适当的手术切口和正确的复位顺序是手术能够达到解剖复位的关键 ;
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     Which is correct?
     到底哪一种说法合理?
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Objective: To study selection of surgical incisions and therapy sequences in complex fractures of midfacial region.Method: 62 patients with complex fractures of midfacial region were treated with open reduction and internal fixation. After surgery the complexion, proportion of the face, occlusion, opening mouth extent,facial paralysis,cerebrospinal fluid leak, diplopia,X ray and spiral CT etc. were evaluated.Result: In 52 of 57 patients, the facial complexions resumed after surgery; all of 44 patients with abnormal...

Objective: To study selection of surgical incisions and therapy sequences in complex fractures of midfacial region.Method: 62 patients with complex fractures of midfacial region were treated with open reduction and internal fixation. After surgery the complexion, proportion of the face, occlusion, opening mouth extent,facial paralysis,cerebrospinal fluid leak, diplopia,X ray and spiral CT etc. were evaluated.Result: In 52 of 57 patients, the facial complexions resumed after surgery; all of 44 patients with abnormal facial proportion were resumed; in 37 of 41 patients occlusive relations were resumed or nearly resumed; all of 48 patients with open reduction resumed; in 47 of 62 patients anatomic reduction were achieved by X-ray; in 34 patients 24 achieved anatomic reduction and 10 nearly did so by CT examination.Conclusion: It's essential for the anatomic reduction that proper surgical incision and correct surgery sequence be selected for complex fractures; Le-Fort I osteotomy normally be selected in high-level maxillary fractures to restore occlusion; reduction of nasal bone and medial cathal tendon is crucial for naso-orbital-ethmoid fractures.

目的 :探讨面中部复杂骨折手术切口设计和骨折复位顺序。方法 :对 62例面中部复杂骨折进行手术复位和内固定 ,术后对面形、面部比例、牙合关系、张口度、面瘫、脑脊液鼻耳漏、复视、X线和CT等项目进行评估。结果 :5 7例中 5 2例术后面部外形恢复正常 ;出现面中、面下比例异常的 44例患者全部恢复正常比例 ;41例中 3 7例术后牙合关系恢复正常或接近正常 ;48例出现张口受限病例全部恢复正常 ;62例患者中 47例术后X线复查达到解剖复位 ;3 4例中术后CT复查 2 4例达到解剖复位 ,10例为基本复位。结论 :选择适当的手术切口和正确的复位顺序是手术能够达到解剖复位的关键 ;上颌骨高位骨折一般采用Le -FortⅠ型截骨复位 ,恢复术前牙合关系 ;鼻眶筛骨骨折鼻骨和内眦韧带复位非常关键

 
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