Abstract
目的 探讨颅骨凹陷骨折治疗的合理手术方法和最佳手术时机.方法应用自行设计的颅骨凹陷骨折整复器,在伤后7～14 d对182例颅骨凹陷骨折患者(含开放性凹陷骨折93例)进行手术骨瓣塑形.结果骨折解剖复位163例,19例在整复塑型时骨瓣破裂,但整体形状复原能镶嵌回置.凹陷骨折并发的各种颅内病变(脑膜脑损伤及血肿)均在术中得到直视下的探查处理.全组无感染病例.因凹陷骨折压迫造成的神经功能障碍术后均得到恢复.影像学检查骨折均达解剖复位.1年后随访的31例骨折患者愈合良好.结论颅骨凹陷骨折成形骨瓣塑型整复术能恢复颅骨原有解剖形状,解除脑受压,有效的探查处理凹陷骨折深面并存病变,又能避免颅骨缺损.手术时机以伤后7～14 d为最佳.污染不重和未发生明显感染的开放性凹陷骨折也可行手术整复。
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