ABSTRACT
Objective To evaluate the effectiveness of computer-assisted navigation system on open reduction as treatment for complicated orbital fractures.Methods The computed tomography (CT) data for 6 patients with complicated orbital fractures were obtained before surgery and imported into the surgical planning software.After 3-dimensional (3D) construction and segmentation,data from the unaffected side were used to guide the reduction data,and surgical simulation was performed.All patients underwent open reduction under the guidance of the navigation system.The segments were then reduced to the predetermined places.CT measurements were used to evaluate navigation accuracy and bone symmetry.Results A fairly accurate match between the intraoperative anatomy and the computed tomography images was achieved through registration,with a systematic error of 1 mm difference.With guidance of the navigation system,open reduction of fractures was performed in all cases.The reduction was checked by postoperative computed tomography scans,with a good match with preoperative planning noted.The maximal deviation between the reduction and preoperative planning was less than 2 mm.The postoperative facial appearance of the patients was clearly improved.Conclusions Navigation-guided open reduction of complicated orbital fractures can be regarded as a valuable treatment option for this potentially complicated procedure.
ABSTRACT
Objective:To summarize the experience in the postopera ti ve management of free flap transfer for the repair of the defects in head and ne ck region. Methods:Thirty three free flaps were transfere d to repair head and neck defects.The factors that may influence the survive of the flaps,and the way that may be used to handle those problems were analyzed. Result: Thirty two of the thirty three free flaps surviv ed and one was lost. The overall free flap success rate was 97.0% .Thrombosis of vein developed in 2 patients. By flap salvage, one flap survived,the other ex perienced total failure. The total postoperative complication rate was 36.4% inc luding thrombosis,infection,bleeding,wound break and so on.Corresponding treatme nt was given and all the flaps were kept except one mentioned above. Conclution:The most common complications in free flaps transfer are v essel thrombosis and hematoma. Timely salvage can prevent the necrosis of the flaps
ABSTRACT
Objective:To study the indications, surgical technique and complications of the coronal approach in the treatment of zygomatic complex fractures.Methods:Eighty-four patients with zygomatic complex fracture underwent coronal incisions for surgery. Micro or mini titanium bone plates were used to stabilize the fractured bones.In patients with endophthalmos orbital wall fractures were treated with hydroxyapatite.Follow-up was conducted for 3 months to 2 years.Results:All patients had no wound infection after operation. There was no permanent facial nerve motor function deficit. All of the patients with malocclusion regained their functional occlusion after treatment. The patients with restriction of mouth opening recovered after training. Eight patients had observable asymmetry characterized by widening of the face on the side of the injury. One patient sustained the postoperative endophthalmos beyond 3 mm.Conclusion:Coronal approach is feasible in the surgical treatment of zogomatic complex fracture.