背景:由于复杂的解剖形态和zy复合体(ZMC)表面缺乏解剖标记,ZMC骨折的治疗效果往往不理想.
目的:该研究旨在评估术中计算机断层扫描(ICT)治疗单侧ZMC骨折的有效性,并进一步研究ICT替代术后早期计算机断层扫描(CT)的可行性。
■研究人员设计了一项回顾性队列研究。纳入接受单侧ZMC骨折手术的成年患者。
方法:根据术中是否使用CT,将受试者分为ICT组和对照组(不含ICT)。
方法:代表双侧ZMC对称性的5个距离和3个角度是主要结果变量。比较2组之间结果变量的差异,并进一步比较ICT组的指标及其术后指标。
■人口统计(如年龄),病因(如交通伤害),功能障碍(如复视),和手术入路(如前庭切口)作为协变量进行临床研究,考试,和执行。
方法:数据采用独立样本t检验,配对样本t检验,Mann-WhitneyU测试,和χ2检验。P值<0.05被认为具有统计学意义。
结果:本研究共纳入60例患者(18-59岁)。ICT组的所有测量值的中位数均小于对照组,以及水平位移距离的差异(0.56对1.02mm),前后位移距离(1.69对2.34mm,0.90对2.35mm),双侧颧弓水平角(2.31vs4.19°),2组之间的双侧the突水平角度(1.77vs2.94°)差异有统计学意义,P值<.05。此外,ICT组的术中和术后损伤侧的所有指标均无统计学差异。
结论:通过评估手术中骨折复位的充分性,ICT可以改善ZMC骨折的治疗效果。此外,ICT可以代替术后早期CT。
Due to the complex anatomical morphology and lack of anatomic markers on the surface of zygomatic complex (ZMC), the treatment results of ZMC fractures are often suboptimal.
The study aimed to evaluate the effectiveness of intraoperative computed tomography (ICT) in the treatment of unilateral ZMC fractures, and further study the feasibility of ICT to replace early postoperative Computed Tomography (CT).
The investigators designed a retrospective cohort study. Adult patients who underwent surgery with unilateral ZMC fractures were enrolled.
According to whether intraoperative CT was used, the subjects were divided into the ICT group and the control group (without ICT).
Five distances and 3 angles representing bilateral ZMC symmetry were main outcome variables. The differences of outcome variables were compared between the 2 groups and the indices of ICT group were further compared with their postoperative indices.
Demographics (eg age), etiology (eg traffic injury), dysfunction (eg diplopia), and surgical approach (eg vestibular incision) were collected as covariates while we conducted clinical investigation, examination, and implementation.
The data were analyzed using independent-samples t test, paired-samples t test, Mann-Whitney U test, and χ2 test. P value < .05 was considered statistically significant.
A total of 60 patients (18 to 59 years) were enrolled in this study. All median values of the measurements in the ICT group were smaller than those in the control group, and the differences of horizontal displacement distance (0.56 vs 1.02 mm), anteroposterior displacement distance (1.69 vs 2.34 mm, 0.90 vs 2.35 mm), horizontal angle of bilateral zygomatic arch (2.31 vs 4.19°), and horizontal angle of bilateral zygomatic process (1.77 vs 2.94°) were significantly different between the 2 groups with P value < .05. Moreover, there was no statistically significant difference in all indices between the intraoperatively and postoperatively injured sides in the ICT group.
ICT can improve the treatment outcomes of ZMC fractures by evaluating the fracture reduction adequacy during surgery. Moreover, ICT can replace early postoperative CT.