Abstract：Objective A study was conducted to explore the curative effect of M-type zygomatic arch fractures using microincision closed reduction.Methods From March 2015 to May 2019, 45 cases of M-type fractures of the zygomatic arch were admitted to the 901st Hospital of the Joint Logistics Support Force of PLA and recruited for the study. There were 35 males and 10 females with age of 16-71 years old, and 30 patients were on the left side, 15 patients on the right side. Thus, surgery was performed by intraoral small incision approach. The reduction effect was preliminarily evaluated with C-arm machine and mouth opening change. The reduction effect and satisfaction assessment of the patients were evaluated with CT and visual analog scale (VAS).Results Among the 45 patients, 44 were successfully reset once, and one patient was reset twice during the operation. No facial nerve injury was observed, and the therapeutic effect was satisfactory. Postoperative follow-up was conducted for 3-6 months. The average preoperative mouth opening was (2.76±0.37) cm, and the average postoperative mouth opening was (3.91±0.15) cm; the differences were statistically significant (t=23.752, P<0.05). The 45 patients who underwent CT evaluation in 3-6 months after the operation achieved anatomical reduction. The differences between the degrees of zygomatic protrusion on both sides were (4.43±0.28) mm preoperatively and (0.47±0.09) mm postoperatively with statistically significant differences (t=93.281, P<0.05). Among these 45 patients, 42 patients and 3 patients had grade Ⅰ and grade Ⅱ healing respectively. The VAS score of postoperative satisfaction was 99.50%±2.15%.Conclusions The treatment of M-type zygomatic arch fractures with microincision closed reduction is a safe, effective and easy to master method, which deserves further clinical application.
周本忠, 马云霞, 王胜国, 李龙巧, 陈志太, 史先萍, 吴飞凤, 张泽生. 微切口闭合复位术治疗单纯性颧弓M型骨折的疗效分析[J]. 中华解剖与临床杂志, 2020, 25(5): 532-536.
Zhou Benzhong, Ma Yunxia, Wang Shengguo, Li Longqiao, Chen Zhitai, Shi Xianping, Wu Feifeng, Zhang Zesheng. Curative effect analysis of M type zygomatic arch fracture using microincision closed reduction. Chinese Journal of Anatomy and Clinics, 2020, 25(5): 532-536.
Kim J, Kim S, Chung S, et al. Zygomatic arch fracture: a new classification and treatment algorithm with epidemiologic analysis[J]. J Craniofac Surg, 2014, 25(4): 1389-1392. DOI:10.1097/SCS.0000000000000864.
[2]
He Y, Zhang Y, An JG, et al. Zygomatic surface marker-assisted surgical navigation: a new computer-assisted navigation method for accurate treatment of delayed zygomatic fractures[J]. J Oral Maxillofac Surg, 2013, 71(12): 2101-2114. DOI:10.1016/j.joms.2013.07.003.
[3]
喻棣, 陈剑云, 李小新, 等. 局部小切口结合可吸收接骨板治疗颧骨颧弓骨折效果观察[J]. 现代实用医学, 2015, 27(6): 733-734. DOI:10.3969/j.issn.1671-0800.2015.06.019.Yu L, Chen JY, Li XX, et al. The effect of small local incision combined with absorbable bone plate on zygomatic arch fracture of zygomatic bone was observed[J]. Modern Practical Medicine, 2015, 27(6): 733-734. DOI:10.3969/j.issn.1671-0800.2015.06.019.
[4]
张清彬, 东耀峻, 李祖兵, 等. 210例颧骨复合体骨折的临床回顾性研究[J]. 北京口腔医学杂志, 2005, 13(1): 41-43. DOI:10.3969/j.issn.1006-673X.2005.01.014.Zhang QB, Dong YJ, Li ZB, et al. A 12-year retrospective clinical study of zygomatic complex fractures of 210 patients[J]. Beijing Journal of Stomatology, 2005, 13(1): 41-43. DOI:10.3969/j.issn.1006-673X.2005.01.014.
[5]
Knight JS, North JF. The classification of malar fractures: an analysis of displacement as a guide to treatment[J]. Br J Plast Surg, 1961, 13(2): 325-339. DOI:10.1016/s0007-1226(60)80063-x.
[6]
Hwang K, Kim DH. Analysis of zygomatic fractures[J]. J Craniofac Surg, 2011, 22(4): 1416-1421. DOI:10.1097/SCS.0b013e31821cc28d.
[7]
邱蔚六. 口腔颌面外科学[M]. 6版. 北京: 人民卫生出版社, 2008: 208.
[8]
赵平, 徐兵, 史俊. 颧骨复合体骨折的治疗(附108例病例报告)[J]. 上海口腔医学, 2001, 10(3): 281-283. DOI:10.3969/j.issn.1006-7248.2001.03.031.Zhao P, Xu B, Shi J. Treatment of the zygomatic complex fracture(ZMC) with clinical reports of 108 cases[J]. Shanghai Journal of Stomatology, 2001, 10(3): 281-283. DOI:10.3969/j.issn.1006-7248.2001.03.031.
[9]
刘磐, 谷峰, 闫德民, 等. 颧弓上缘小切口入路治疗颧弓骨折[J]. 河南科技大学学报, 2018, 36(1): 34-36. DOI:10.15926/j.cnki.issn1672-688x.2018.01.009.Liu P, Gu F, Yan DM, et al. Using micro-incision approach on superior margin of zygomatic arch to treat zygomatic arch fractures[J]. J Henan Univ Sci Tech(Med Sci), 2018, 36(1): 34-36. DOI:10.15926/j.cnki.issn1672-688x.2018.01.009.
[10]
Swanson E, Vercler C, Yaremchuk MJ, et al. Modified Gillies approach for zygomatic arch fracture reduction in the setting of bicoronal exposure[J]. J Craniofac Surg, 2012, 23(3): 859-862. DOI:10.1097/SCS.0b013e31824dd5c3.
[11]
de Souza Carvalho AC, Pereira CC, Queiroz TP, et al. Intraoral approach to zygomatic fracture: modified technique for infraorbital rim fixation[J]. J Craniofac Surg, 2012, 23(2): 537-538. DOI:10.1097/SCS.0b013e3182418ea6.
[12]
骆琦, 肖文芝, 陈涌, 等. 内镜辅助下颧弓骨折切开复位内固定治疗的临床研究[J]. 华西口腔医学杂志, 2016, 34(2): 166-168. DOI:10.7518/hxkq.2016.02.012.Luo Q, Xiao WZ, Chen Y, et al. Clinical study on endoscope-assisted repair of zygomatic arch fracture[J]. West China Journal of Stomatology, 2016, 34(2): 166-168. DOI:10.7518/hxkq.2016.02.012.
[13]
薄琳, 苏法仁, 丁静华. 颧弓骨折临床诊断进展[J]. 国际耳鼻咽喉头颈外科, 2016, 40(1): 53-56. DOI:10.3760/cma.j.issn.1673-4106.2016.01.012.Bo L, Su FR, Ding JH. Treantment progress of zygomatic and zygomatic arch fracture[J]. Int J Otolaryngol Head Neck Surg, 2016, 40(1): 53-56. DOI:10.3760/cma.j.issn.1673-4106.2016.01.012.
[14]
杨荣涛, 李智, 李祖兵. 应用计算机辅助手术导航系统经口内径路复位颧弓M型骨折临床观察[J]. 中国实用口腔科杂志, 2015, 8(11): 675-678. DOI:10.7504/kq.2015.11.010.Yang RT, Li Z, Li ZB. Reduction of zygomatic arch M-shaped fracture with computer-assisted navigation system by intraoral approach[J]. Chinese Journal of Practical Stomatology, 2015, 8(11): 675-678. DOI:10.7504/kq.2015.11.010.
[15]
王科, 彭国光, 谭玉莲, 等. 皮下双筋膜切口治疗颧弓M型骨折[J]. 中华口腔医学研究杂志(电子版), 2016, 10(1): 55-58. DOI:10.3877/cma.j.issn.1674-1366.2016.01.010.Wang K, Peng GG, Tan YL, et al. Treatment of M type zygomatic arch fracture using two subperiosteal access[J]. Chinese Journal Stomatol Res(Electronic Edition), 2016, 10(1): 55-58. DOI:10.3877/cma.j.issn.1674-1366.2016.01.010.
[16]
Homer A, Homer B, Sullivan SR, et al. The natural history of treated and untreated zygomatic arch fractures[J]. J Craniofac Surg, 2019, 30(7): e631-e633. DOI:10.1097/SCS.0000000000005657.
2020, Vol. 25 
