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目的：探讨外伤性颌面部骨折患者实施正颌外科治疗的适应症、治疗步骤及容易出现的问题。方法：从1990年7月～1999年4月，我科共收治了67例因外伤性颌面部陈旧性骨折引起错位愈合而实施正颌外科手术的患者，骨折包括面中18骨折，下颌骨骨折，多发性骨折。采用的术式包括LefortI截骨术、下颌骨垂直或矢状劈开截骨术、切开复位固定术等，术中均采用骨间的小钛板坚强内固定。结果：术后63例获得良好的解剖外形及咬合关系。2例颧上颌骨骨折的患者，术后颧骨突度略显不足；2例下颌骨骨折患者术后出现局部感染，经二期手术后愈合。结论：对于外伤性颌面部陈旧性骨折引起的牙、、面畸形，正颌外科手术既能恢复其良好的解剖外形，又能改善其咬合关系，是目前最为行之有效的治疗方法。
Objective: To investigate the indications, treatment steps and problems that are prone to be treated by orthognathic surgery in traumatic maxillofacial fractures. Methods: From July 1990 to April 1999, a total of 67 patients underwent orthognathic surgery due to dislocation healing caused by obsolete fractures of traumatic maxillofacial region. The fractures included 18 fractures of the face, mandible Fractures, multiple fractures. The surgical procedures used include LefortI osteotomy, mandibular vertical or sagittal split osteotomy, open reduction and fixation, intraoperative osteosynthesis using a small titanium plate. Results: 63 patients achieved good anatomical appearance and occlusal relationship. In 2 patients with zygomatic maxilla fractures, the protrusion of the zygomatic bone was slightly less than that after operation. Two patients with mandibular fracture had local infection after operation and healed after two operations. CONCLUSIONS: It is the most effective and effective treatment for tooth, facial deformity and orthognathic surgery caused by the old fractures of traumatic maxillofacial region, which can not only restore its good anatomic appearance but also improve the occlusion relationship.