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1、Universal Neuro 2,1.2mm Upper-Face Module 1.2mm上面部模块,1.7mm Mid-Face Module 1.7mm面中部模块,Universal Mandible 下颌通用套件,Mini-Plating System 迷你接骨板系列,Universal Neuro2系列,Mini-Plating System 迷你接骨板系列,Upper Face/ Mid Face 上面部/面中部,Midface面中部,The Midface is comprised primarily by Two Bones: 面中部主要包括两块骨骼： The Maxilla
2、 & the Zygoma上颌骨和颧骨 Maxillary fractures account for approximately 10% to 20% of all facial fractures 在所有面部骨折中上颌骨骨折的发生率约为10%-20%。,Buttresses支柱效应,Support pillars of the face and they transmit forces to the base of the skull. 像柱子一样支撑面部并将压力传导到头盖骨底部。 Reconstruction of these buttresses is the key to maxil
3、lary/midfacial repair (and the general principle of plate osteosynthesis) 在上颌骨/面中部骨折的修复中重建这些支柱非常关键（这也是颌面修复接骨板应用的普遍原则）。,Buttresses支柱效应,Vertical垂直的 Pterygomaxillary (posterior)翼突上颌（后面） Zygomatico-maxillary (lateral)颧骨上颌 （侧面） Nasomaxillary (medial) 鼻上颌（中间） Horizontal水平的 Nasofrontal (supraorbital rims)鼻
4、骨额骨（眼眶上缘） Nasomaxillary (inferior orbital rims)鼻上颌（眼眶下壁） Inferior border of mandible下颌骨下缘,Horizontal Vertical 水平的 垂直的,Frontal Bone额骨 Nasal Bones鼻骨 Ethmoid筛骨 Lacrimal Bone泪骨 Zygoma颧骨 Maxilla上颌骨 Alveolar Process牙槽突,Craniomaxillofacial (CMF) Trauma 颅颌面（CFM）外伤,Direct exposure and fixation of these buttr
5、esses provides anatomical restoration. 直接暴露并固定这些支柱有助于解剖结构的恢复。 Main goal is to restore:修复的主要目标： Height高度 Width宽度 Projection 投影,Surgical Exposure Selection 术野选择,Cosmetic appearance, inconspicuous area 对外表影响较小的不明显的区域。 Avoid when possible muscles and nerves尽量避开肌肉及神经。 Sensory nerves and cranial nerves感觉神
6、经及颅神经 Also consider unique anatomy of patient 还要考虑到患者解剖结构的特殊性。 Utilize open wounds for exposure to fracture site 利用开放的伤口暴露出骨折的位置。,Exposure of the maxilla: 暴露上颌骨 Intraoral: vestibular incision/ Sublabial/Gingivobuccal sulcus 口内入路：前庭切口/唇下/牙槽沟 Periorbital:眶周入路 Subciliary 睫下 Transconjunctival经结膜 Subtars
7、al 跗骨下 Infraorbital眶下 Lateral brow眉弓外侧 Coronal冠状 Upper Eyelid/Blephoroplasty 上睑/内眼角,Zygoma:颧骨： Gillies Gillies入路 Coronal冠状 Lateral brow眉弓外侧 Blepharoplasty眼睑成形术 Naso-orbital-ethmoidal:鼻-眶-筛 bicoronal incision 双侧冠状切口,Upper/MidFace Surgical Approaches 上面部/面中部手术入路,Coronal Approach冠状入路,To access: Zygomat
8、ic arch, Superior, medial & lateral orbital rims, Naso ethmoidal Region, and Frontal Sinus 可进入：颧弓、眼眶前部、中间及后部、鼻筛区及额陡,Coronal Approach 冠状入路,Pericranium颅骨膜,Coronal Approach 冠状入路,Gillies Approach Gillies 入路 For Closed Reduction of a Zygoma Fracture 用于颧骨骨折的闭合性复位,Upper Lid Blepharoplasty 上眼睑成形术入路,Zygoma F
9、ractures, Frontozygomatic Suture Line, and Orbital Roof Fractures, Lateral brow 颧骨骨折、额颧缝及眶顶骨折、眉弓外侧,Lateral Brow Incision 眉弓外侧切口,Zygoma Fractures, Frontozygomatic Suture Line, and Orbital Roof Fractures, Lateral brow 颧骨骨折、额颧缝及眶顶骨折、眉弓外侧,Lateral Brow Incision 眉弓外侧切口,Transconjunctival Approach 经结膜入路,Inf
10、erior Orbital Rim, Orbital Floor, ZMC fractures, Lateral Rim, and Medial Wall 前眶部、眶底、颧颌骨折、眶外侧壁及内侧壁,Subcilliary Approach 睫下入路,Inferior Orbital Rim, Orbital Floor, ZMC fractures and Lateral Rim 眶下缘、眶底、颧颌骨折、眶外侧,Infraorbital Incision 眶下切口,Inferior Orbital Rim, Orbital Floor, ZMC fractures and Lateral Ri
11、m 眶下缘、眶底、颧颌骨折、眶外侧,Subtarsal Approach 跗骨下入路,Subtarsal Approach 跗骨下入路,Tarsal Plate 睑板,Periorbital Incisions 眶周切口,Lateral Brow眉弓外侧 Upper Eyelid/Blepharplasty上睑/睑成形术 Transconjunctival经结膜 Subciliary睫下 Subtarsal跗骨下 Infraorbital眶下,Vestibular/Sublabial/ Gingivobuccal Sulcus Incision 前庭/唇下/牙龈槽切口,Vestibular/S
12、ublabial/ Gingivobuccal Sulcus Incision 前庭/唇下/牙槽沟切口,Vestibular/Sublabial/ Gingivobuccal Sulcus Incision 前庭/唇下/牙槽沟切口,Universal Upperface/Midface 通用上面部/面中部,Zygomaticomaxillary Complex Fracture (ZMC) 颧颌复合体骨折（ZMC）,Most common midface fracture! 是最常见的中面骨折,Zygoma Fracture: Surgical Approaches 颧骨骨折：外科手术入路,L
13、ateral brow incision (in or below the eyebrow) for access to the ZF suture 眉弓外侧切口（在眉毛里或在眉毛下）达到颧骨骨折线。 Vestibular incision for access to the zygomaticomaxillary buttress 前庭切口可以暴露颧颌支。 Subciliary, transconjunctival, subtarsal, or infraorbital for the inferior orbital rim and orbital floor 睫下、经结膜、跗骨下或眶下入
14、路用于暴露眶下部及眶底。 Gillies: Reposition of the zygoma temporally Gillies入路：可用于颧骨的临时复位。 Transbuccal (sharp hook or bone repositioning pin) 经颊的（可应用锐钩或骨复位针）,ZMC Fracture: Treatment 颧颌复合体骨折：治疗,Exposure of the fracture sites 暴露骨折位点。 Reduction of the fractured bone with a sharp hook or repositioning pin 用锐钩或复位针将
15、断骨复位。 Functionally stable plate osteosynthesis 功能性稳定的接骨术,ZMC Fracture: Repositioning Pin 颧颌复合体骨折：复位针,Transbuccal Stab Incision 经颊针刺切口,Classification of ZMC Fractures 颧颌复合体骨折的分类,Increasing displacement 位移增大 Occular dystopia异位 Flat cheekbone cosmetic deformity颧弓变平 Increased comminuting 加重粉碎损伤 Floor &
16、lateral wall disruption 底部及外侧壁断裂,ZMC Fracture Types 颧颌复合体骨折类型,第1类,第2类,第3类,第4类,Type 1 & 2 ZMC Treatment 第1类及第2类颧颌复合体骨折的治疗,Reduction修复 Two point fixation with rigid miniplates (1.2/1.7mm): 用微型硬接骨板（1.2/1.7mm）进行两点固定 ZF suture & Inferior orbital rim 颧颌缝及眶下缘,Type 3 ZMC Treatment 第3类颧颌复合体骨折,Reduction 修复 Wire interfragmentary alignment 线性骨折 Three point fixation:三点固定 ZF suture颧颌缝 Inferior Orbital Rim眶下缘 Zygomaticomaxillary buttress 颧颌支,Type 4 ZMC Treatment 第4类颧颌复合体骨折,Reduction修复 F
