多孔聚乙烯包埋的钛网植入治疗眼眶爆裂性骨折

摘要

目的 观察多孔聚乙烯包埋的钛网植入治疗眼眶爆裂性骨折的临床疗效.方法 回顾性总结20例(20只眼)眼眶爆裂性骨折(6例内侧壁骨折,6例下壁骨折,8例内、下壁联合骨折).复视6例,眼球内陷大于3 mm者6例,眼球明显下移2例,眼眶骨折面积大于20 mm×20 mm且较多眶内容疝出者6例.所有病例均行眼眶骨折整复术,内侧壁骨折者经内眦顺皮纹切口,下壁骨折及内、下壁联合骨折患者经下睑缘皮肤切口.骨折区植入多孔聚乙烯包埋的钛网.结果 随访3～6个月,复视完全消失5例,明显改善1例,6例眼球内陷者均矫正至内陷2 mm以内,2例眼球下移者均恢复正位,6例眼眶骨折大于20 mm×20 mm者未出现明显眼球凹陷,术后视力无明显变化.术后无植入物移位、脱出或眼球运动受限等并发症.结论 多孔聚乙烯包埋的钛网治疗眼眶骨折是安全、有效、稳定的.%Objective To observe the clinical efficacy of porous polyethylene titanium mesh implants for orbital blowout fractures.Methods The data of 20 eyes of 20 cases of blowout orbital fracture were retrospectively analyzed,including 6 cases of orbital medial wall fractures,6 cases of orbital floor fractures,and 8 cases of orbital floor and medial wall fractures.There were 6 cases with diplopia,6 cases with enophthalmos more than 3 mm,2 cases with apparent downward globe dystopia,6 cases of the fracture area over 20mm x 20mm with herniation of large amount of orbital contents.Orbital fracture repair surgery was performed in all cases.The diorthosis of orbital fracture with an incision at inner canthus to implant porous polyethylene titanium mesh was performed in 6 cases of orbital medial wall fractures.Diorthosis of orbital fracture with an incision at lower palpebral margin to implant prefabricated mesh was performed in the rest 14 cases.Results All patients were followed up for 3 to 6 months.Diplopia was completely disappeared in 5 cases,and improved in 1 case.The 6 cases of enophthalmos was successfully corrected to less than 2 mm of enophthalmos.The vertical globe dystopia of the 2 cases disappeared.6 cases of the fracture area more than 20 mm × 20 mm had not showed enophthalmos.No visual acuity impairment was observed.No complications such as limited eyeball movement,rejection or migration of the implants occurred.Conclusion Porous polyethylene titanium mesh implants for orbital blowout fractures is safe,effective and stable.