Comparative study of different surgical approaches in the treatment of
zygomatic complex fractures

doi:10.3760/cma.j.issn.1007-1245.2022.10.024

Abstract

Abstract: Objective　To observe the effects of open reduction and internal fixation through local small incision and semi coronal incision in the operation of zygomatic complex fractures. Methods　A prospective study was conducted to select 93 patients with zygomatic complex fractures who were treated in the Department of Stomatology, The People's Hospital of Taierzhuang District, Zaozhuang from January 2017 to August 2021. The patients were divided into a transcranial semi-coronal incision group (45 cases) and a local small incision group (48 cases). The operation time and intraoperative bleeding volume were compared between the two groups. Three dimensional reconstruction of maxillofacial CT was performed again 3 months after operation to evaluate fracture reduction and healing, and the success rate of reduction was compared between the two groups. The incidence of adverse reactions such as alopecia and scalp sensory disturbance was compared. Independent sample t test was used for the measurement data and χ² test was used for the count data. Results　In the semi-coronal incision group, there were 33 males and 12 females, aged (36.24±7.58) years; in the small incision group, there were 37 males and 11 females, aged (34.81±6.73) years. The operation time and intraoperative bleeding volume of the semi-coronal incision group were (116.84±23.36) min and (86.73±20.47) ml, respectively, which were higher than those of the local small incision group [(87.31±18.59) min and (25.06±12.53) ml], with statistically significant differences (both P<0.05). The success rate of reduction in the semi-coronal incision group was 97.78% (44/45), which was significantly higher than that in the small local incision group [83.33% (40/48)] (χ²=5.544, P=0.189); there was no statistically significant difference in the success rate of Zingg type B reduction between the two groups (P>0.05); the success rate of type C reduction in the semi-coronal incision group was 95.24% (20/21), which was higher than that in the local small incision group [70.00% (14/20)], with a statistically significant difference (χ²=4.609, P=0.032). The incidence of adverse reactions in the semi-coronal incision group was 24.44% (11/45), which was higher than that in local small incision group [6.25% (3/48)], with a statistically significant difference (χ²=6.012, P=0.014). Conclusions　Patients with Zingg classification type B can choose the local small incision approach to reduce the amount of bleeding and complications such as temporal depression and local alopecia. Type C patients can choose the semi coronal approach to achieve accurate reduction and reliable fixation.

摘要： 目的　观察复杂颧骨复合体骨折手术中局部小切口入路与半冠状切口入路行切开复位内固定术的效果。方法　采用前瞻性研究方法，选择2017年1月至2021年8月枣庄市台儿庄区人民医院口腔科收治的颧骨复合体骨折拟行切开复位内固定患者93例，分为经头皮半冠状切口组45例和局部小切口入路组48例。比较两组手术时间、术中出血量；于术后3个月再次行颌面部CT三维重建，评估骨折复位以及愈合情况，比较两组复位成功率；比较术区秃发、头皮感觉障碍等不良反应发生情况。计量资料行独立样本t检验，计数资料行χ²检验。结果　半冠状切口组男33例、女12例，年龄（36.24±7.58）岁；局部小切口组男37例、女11例，年龄（34.81±6.73）岁。半冠状切口组手术时长、术中出血量分别为（116.84±23.36）min、（86.73±20.47）ml，均高于局部小切口组的（87.31±18.59）min、（25.06±12.53）ml，差异均有统计学意义（均P<0.05）。半冠状切口组复位成功率为97.78%（44/45），高于局部小切口组83.33%（40/48），差异有统计学意义（χ²=5.544，P=0.189）；两组Zingg B型复位成功率比较，差异无统计学意义（P>0.05）；半冠状切口组C型复位成功率为95.24%（20/21），高于局部小切口组70.00%（14/20），差异有统计学意义（χ²=4.609，P=0.032）。半冠状切口组不良反应发生率为24.44%（11/45），高于局部小切口组6.25%（3/48），差异有统计学意义（χ²=6.012，P=0.014）。结论　Zingg分类B型患者可选择局部小切口入路以降低出血量，减少颞部凹陷、切口局部秃发等并发症。C型患者可选择半冠状入路以实现精确复位、可靠固定。

Li Changdong, Wang Siming. Comparative study of different surgical approaches in the treatment of zygomatic complex fractures[J]. International Medicine and Health Guidance News, 2022, 28(10): 1431-1434.

李常东, 王思明. 不同手术入路治疗颧骨复合体骨折的对照研究[J]. 国际医药卫生导报, 2022, 28(10): 1431-1434.

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Comparative study of different surgical approaches in the treatment of zygomatic complex fractures

不同手术入路治疗颧骨复合体骨折的对照研究

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