簡易型鼻外夾板固定

A Simple External Nasal Splint Fixation

背景：在封閉式鼻骨矯正術後最好能施以鼻外固定，但無一材料盡善盡美，特於此介紹簡易型鼻外夾板固定術。材料及方法：回顧2004 至2008 年間，由作者所醫治之封閉性鼻骨折病患共計28人。對照組10 人，年齡23.4±4.16 歲（平均值± 標準差），均於封閉性鼻骨折發生後急診當下進行封閉式鼻骨矯正術，術後鼻外固定使用石膏熱塑板1片及3M 皮膚膠帶，建議配戴2週。研究組18 人，年齡29.3±12.9 歲，均於封閉性鼻骨折發生後3日至1週內進行封閉式鼻骨矯正術，術後鼻外固定採用3M 紙膠帶1卷、雙面膠帶1卷及木製壓舌板1 支，建議配戴1 週。結果：對照組之石膏熱塑板均無鬆脫。研究組中1 人對3M 紙膠帶過敏，於術後隔日自行將鼻夾板移除，其餘17 人之鼻外夾板均無鬆脫。對照組與研究組均無人復發鼻扭曲。結論：石膏熱塑板與簡易型鼻外夾板固定術均簡易可行，但後者材料更為唾手可得且經濟實惠，期待能以此為基礎，修正出更好的作法。

BACKGROUND: External nasal fixation is recommended after the nasal bone has been closely reduced. A perfect material for external nasal fixation has not yet been found. We introduce a simple external nasal splint fixation. METHODS: From 2004 to 2008, 28 patients were enrolled retrospectively. The controlled group included 10 patients with an average age of 23.4±4.16 years (average±standard deviation). They received immediate close reduction when they visited the emergency due to close nasal bone fracture. Their post-operative noses were fixed by one thermoplastic splint and several pieces of 3M skin closures for two weeks. The studied group included 18 patients with an average age of 29.3±12.9. They received delayed close reduction three days to a week after the close nasal bone fracture had occurred. Their post-operative noses were fixed by a 3M paper adhesive tape, a twin adhesive tape, and a wooden tongue depressor for one week. RESULTS: The thermoplastic splint fixations of the controlled group were not loose. One patient in the studied group was sensitive to 3M paper adhesive tape and removed the external nasal splint fixation by himself on the next day of close reduction. The other 17 patients’external nasal splint fixations were not loose, and were then removed by the physician at the clinic. Neither the control group nor the studied groups regained twisted noses. CONCLUSIONS: Thermoplastic splint fixation and simple external nasal splint fixation are both easy to perform. The latter is not only cheaper but also more available than the former. We hope simple external nasal splint fixation will be modified better and better.