| 摘要 |
FIELD: medicine.SUBSTANCE: invention relates to field of medicine, namely to maxilla-facial surgery and ophthalmology and can be applied in treatment of patients with fractures of middle zone of face and orbit bottom. Essence of method lies in performing access to reposition place, reposition of bone fragments by means of plate with further wound sewing. Access is performed outside face skeleton. Two cuts are made: first 15-20 mm long cut is made on upper eyelid crease, second cut is made after hydropreparation of conjunctiva with 0.09% sodium chloride solution and 0.1% adrenalin solution. In it lower eyelid skin is dissected for 10-12 mm downward at 45° angle to horizontal plane. After that, lateral canthal ligament in dissected in horizontal plane, ligament ends are taken on holders. Dissected are: conjunctiva to lacrimal sac in medial direction, orbicular muscle of eye and periosteum on infraorbital edge. Revision of orbit bottom to orbital eminence is performed by means of hydropreparation and periosteum dissection. After that, reposition of zygomatic bone fragments of inferior wall of orbit is performed by means of Limberg's hook. Strangulated muscles of eye and orbital cellular tissue are released to orbital eminence by means of orbital retractor. Osteosynthesis with titanium mini-plates and screws is performed first on zygomaticofrontal suture, then on infraorbital edge. Replacement of orbit bottom defect is performed with mesh implant from perforated polymer, which has shape of isosceles trapezoid with rounded angles and parallel arch-like bases, in which cone-shaped holes are made for its fixation on anterior edge of orbit.EFFECT: application of claimed invention makes it possible to reduce number of early and late postoperative complications, both after acute trauma and in elimination of posttraumatic deformation, eliminate diplodia by orbit bottom plasty with modelled polymer plate.1 dwg, 1 ex |
