Early definitive surgical treatment of severe naso-orbital-
【Abstract】 Objective: To evaluate the treatment of early definitive surgery nasal orbital-ethmoid (naso orbital
ethmoid, NOE) fractures. Methods: 23 patients with severe
naso-orbital-ethmoid fractures of emergency patients,
according to body condition, fracture site, deformity surgery in order to determine characteristics, mode of operation combination, OK naso-orbital-ethmoid fractures, rigid fixation
with mini-titanium plate, inner canthal ligament suspension hanging and so on, to restore facial frame, appearance and function. Results: 23 patients face, mouth opening and biting jaw relations were restored or returned to normal, smaller inner canthal distance, inner canthal level of the sagittal nose height increases, three cases of depression did not improve the eye, diplopia disappeared. Conclusion: The severe naso-orbital-ethmoid fractures in patients with early
implementation of definitive surgery.
Key words naso-orbital ethmoid rigid internal fixation
[ABSTRACT] Objective: To explore the clinical effect of early definitive surgery for naso orbital ethmoid
fractures. Methods: Ddefinitive surgeries in early stage such as reduction of the fracture, rigid internal fixation (RIF), reconstruction, reattachment of the medial canthal ligament were performed on 23 cases of naso orbital ethmoid
fractures based on the conditions of physical examination, fracture and malformation. Results: In the 23 cases, the
complexions, occlusive relation and open reduction were resumed or nearly resumed. Conclusion: Early definitive surgery is a reliable and effective technique for naso
orbital ethmoid fractures patients.
[KEY WORDS] Naso orbital ethmoid; Rigid internal
fixation naso-orbital-ethmoid (naso orbital ethmoid,
NOE) refers specifically to the middle from both sides of the supraorbital foramen surface composition between the rectangular area , is located at the junction of craniofacial , including the nasal bone, maxillary, zygomatic, lacrimal bone, frontal and ethmoid bone, is the human body, one of the most complex anatomical structures. NOE fracture as soon as possible to restore its shape and function, reduce the incidence of deformity. We are NOE fractures in 23 patients with severe systemic disease in patients with stable conditions in the downstream of early definitive surgery, curative effect satisfaction, report as follows.
1 Data and methods
1.1 General information from 1998 to 2006 severe acute naso-orbital-ethmoid fractures of 23 patients, with brain, viscera and other relevant departments are required to injury treatment and to be in a stable condition Across definitive surgery. Male and 18 cases, female 5 cases, 16 53 years old,
an average of 33 years. 7 cases of maxillary fractures, zygomatic, zygomatic arch fracture in 15 cases, 19 cases of nasal bone fracture, orbital bone fracture in 11 cases. Patients with more than a facial collapse, deformity such as
performance, 18 cases of nasal collapse, 13 cases of widened inner canthal distance, two cases of diplopia, three cases of eye subsidence did not, three cases of facial numbness, 5 cases of limited mouth opening, three cases of biting jaw relationship poor, 2 cases with cerebrospinal fluid
rhinorrhea. According to Hopkins classification  a total of 35 side, ? categories: Center for bone fractures, 19 sides (54.29%); ? categories: Center for bone fracture segment, but the fracture line outside the area, including canthal ligament 11 sides (31.42% ); ? categories: center bone segment
fracture, fracture of the medial canthal ligament affected
area five sides (14.29%).
1.2 Materials used Xi'an Bang Co., Ltd. production of biological materials of titanium rigid internal fixation Titanium series, mini-titanium plate thickness of 0.6? Mm,
titanium screw diameter of 1.5? Mm, length 3 7? Mm.
1.3 treatments are guided minimally invasive facial incision principles, use of intraoral vestibular sulcus incision extraoral small incision, such as the palpebral margin, superciliary arch, ears ago, the nose next to the
temporal region, the eyes canthal incision, etc., for open wounds to make full use original port. Class ? fracture line
of fracture reduction and rigid internal fixation, ?, ? type
fractures fracture reduction, rigid internal fixation and inner canthal ligament suspension. With various forms of micro-titanium stent-line facial reconstruction and rigid
internal fixation to restore facial form and function.
After the January review, 22 cases (95.65%) population inside and outside the wound a healing, 1 case (4.35%), two healing. All the patients face, mouth opening and biting jaw relations restored or returned to normal, smaller inner canthal distance, inner canthal level of the sagittal nose height increases, three cases of depression did not improve
the eye, diplopia disappeared, but the facial numbness is not clear improvement. Reposted elsewhere in the paper for free download http://
In dealing with naso-orbital-ethmoid fractures, should
adhere to AO / ASIF (Association for the Study of
international fixation) advocated by anatomic reduction and stable fixation, non-invasive surgery and early functional
treatment of jaw fractures basic principles. In clinical, we found that for severe naso-orbital-ethmoid fractures, stump as
soon as possible line of micro-titanium rigid fixation of
fracture reduction can get a good three-dimensional film
stability, rare and then shift, and in parts of the bear and fractures the static and dynamic load, the stress transfer to effectively guide and avoid stress shielding, so that in absolute steady state reached I heal. While maintaining the
local blood supply, save the periosteum is also conducive to early healing of bone, so as to achieve satisfactory appearance and function of recovery, is particularly suited to be associated with bone defects and bone repair in patients
over the same period . Clinical fracture healing of delayed union or non-volatile and more from the retention caused by
poor blood circulation, two-dimensional instability and poor
blood circulation will fracture healing delay, three-
dimensional instability and ischemia have resulted in nonunion. Therefore, fracture fixation, when both have a good dimensional stability, but also consider the stress transfer, which is a prerequisite for bone remodeling later.
Treatment of NOE fracture fracture of the core issue is
reset, restore inner canthal distance and nose shape , to restore the stent surface, try to seek an orthopedic suture, because the availability of soft tissue is extremely limited, to tissue defect is too large may use of flaps, but should be
minimized with the "Z"-type "W" flap, to prevent the impact of facial scars and even lead to dysfunction, nose, ears and other parts should be noted that alignment suture, defects may be shaping the same period, the wounds sutured using minimally
invasive , and pay attention to maintaining the edge of lysis, generally do not lock suture.
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