中国修复重建外科杂志

中国修复重建外科杂志

新型缝合钛丝联合钛钉内固定矫正严重陈旧性内眦畸形

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目的探讨新型缝合钛丝联合钛钉内固定矫正严重陈旧性内眦畸形的疗效。方法2012 年 3 月—2015 年 6 月,收治 18 例单侧严重陈旧性内眦畸形患者。男 14 例,女 4 例;年龄 23~62 岁,平均 42 岁。病因:交通事故伤 10 例,拳击伤 4 例,锐器划伤 3 例,动物咬伤 1 例。伤后患者均于外院采用缝线或钢丝内固定行内眦畸形矫正术但复发。该次手术与首次手术间隔 6 个月~2 年,平均 16 个月。术中采用鼻根部或内眦部皮肤瘢痕切口入路,充分松解内眦韧带与邻近组织瘢痕粘连,将新型缝合钛丝尾钩端固定于内眦韧带残端处,缝针端穿过陈旧瘢痕组织后缠绕固定于泪前嵴骨壁处钛钉,通过调节钛丝松紧确定内眦角的位置及形态。结果18 例患者术后切口均 Ⅰ 期愈合。患者均获随访,随访时间 6~12 个月,平均 10 个月。16 例患者双眼外形基本对称,内眦窝形成良好,未见钛钉及钛丝暴露。2 例患者术后 6 个月测量内眦回退 2 mm,因患者对外形满意未再次手术。结论新型缝合钛丝联合钛钉内固定矫正严重陈旧性内眦畸形可获得较好疗效,复发率低。

ObjectiveTo evaluate the effectiveness of a new type of sutured titanium wire combined with titanium nail internal fixation in correction of serious old medial canthus deformity.MethodsBetween March 2012 and June 2015, 18 patients with unilateral serious old medial canthus deformity were treated. There were 14 males and 4 females. The patient’s age ranged from 23 to 62 years (mean, 42 years). The causes of deformity included accident injury in 10 cases, boxing injury in 4 cases, sharp device scratching in 3 cases, and animal bite in 1 case. All patients had been treated with suture or steel wire fixation in other hospitals to correct the medial canthus deformity and the deformity recurred. The interval between this operation and the first operation was 6 months to 2 years (mean, 16 months). The nasal root or medial canthus skin scar incision was used as the operative approach, and the adhesion of the medial canthus ligament to the adjacent tissues was fully loosened, then the tail end of the new type sutured titanium wire was fixed to the residual end of the medial canthus ligament. After passing through the scar tissue, the needle end of wire was fixed on the titanium nail in the bone wall of anterior lacrimal crest. The position and shape of the medial canthus angle was determined by adjusting the tightness of titanium wire.ResultsAll incisions healed by first intention. All patients were followed up 6-12 months (mean, 10 months). In 16 cases, the medial canthus deformity was obviously corrected, and the appearances of bilateral eyes were basically symmetrical, without exposure of titanium nail and titanium wire. The medial canthus was retreated at 2 mm after 6 months in 2 cases, who were satisfied with their appearance without reoperation.ConclusionApplication of the new type of suture titanium wire combined with titanium nail in the correction of serious old medial canthus deformity can achieve good effectiveness with the low recurrence rate.

关键词: 陈旧性内眦畸形; 缝合钛丝; 钛钉; 内固定

Key words: Old medial canthus deformity; sutured titanium wire; titanium nail; internal fixation

引用本文: 张颖, 曾昌洪, 陈俊, 郭波. 新型缝合钛丝联合钛钉内固定矫正严重陈旧性内眦畸形. 中国修复重建外科杂志, 2018, 32(6): 718-721. doi: 10.7507/1002-1892.201712046 复制

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