目的探讨运用眶周分块截骨术治疗因眶颧部骨折所致眼球错位的可行性及效果。方法 26例单侧非爆裂性颧骨骨折患者的眶颧部移位骨块被截成两部分,将参与构成眼眶外下部的骨块向内上移位、固定以重建眼眶,对于不影响眼眶重建的移位骨块不作截骨复位。结果术后眼眶容积及眼球凸度得到有效改善,23例眼球位置显著改善,3例眼球凹陷症状部分纠正。术后随访1年,眼球位置及眼眶形态满意。结论眶周分块截骨术较传统的截骨术式操作简单,术中剥离范围小,可以恢复眼眶的生理解剖结构,并可有效矫正因眶颧部骨折所致的眼球错位。

Objective To explore the feasibility and outcome of segmental osteotomy in the treatment of the eyeball dystopia resulted from orbitalzygomatic fracture.Methods Among 26 cases of unilateral non-comminuted orbitozygomatic fractures,segmental osteotomy technique was used to depart the displaced orbitozygomatic complex.The fragment with contribution to lateral inferior orbital structure was mobilized upward and fixed.On the contrary,the fragment without contribution to the orbital structure was not mobilized.Results The volume of fractured orbit and the globe projection were adjusted considerably.Subjective assessment of the patients’ globe position displayed that 23 cases were satisfied with the outcome and 3 cases thought it acceptable.After 1 year follow-up,clinic appearances of ocular malposition and orbital deformity have been improved and retrieved efficiently.Conclusion Compared to the traditional methods,the segmental osteotomy as a simple technique with less dissection can reconstruct the orbital anatomic structure and restore globe position effectively.