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Facial fractures كسور عظام الوجه

كسور عظام الوجه

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ٚ‫حُٞؿ‬ ّ‫ػظخ‬ ًٍٞٔ ّ‫كَح‬ .‫ى‬‫ؿٞىص‬‫ًٔخد‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ ‫كساب‬ ‫جودت‬ ‫فراس‬ .‫د‬
ّ‫انٕخ‬ ‫عظاو‬ ‫كغٕس‬ ‫كساب‬ ‫جودت‬ ‫فراس‬ ّ‫انٕخ‬ ‫عظاو‬ ‫كغٕس‬
ّ‫انٕخ‬ ‫عظاو‬ ‫كغٕس‬ ‫كساب‬ ‫جودت‬ ‫فراس‬ ّ‫انٕخ‬ ‫عظاو‬ ‫كغٕس‬1 Copyright© 2017 by Sallab Edition Copyright © 2017 by Sallab, Inc., an affiliate of Sallab Alliance . ‫تأٚح‬ ٔ‫أ‬ ‫شكم‬ ‫تأٚح‬ ّ‫َمه‬ ٔ‫أ‬ ‫انكراب‬ ‫ْزا‬ ٍ‫ي‬ ‫خضء‬ ٘‫أ‬ ‫اَراج‬ ‫إعادج‬ ٍ‫ًٚك‬ ‫ال‬ .‫يسفٕظح‬ ‫انسمٕق‬ ‫خًٛع‬ ٍٚ‫نرخض‬ ‫َظاو‬ ٘‫أ‬ ٔ‫أ‬ ،‫انرغدٛم‬ ،‫انرظٕٚش‬ ‫فٛٓا‬ ‫تًا‬ ،‫ٚذٔٚح‬ ٔ‫أ‬ ‫إنكرشَٔٛح‬ ،‫ٔعٛهح‬،‫اعرعادذٓا‬ ٔ ‫نهًعهٕياخ‬ ٍَٛ‫لٕا‬ ‫زٕل‬ ‫اضافٛح‬ ‫نًعهٕياخ‬ ،ٌ‫اإلر‬ ٗ‫عه‬ ‫انسظٕل‬ ‫كٛفٛح‬ ‫زٕل‬ ‫انرفاطٛم‬ .‫انُاشش‬ ٍ‫ي‬ ٙ‫خط‬ ٌ‫إر‬ ٌٔ‫د‬ ٙ‫ف‬ ‫ذٕخذ‬ ،‫انُشش‬ ‫زمٕق‬ ‫ذشخٛض‬ ‫ٔكانح‬ ٔ ‫انُشش‬ ‫زمٕق‬ ‫كًشكض‬ ‫يُظًاخ‬ ‫يع‬ ‫ذشذٛثاذُا‬ ٔ ‫انُاشش‬ ٌ‫إر‬ ‫ا‬‫نثشٚذ‬:َٙٔ‫اإلنكرش‬Kessab1976@hotmail.com. ‫انُاشش‬ ‫لثم‬ ٍ‫ي‬ ‫انًهكٛح‬ ‫زمٕق‬ ‫تًٕخة‬ ‫يسًٛح‬ ًُّ‫ض‬ ‫انًسرٕاج‬ ‫اإلفشادٚح‬ ‫انًشاسكاخ‬ ٔ ‫انكراب‬ ‫ْزا‬ (‫ُْا‬ ّٛ‫إن‬ ‫اإلشاسج‬ ‫ذدذس‬ ‫لذ‬ ‫يا‬ ‫عذا‬) ‫إشعاساخ‬ ‫ذٕعع‬ ‫انخثشج‬ ٔ ‫اندذٚذ‬ ‫انثسث‬ ٌ‫أل‬ .‫يغرًش‬ ٍ‫تشكم‬ ‫انًدال‬ ‫ْزا‬ ٙ‫ف‬ ‫األفضم‬ ‫انغشٚشٚح‬ ‫انًًاسعح‬ ٔ ‫انًعشفح‬ ‫ٚرغٛش‬ .‫ضشٔسٚح‬ ‫ذظثر‬ ‫لذ‬ ‫انطثٛح‬ ‫انًعاندح‬ ٔ‫أ‬ ،‫انًسرشفح‬ ‫انًًاسعاخ‬ ،‫انثسث‬ ‫طشق‬ ٙ‫ف‬ ‫انرغٛشاخ‬ ٔ ،‫فًُٓا‬ ٔ ‫ذمٛٛى‬ ٙ‫ف‬ ‫انخاطح‬ ‫يعشفرٓى‬ ٔ ‫خثشذٓى‬ ٗ‫عه‬ ً‫ا‬ً‫دائ‬ ‫االعرًاد‬ ٍٛ‫انثازث‬ ٔ ٍٛٚ‫انغشٚش‬ ٍٛ‫انًًاسع‬ ٗ‫عه‬ ‫ٚدة‬ ‫ي‬ ‫ْكزا‬ ‫اعرخذايٓى‬ ٖ‫نذ‬ .‫ُْا‬ ‫يشغٕتح‬ ‫ذداسب‬ ٔ‫أ‬ ،‫عُاطش‬ ،‫طشق‬ ،‫يعهٕياخ‬ ‫أٚح‬ ‫اعرخذاو‬ٌ‫أ‬ ‫ٚدة‬ ‫طشق‬ ٔ‫أ‬ ‫عهٕياخ‬ .‫يُٓى‬ ٍٛ‫انًغؤٔن‬ ٗ‫انًشض‬ ‫فٛٓى‬ ‫تًا‬ ،ٍٚ‫اٜخش‬ ‫عاليح‬ ٔ ‫انشخظٛح‬ ‫عاليرٓى‬ ‫اعرثاسْى‬ ٙ‫ف‬ ‫ٚضعٕا‬ ( ‫انًعطاج‬ ‫انسانٛح‬ ‫انًعهٕياخ‬ ٍ‫ع‬ ‫تانثسث‬ ٌٕ‫انماسئ‬ ‫ُٚظر‬ ،‫يعشف‬ ٙ‫دٔائ‬ ٍ‫يُرح‬ ٔ‫أ‬ ‫دٔاء‬ ٘‫أل‬ ‫االزرشاو‬ ‫يع‬iٍ‫ع‬ ) ( ٔ‫أ‬ ‫انًعشٔضح‬ ‫اإلخشاءاخ‬ii‫ٚرى‬ ‫يُرح‬ ‫كم‬ ‫ُع‬َ‫ظ‬ُ‫ي‬ ‫تٕاعطح‬ )،‫انرشكثٛح‬ ٔ‫أ‬ ‫تٓا‬ ٗ‫انًٕط‬ ‫اندشعح‬ ٍ‫ي‬ ‫نهرأكذ‬ ،ّ‫ذطثٛم‬ ٔ ‫انخاطح‬ ‫خثشذٓى‬ ٗ‫عه‬ ‫االعرًاد‬ ،ٌٕ‫انًًاسع‬ ‫يغؤٔنٛح‬ ‫إَٓا‬ .‫االعرطثاب‬ ‫يضاداخ‬ ٔ ،‫انرطثٛك‬ ‫يذج‬ ٔ ‫طشٚمح‬ ‫خًٛع‬ ‫الذخار‬ ٔ ،‫يشٚض‬ ‫نكم‬ ‫األفضم‬ ‫انعالج‬ ٔ ‫اندشعح‬ ‫يمذاس‬ ‫نرسذٚذ‬ ،‫انرشخٛض‬ ‫نٕضع‬ ،‫تًشضاْى‬ ‫يعشفرٓى‬ .‫انغاليح‬ ‫إخشاءاخ‬ ٗ‫إن‬ٔ‫أ‬ ،ًٍْٛ‫انًغا‬ ٔ ،ٍٛ‫انًؤنف‬ ‫ال‬ ٔ ‫انُاشش‬ ٗ‫عه‬ ‫يغؤٔنٛح‬ ‫أٚح‬ ‫ذمع‬ ‫ال‬ ،ٌَٕ‫انما‬ ّ‫ت‬ ‫ٚغًر‬ ‫زذ‬ ٗ‫ألظ‬ ،‫انًُرداخ‬ ‫يغؤٔنٛح‬ ‫عثٛم‬ ٗ‫عه‬ ‫انًًرهكاخ‬ ٔ‫أ‬ ‫األشخاص‬ ‫ٚظٛة‬ ‫لذ‬ ٘‫انز‬ ‫ضشس‬ ٔ‫ٔ/أ‬ ‫إطاتح‬ ‫أٚح‬ ٍ‫ع‬ ،ٍٚ‫انًسشس‬ ‫أ‬ ،‫ذعهًٛاخ‬ ،‫يُرداخ‬ ٔ ،‫ٔعائم‬ ٍ‫ي‬ ٘‫أ‬ ‫ذشغٛم‬ ٔ‫أ‬ ‫اعرخذاو‬ ٘‫أ‬ ٍ‫ع‬ ٔ‫أ‬ ،‫غٛشْا‬ ٔ‫أ‬ ‫اإلًْال‬‫األفكاس‬ ٔ .‫ُْا‬ ‫انٕاسدج‬ ‫انًٕاد‬ ٙ‫ف‬ ‫انٕاسدج‬ Library of Congress Cataloging-in-Publication Data Kassab Firas Faciale Fractures Firas J. Kassab,.2th ed. Design: Firas Kassab Printed in Syria
ّ‫انٕخ‬ ‫عظاو‬ ‫كغٕس‬ ‫كساب‬ ‫جودت‬ ‫فراس‬ َّ‫عهطا‬ ‫عظٛى‬ ٔ ّٓ‫ٔخ‬ ‫تدالل‬ ‫ٚهٛك‬ ‫كًا‬ ‫زًذا‬ ‫هلل‬ ‫انسًذ‬ ّ‫َفغ‬ ٗ‫عه‬ ْٕ ُٗ‫أث‬ ‫كًا‬ ّٛ‫عه‬ ً‫ء‬‫ثُا‬ ٙ‫َسظ‬ ‫ال‬ َّ‫عثسا‬ ٗ‫إن‬ ‫ٓذاج‬ُ‫ي‬ ‫انطثعح‬ ِ‫ْز‬‫انعضٚض‬ ٘‫ٔانذ‬ ‫سٔذ‬ ‫انغانٛح‬ ٙ‫ٔانذذ‬ ٗ‫إن‬ ٙ‫تُاذ‬ ٔ ٙ‫صٔخر‬ ٙ‫أطذلائ‬ ٔ ٙ‫إخٕذ‬ ‫خٕدخ‬ ‫فشاط‬‫كغاب‬ 21-11-2017
ّ‫انٕخ‬ ‫عظاو‬ ‫كغٕس‬ ‫كساب‬ ‫جودت‬ ‫فراس‬ ‫يمذيح‬ ‫تغٛطح‬ ‫فكشج‬ ‫إعطاء‬ ‫يع‬ ّ‫انٕخ‬ ‫عظاو‬ ‫ذظٛة‬ ٙ‫انر‬ ‫انكغٕس‬ ‫يدًم‬ ‫انكراب‬ ‫ْزا‬ ٙ‫ف‬ ‫ذُأنُا‬ ٔ ‫انعانًٛح‬ ‫انرظاَٛف‬ ٍ‫ع‬‫انعًم‬ ‫ذفظٛم‬ ٙ‫ف‬ ‫انذخٕل‬ ٌٔ‫د‬ ٔ ‫انعالج‬ ٔ ‫انرشخٛض‬ ٍ‫ع‬ ‫زذٔثا‬ ‫األكثش‬ ‫انكغٕس‬ ‫دساعح‬ ‫زأنُا‬ ‫لذ‬ ٔ ، ٙ‫اندشاز‬ ٔ ٙ‫شخظ‬ ‫خٓذ‬ ْٕ ‫انعًم‬ ‫ْزا‬‫ٔاكثد‬ ‫لذ‬ ٔ ‫انطثاعٛح‬ ‫األخطاء‬ ٍ‫ي‬ ِٕ‫خه‬ ‫خاْذا‬ ‫عًهد‬ ‫لذ‬ ٙ‫ف‬ ٙ‫يشاعهر‬ ‫أسخٕا‬ ٔ ‫انعهًٛح‬ ‫انًماٚٛظ‬ ٔ ‫انًفاْٛى‬ ٍ‫ي‬ ‫انكثٛش‬ ‫انثانثح‬ ‫انطثعح‬ ‫ْزا‬ ٙ‫ف‬ ٘‫أ‬ ‫ٔخٕد‬ ‫زال‬‫أخطاء‬ُٙ‫ي‬ ‫عٕٓا‬ ‫عمطد‬:Kessab1976@hotmail.com ‫انعًم‬ ‫ْزا‬ ‫خالل‬ ٍ‫ي‬ ‫أسخٕا‬‫انطثٛح‬ ‫يُٓرُا‬ ‫ذطٕٚش‬ ٙ‫ف‬ ‫تغٛطح‬ ‫يسأنح‬ ‫لذيد‬ ‫لذ‬ ٌٕ‫أك‬ ٌ‫أ‬ ‫انغايٛح‬ ‫خٕدخ‬ ‫فشاط‬‫كغاب‬ َٙ‫انثا‬ ٍٚ‫ذشش‬2017 ‫طفش‬1431
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 1 ّ‫ػظخ‬ ًٍٞٔٚ‫حُٞؿ‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 2 ٟٞ‫حُٔلظ‬ ‫ٓويٓش‬...........................................................................................................7 ‫طٜٔ٤ي‬...............................................................................................................8 ‫حُظَ٘٣ق‬٢‫حُـَحك‬...............................................................................................10 ٚ٤‫حُظ٘و‬٢‫حُ٘ؼخػ‬...........................................................................................10 ٌَ٤ُٜ‫ح‬٢ٜ‫حُٞؿ‬١ِٞ‫حُؼ‬.........................................................................................11 ٌَ٤ُٜ‫ح‬٢ٜ‫حُٞؿ‬٢ٓٝ٧‫ح‬........................................................................................11 ‫حُلي‬٢ِ‫حُٔل‬....................................................................................................14 ‫اٛخرش‬ًٍّٞٔ‫ػظخ‬ٖ٤ٌ‫حُل‬ٝٚ‫حُٞؿ‬ٝ‫ٓلخِٜٛخ‬..........................................................15 ‫حُٔ٠خػلخص‬........................................................................................................15 ‫حُوطٍٞس‬............................................................................................................15 ‫حُٞهخ٣ش‬..............................................................................................................15 ًٍٞٔ‫حُلي‬٢ِ‫حُٔل‬..........................................................................................17 ‫ٓويٓش‬..............................................................................................................17 ‫حُظٜ٘٤ق‬..........................................................................................................18 ‫أٓزخد‬ًٍٞٔ‫حُلي‬٢ِ‫حُٔل‬................................................................................21 ٝ‫أػَح‬ًٍٞٔ‫حُلي‬٢ِ‫حُٔل‬................................................................................22 ٌَُٔ‫ح‬٢ُ٘ٔ‫ح‬٢‫حُٔ٘و‬.....................................................................................22 ًَٔ‫حُِؤش‬........................................................................................................23 ًٍٞٔ‫حُ٘خطت‬١ٍ‫حُٔ٘وخ‬........................................................................................23 ًٍٞٔ‫حَُأى‬........................................................................................................23 ًٍٞٔ‫حُِحٝ٣ش‬.......................................................................................................23 ًٍْٞٔٔ‫ؿ‬‫حُلي‬................................................................................................23 ًٍٞٔ‫اٍطلخم‬ٖ‫حٌُه‬‫ٝؿخٗذ‬‫ح٩ٍطلخم‬....................................................................24 ٚ‫حُلل‬١َ٣َُٔ‫ح‬..................................................................................................24 ٚ‫حُلل‬‫هخٍؽ‬١ٞٔ‫ك‬..........................................................................................24 ٚ‫حُلل‬َ‫ىحه‬١ٞٔ‫حُل‬.........................................................................................24 ْ‫حُـ‬...........................................................................................................25 ٚ‫حُلل‬٢‫حُ٘ؼخػ‬............................................................................................26 ‫هخٍؽ‬١ٞٔ‫ك‬...................................................................................................26 َ‫ىحه‬ْ‫حُل‬......................................................................................................27 ‫حُٔؼخُـش‬..........................................................................................................27 ‫حُٔؼخُـش‬‫حُزيث٤ش‬..............................................................................................27
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 3 ‫ٓؼخُـش‬ًٍٞٔ‫حُلي‬٢ِ‫حُٔل‬١ٝ‫حُلخ‬٠ِ‫ػ‬ٕ‫ح٧ٓ٘خ‬..................................................28 ‫حَُى‬..............................................................................................................28 ‫حُظؼز٤ض‬...........................................................................................................28 ‫أٓخُ٤ذ‬‫حُظؼز٤ض‬..............................................................................................28 ‫طؼز٤ض‬‫ٓؼظٔي‬٠ِ‫ػ‬ٕ‫ح٧ٓ٘خ‬..............................................................................28 ‫حُظؼز٤ض‬َٗ‫حُٔزخ‬٢‫ك‬ْ‫حُؼظ‬...................................................................................30 ‫حُو٤خ١ش‬ٖٟٔ‫حُؼظٔ٤ش‬.....................................................................................31 ‫حُو٤خ١ش‬‫حُيحثَ٣ش‬................................................................................................32 ‫حُٜلخثق‬‫حُؼظٔ٤ش‬.............................................................................................33 ْ٤‫حُيرخر‬‫حُوخٍؿ٤ش‬‫حُٔؼزظش‬.................................................................................34 ‫حُٔوخُذ‬‫حُؼظٔ٤ش‬.............................................................................................35 ‫أٓ٬ى‬َ٘٘٣ًَ................................................................................................35 ٍ‫اهظ٤خ‬‫أِٓٞد‬‫حُظؼز٤ض‬........................................................................................35 ًٍٞٔ‫حُِؤش‬...................................................................................................36 ‫حُظٜ٘٤ق‬...........................................................................................................36 ٚ٤‫حُظ٘و‬......................................................................................................38 ‫حُٔؼخُـش‬.........................................................................................................41 ٍ‫ح٧١لخ‬.........................................................................................................41 ٖ٤‫حُزخُـ‬..........................................................................................................41 َٔ‫حُؼ‬٢‫حُـَحك‬...............................................................................................42 ‫حُظؼز٤ض‬...........................................................................................................46 ّ‫حُطؼخ‬َ‫ٝحُٔٞحث‬..............................................................................................47 ًٍٞٔ‫حُلي‬٢ِ‫حُٔل‬‫ػ٘ي‬ٍ‫ح٧١لخ‬.......................................................................48 ٚ‫حُلل‬١َ٣َُٔ‫ح‬.............................................................................................48 ٚ‫حُلل‬٢‫حُ٘ؼخػ‬............................................................................................48 ‫حُٔؼخُـش‬........................................................................................................48 ًٍٞٔ‫حُلي‬١ِٞ‫حُؼ‬...........................................................................................51 ‫أٓزخد‬ًٍٞٔ‫حُلي‬١ِٞ‫حُؼ‬ٝٚ‫حُٞؿ‬......................................................................51 ‫حُظٜ٘٤ق‬........................................................................................................52 ‫ُٞكٍٞص‬1ٝ‫أ‬ٌَُٔ‫ح‬ْ‫حُؼخث‬..................................................................................53 ‫ُٞكٍٞص‬2ٝ‫أ‬ٌَُٔ‫ح‬٢َُٜٓ‫ح‬................................................................................54 ‫ُٞكٍٞص‬3ٝ‫أ‬ٌٍُٞٔ‫ح‬‫حُٔؼظَٟش‬..........................................................................55 ٝ‫ح٧ػَح‬.........................................................................................................57 ‫حُٔ٠خػلخص‬.....................................................................................................57 ٚ٤‫حُظ٘و‬١َ٣َُٔ‫ح‬.........................................................................................57 ‫حُؼ٬ؽ‬............................................................................................................60
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 4 ‫حَُى‬...............................................................................................................61 ‫حُظؼز٤ض‬..........................................................................................................62 ‫طؼز٤ض‬٢ِ‫حُيحه‬................................................................................................62 ‫طؼز٤ض‬٢‫حُوخٍؿ‬...............................................................................................66 ‫ح٧ً٣خص‬‫حَُٔحكوش‬ٝ‫ح٩هظ٬١خص‬.............................................................................68 ًَٔ‫هخع‬‫حُلـخؽ‬.............................................................................................68 ‫حُؼ٬ٓخص‬‫حَُٔ٣َ٣ش‬...........................................................................................69 ‫حُٔؼخُـش‬.......................................................................................................70 َ٤ٛ‫حُظؤ‬.........................................................................................................72 ًٍْٞٔ‫ػظ‬‫ح٧ٗق‬ٝ‫حًَُٔذ‬٢‫ح٧ٗل‬٢ُ‫حُـَرخ‬........................................................73 ‫ٓويٓش‬........................................................................................................73 ‫ح٧ٓزخد‬......................................................................................................74 ‫طٜ٘٤ق‬........................................................................................................74 ٝ‫ح٧ػَح‬......................................................................................................77 ٚ٤‫حُظ٘و‬..................................................................................................78 ‫اهظ٬١خص‬ٌُٔ‫ح‬َ...........................................................................................80 ‫حُؼ٬ؽ‬.........................................................................................................80 َ‫حُٔيحه‬‫حُـَحك٤ش‬.........................................................................................81 َ‫ٓيه‬٢‫هخٍؿ‬..............................................................................................81 َ‫ٓيه‬٢ِ‫ىحه‬...............................................................................................83 ‫حَُى‬ٝ‫حُظؼز٤ض‬...............................................................................................83 ‫اٗو٬ع‬‫ٓآم‬ٖ٤‫حُؼ‬..........................................................................................84 ‫اٛخرش‬‫حُو٘خس‬‫حُيٓؼ٤ش‬......................................................................................85 ‫حُٔ٠خػلخص‬...................................................................................................86 ‫حُ٘وخٛش‬........................................................................................................86 ‫حُؼ٘خ٣ش‬‫حٌُحط٤ش‬..................................................................................................86 ‫حُٞهخ٣ش‬..........................................................................................................87 ًٍْٞٔ‫حُؼظ‬٢٘‫حُٞؿ‬.......................................................................................88 ‫ٓويٓش‬..........................................................................................................88 ‫ح٧ٓزخد‬........................................................................................................89 ‫حُظٜ٘٤ق‬........................................................................................................89 ٝ‫ح٧ػَح‬........................................................................................................91 ٚ‫حُلل‬١َ٣َُٔ‫ح‬ٝٚ٤‫حُظ٘و‬.............................................................................91 ‫حُوٜش‬‫حَُٔ٣َ٣ش‬...............................................................................................91 ٚ‫حُلل‬١َ٣َُٔ‫ح‬.............................................................................................91 ٚ‫حُلل‬٢‫حُ٘ؼخػ‬...........................................................................................92
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 5 ‫حُٔ٠خػلخص‬....................................................................................................93 ‫حُؼ٬ؽ‬...........................................................................................................94 ‫حُؼ٬ؽ‬‫حُٔلخكع‬...............................................................................................94 ‫حُؼ٬ؽ‬٢‫حُـَحك‬..............................................................................................95 ‫حَُى‬..............................................................................................................95 ‫حُ٘ن‬٢‫حُـَحك‬..............................................................................................98 ‫حُظؼز٤ض‬.........................................................................................................100 ‫حُٔ٠خػلخص‬....................................................................................................101 ‫حَُٔحؿغ‬........................................................................................................102
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 6
‫الوجه‬ ‫عظام‬ ‫كسور‬ ‫كساب‬ ‫جودت‬ ‫فراس‬ .‫د‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 7 ‫اٛيحء‬ ٠ُ‫ا‬٢ُ‫حُـخ‬ ١‫ٝحُي‬ ‫ٍٝف‬ ٢‫ٝحُيط‬‫حُؼِ٣ِس‬ ٢‫ُٝؿظ‬‫حُلز٤زش‬ ٢‫ر٘خط‬‫حُلز٤زخص‬ ٢‫اهٞط‬٢‫أٛيهخث‬ ٝ : ‫ٓويٓش‬ ٕ‫ا‬ًٌٍَٞٔ٤ُٜ‫ح‬٢ٜ‫حُٞؿ‬٢ٛ‫ؿِء‬ٖٓ‫اٛخرخص‬‫ٓ٘طوش‬ٚ‫حُٞؿ‬ٖٝ٤ٌ‫حُل‬َٟٝ‫أه‬ ‫اٛخرخص‬ ‫ٓغ‬ ‫طظَحكن‬‫ٓوظِلش‬‫حُيٍؿخص‬‫ُ٨ٗٔـش‬ ‫حُٔل٤طش‬‫رخُٔ٘طوش‬.ٝ‫ًٌُي‬‫ح٧ؿِحء‬‫حُل٤ٞ٣ش‬َ‫ٓؼ‬ٖ٤‫حُؼ‬ٝ١ٍ‫ٓـخ‬‫حُٜٞحء‬ٝ‫حُـ٤ٞد‬‫حُٔـخٍٝس‬‫ُ٨ٗق‬ٝ‫ًٌُي‬ٕ‫حُِٔخ‬. ‫طظلخٝص‬‫ىٍؿخص‬‫ح٩ٛخرش‬٢‫ك‬ٌٙٛ‫حُٔ٘طوش‬ٖٓ‫ٓـَى‬‫ؿَف‬٢٤ٔ‫ر‬٠ُ‫ا‬‫اٛخرخص‬‫رخُـش‬‫حُوطٍٞس‬َ‫طئػ‬٠ِ‫ػ‬ٌَ٤ُٜ‫ح‬٢ٜ‫حُٞؿ‬َٓ‫رخٌُخ‬ٝ ٝ ُٚٞ‫ك‬ ‫ٓخ‬‫ٜٓ٘خ‬ َٟ‫أه‬ ‫اهظٜخٛخص‬ ٠ُ‫ا‬ ‫طٔظي‬ ‫اٜٗخ‬ ً‫ا‬ ‫ٓليى‬ ٍ‫ٓـخ‬ ٢‫ك‬ ‫كَٜٛخ‬ ٌٖٔ٣ ٫ ٢‫حُظ‬ ٝ ‫حُٔؼويس‬ ‫ح٩ٛخرخص‬ ٖٓ ٢ٛ‫حُـَحكش‬ ‫حُظـٔ٤ِ٤ش‬ ‫حُـَحكش‬ ٝ ‫حُؼ٘ن‬ ‫ؿَحكش‬ ٝ ‫حُؼٜز٤ش‬ ٫‫ا‬ ٌٕٞ٣ ُٖ َ٤‫كخُظير‬ ٍِ‫ٓ٘ؼ‬ ًَٔ ‫ٓ٘خٛيس‬ ‫ٗٔز٤خ‬ ٍ‫حُ٘خى‬ ٖٓ ٚٗ‫أ‬ ٠ُ‫ا‬ ‫ٗظَح‬ َٟٝ‫ح٧ه‬ ‫ح٩هظٜخٛخص‬ ‫ٓغ‬ ‫رخُٔ٘خًٍش‬ ‫ؿَحك٤خ‬ ‫طير٤َٛخ‬ ٝ ‫حُٜٔخرش‬ ‫حُٔ٘طوش‬ ‫كٔذ‬ ٚ‫حُٞؿ‬ ًٍٞٔ ‫رزلغ‬ ‫هٔ٘خ‬ ‫حَُٔ٘ٝع‬ ‫ٌٛح‬ ٢‫ك‬ ‫ٝكوض‬ ‫هي‬ ًٕٞ‫أ‬ ٕ‫أ‬ ‫أٍؿٞح‬ ٝ ٖ٤ٌ‫حُل‬ ٝ ٚ‫حُٞؿ‬ ‫ؿَحكش‬ ٙ‫اهظٜخ‬ ْ‫ُيػ‬ ‫ٓلخُٝش‬ ٖٓ َ‫أًؼ‬ ‫٣ؼيٝح‬ ٫ ‫حٌُظخد‬ ‫ٌٛح‬ ‫ًٔخد‬ ‫ؿٞىص‬ ّ‫كَح‬َ‫ٗٞكٔز‬2016 َ‫ٛل‬1438
‫الوجه‬ ‫عظام‬ ‫كسور‬ ‫كساب‬ ‫جودت‬ ‫فراس‬ .‫د‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 8 : ‫طٜٔ٤ي‬ ٝ ٚ‫حُٞؿ‬ ًٍٞٔ َٔ٘‫ط‬٢ِ٣‫ٓخ‬ ٖ٤ٌ‫حُل‬: *ً‫اىجثه‬ ٌ‫اىؼظ‬ ‫مسىس‬ ‫رٔزذ‬ ‫طليع‬٧‫ح‬ ٜٚ‫حُـز‬ ٠ِ‫ػ‬ ‫ٓزخَٗس‬ ‫هٞ٣ش‬ ‫َٟرش‬‫ٓخٓ٤ش‬ٝ‫أ‬‫كٞم‬( ‫حُلـخؽ‬ٖ٤‫حُؼ‬ َ‫ٓلـ‬)ٝ ،٢‫حُظ‬ْ‫حُؼظ‬ ًَٔ ‫طٔزذ‬ ٧‫ح‬ ٚ‫ؿِث‬ ( ٢ٜ‫حُـز‬ٝ ٢ٓ‫ٓخ‬ٝ ) ٢‫حُوِل‬‫ر‬ ‫حُٜٔخد‬ َ‫٣٘ؼ‬ ً‫س‬‫ػخى‬ٔ٘٠ِ‫ػ‬ َ‫ا‬‫ٓخكٞم‬ ‫حُؼٜذ‬ ‫ٓظيحى‬‫حُلـخؽ‬. *‫مسىس‬: ‫اىحجاج‬ ‫ط‬ٞ‫ر‬ ‫َٟرش‬ ‫رٔزذ‬ ‫ليع‬‫ح‬‫ٓخ١ش‬‫آ‬ُ ‫كخىس‬ َ٤‫ؿ‬ ‫ُش‬‫ِلـخؽ‬‫أ‬ٝ‫أ‬‫ىحس‬‫أ‬٢‫ك‬ ‫حٌَُحص‬ ( َ‫حُٔلـ‬ َ‫ٓيه‬ ٖٓ ‫كـٔخ‬ َ‫ًز‬ٟ‫حَُ٣خ‬‫ش‬ٝ )َ‫٣٘ؼ‬ ‫ػخىس‬ ‫رظ٠خػق‬ ‫حُٜٔخد‬‫حَُإ٣خ‬(Diplopia) *‫االّف‬ ‫مسىس‬: ٧‫ح‬ ٠ِ‫ػ‬ ‫َٟرش‬ ‫رٔزذ‬ ‫طليع‬‫ِٗف‬ ‫٣ٜخكزٜخ‬ ‫ٗق‬ *‫اىىجْح‬ ‫مسىس‬: ‫ٗي٣ي‬ ‫َٟرش‬ ‫رٔزذ‬ ‫طليع‬‫حَُٔكن‬ ْ‫ػظ‬ ‫رٞحٓطش‬ ‫حُٞؿ٘ش‬ ٠ِ‫ػ‬ ٙ‫أ‬‫رٞحٓطش‬ ٝ‫أ‬ٝ ‫ىحس‬ٔ٘‫ٝحُظ‬ ‫حُظ٘٘ؾ‬ ‫طٔزذ‬ ‫هي‬٤‫طلض‬ ‫حُؼٜذ‬ ٢‫ك‬ َ ‫حُلـخؽ‬. *‫اىفل‬ ‫مسىس‬‫اىؼيىي‬: َٝٔ٘‫ط‬: -٠ِ‫أػ‬ َٝ‫ٓٔظؼ‬ ًَٕٔ‫ح٧ٓ٘خ‬ -َُٜٓ‫ح‬ ٌَُٔ‫ح‬٧‫ح‬ ْ‫ػظ‬ َٔ‫ؿ‬ ٚ‫هٔظ‬ ( ٠ِ‫ح٧ػ‬ ‫ُِلي‬ ٢ٝ ‫ٗق‬ٝ ‫ُِـخٗذ‬ ٚ‫٣ظـ‬َ‫ح٧ٓل‬) -ٝ ‫ُِـٔـٔش‬ ّ‫طخ‬ ًَٔٝ )ْٜ٘‫ط‬ ( ٚ‫حُٞؿ‬ٝ ‫حُٞؿ٘ش‬ ًٍٞٔ َٔ٘٣‫حُٔل‬ ٖ٤‫حُؼ‬ َ‫ٓلـ‬ ‫كيٝى‬ٝ ‫ِ٤ش‬ُ‫ح‬ ‫حُلي‬١ِٞ‫ؼ‬ٝ ،‫٣لظخؽ‬ ‫ٌٛح‬ُ‫ا‬٠ ‫ػخُ٤ش‬ ‫هٞس‬,ٝٝ ٖ٤٤ٟ‫حَُ٣خ‬ ‫ػ٘ي‬ ‫ٗخثغ‬ ٌٕٞ٣٫ ‫ٌُٜح‬٢‫ك‬ ‫٣ليع‬ ‫هي‬ ٌُٖ‫(حًُٜٞ٢،حُز‬ َ‫ٓؼ‬ ‫حَُ٣خٟخص‬ ٞ‫رؼ‬ٝ )ٍٞ‫٤ٔز‬‫ٌٛح‬ ٢‫ك‬ ‫ػخىس‬ ٩‫ح‬ ٖٓ ‫حُ٘ٞع‬‫حَُإ٣خ‬ ‫ٓ٠خػلش‬ ‫٣ليع‬ ‫ٛخرش‬(Diplopia)٩‫ح‬ ّ‫ػي‬ ‫ٓغ‬٢‫ك‬ ّ‫ٗظظخ‬‫ا‬‫١زخ‬٧‫ح‬ ‫م‬ٝ ٕ‫ٓ٘خ‬ٔ٘‫حُظ‬٤َ. *‫اى‬ ‫اىفل‬ ‫مسىس‬: ً‫سفي‬ ٩‫ح‬ ّ‫ػي‬ ‫٣٬كع‬٢‫ك‬ ّ‫ٗظظخ‬‫ا‬٧‫ح‬ ‫١زخم‬‫ٓغ‬ ‫حُٜٔخد‬ ‫ػ٘ي‬ ٕ‫ٓ٘خ‬‫أ‬‫حُلي‬ ُْ ٝ ‫طَحًذ‬ ‫ُطَ٣وش‬ َ‫رخُ٘ظ‬‫رؼ٠ٜخ‬ ‫ٓغ‬ ّ‫حُؼظخ‬ ٌٙٛ َ‫طيحه‬‫ك‬‫ح٧ؿِحء‬ ‫رو٤ش‬ ٠ِ‫ػ‬ َ٤‫حُظؤػ‬ ٕٝ‫ى‬ ‫ٜٓ٘خ‬ ‫ؿِء‬ ٌَٔ٘٣ ٕ‫أ‬ ‫حُٜؼذ‬ ٖٓ ٚٗ‫ؤ‬ ‫حُٔـخٍٝس‬ٝ ٚ‫ٍإ٣ظ‬ ‫حُٜؼذ‬ ٖٓ ّ‫ُِؼظخ‬ ‫حُظلظض‬ ‫ٌٛح‬ .ٝ ‫ٓـِوش‬ ً‫ح‬ًٍٞٔ ٚ‫حُٞؿ‬ ٢ٓٝ ‫ٓ٘طوش‬ ًٍٞٔ ٌٕٞ‫ط‬ ‫ٓخ‬ ً‫خ‬‫ؿخُز‬‫ٓظويٓش‬ ‫كخ٫ص‬ ٢‫ك‬ ٠ُ‫ا‬ ٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ ‫٣ظلظض‬ ‫هي‬60ٝ‫أ‬70.ً‫ء‬ِ‫ؿ‬ ًٔ ْ٤ٔ‫طو‬ ٌٖٔ٣:ٖ٤‫ٗٞػ‬ ٠ُ‫ا‬ ‫ػخٓش‬ ٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ ٍٞ 1-ًٍٞٔٝ ّ‫حُؼظخ‬ ٢‫ك‬ ‫طلظض‬ ٕٝ‫ى‬‫حُِ٤٘ش‬ ٝ‫أ‬ ‫حُِٜزش‬ ‫ح٧ٗٔـش‬ ٖٓ ‫أؿِحء‬ ‫كوي‬ ٕٝ‫ى‬ 2-ٝ ّ‫ُِؼظخ‬ ‫طلظض‬ ‫ٓغ‬ ًٍٞٔ‫حُِ٤٘ش‬ ٝ‫أ‬ ‫حُِٜزش‬ ‫ح٧ٗٔـش‬ ٖٓ ‫٧ؿِحء‬ ‫كوي‬ ٍٝ٧‫ح‬ ‫حُ٘ٞع‬ ٖٓ ٢ٛ ٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ ًٍٞٔ ْ‫ٓؼظ‬٢ٜ‫ك‬ ٢ٗ‫حُؼخ‬ ‫حُ٘ٞع‬ ٌٍُٞٔ ‫رخُ٘ٔزش‬ ‫أٓخ‬ .٢‫ك‬ ‫حُٜٞحٍ٣ن‬ ٖٓ ‫اٛخرخص‬ ‫ٗظ٤ـش‬ ً‫خ‬‫ؿخُز‬ ٝ ‫حُٜٔخٗغ‬ ‫اٛخرخص‬ ٝ‫أ‬ ‫حُلَٝد‬٤‫حٌُز‬ ‫ح٧ؿِٜس‬ ‫ك٤ٜخ‬ ّ‫طٔظوي‬ ٢‫حُظ‬ََٜ‫طل‬ ‫ك٤غ‬ ‫حُطَم‬ ‫كٞحىع‬ ‫ٗظ٤ـش‬ ٝ‫أ‬ ‫س‬‫ا‬ْٔ‫ؿ‬ ٖٓ ‫ٓزخَٗس‬ ‫ٛخرش‬ .‫ًز٤َس‬ ‫رَٔػش‬ ‫٣ظلَى‬ ‫كخى‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 9 ٝ٢‫ك‬ ً‫ء‬‫ٓٞح‬ ٍٝ٧‫ح‬ ْٔ‫حُو‬ ‫ػ٬ؽ‬ ٖ‫ػ‬ ً‫خ‬٣ٌٍ‫ؿ‬ ‫٣وظِق‬ ٌٍُٞٔ‫ح‬ ٖٓ ٢ٗ‫حُؼخ‬ ْٔ‫حُو‬ ‫ػ٬ؽ‬ ٕ٧ ‫ٓخ‬ ً‫خ‬‫ٗٞػ‬ ‫ٓل٤ي‬ ّ‫حُؼخ‬ ْ٤ٔ‫حُظو‬ ‫ٌٛح‬ َ‫٣ؼظز‬ ٍٞ١٢ُٝ٧‫ح‬ ‫حُؼ٬ؽ‬‫أ‬.‫حُز٘خء‬ ‫اػخىس‬ ‫ػِٔ٤ش‬ ٢‫ك‬ ٝ ٢ٜ‫حُ٘و‬ ‫حُؼ٘ق‬ :٢ٛ ‫كيٝػٜخ‬ ‫طَط٤ذ‬ ‫كٔذ‬ ٚ‫حُٞؿ‬ ّ‫ػظخ‬ ٌٍُٞٔ ‫حُٔؼخَٛس‬ ‫ح٧ٓزخد‬ ٕ‫ا‬‫حَُ٣خٟ٤ش‬ ‫ح٩ٛخرخص‬ ,١ٞ‫حُٔو‬ ,‫كٞحىع‬ , ٝ ‫حُطَم‬‫ح‬‫حُٜ٘خػ٤ش‬ ‫حُٔ٘خ١ن‬ ٢‫ك‬ ‫٩ٛخرخص‬. ٝ ‫حُؼخٗ٤ش‬ ‫حُؼخُٔ٤ش‬ ‫حُلَد‬ ‫رؼي‬‫ُٔيس‬30ٚ‫حُٞؿ‬ ‫اٛخرخص‬ ٢‫ك‬ َ‫ح٧ًز‬ ‫حُٔزذ‬ ٢ٛ ‫حُطَم‬ ‫كٞحىع‬ ‫ًخٗض‬ ‫ٓ٘ش‬ٝ ,‫رٔخ‬ ‫طظٔزذ‬ ‫ًخٗض‬ ٚ‫ٗٔزظ‬35ٝ60.ٚ‫حُٞؿ‬ ّ‫ػظخ‬ ًٍٞٔ ٖٓ ‫رخُٔجش‬ َ‫طظؤػ‬ٝ ‫حُٔوظِلش‬ َٓ‫حُؼٞح‬ ‫أٛٔ٤ش‬‫حُظ‬٢ًٞٔ ‫كيٝع‬ ‫ٗٔزش‬ ٠ِ‫ػ‬ َ‫طئػ‬‫حُظخُ٤ش‬ َٓ‫رخُؼٞح‬ ٚ‫حُٞؿ‬ ّ‫ػظخ‬ ٍ: 1-٢‫حُــَحك‬ ‫حُٔٞهغ‬ 2-‫ح٩ؿظٔخػ٤ش‬ ‫حُل٤خس‬ ٢ٔٗ 3-ٝ ٍٞ‫حٌُل‬ٝ ‫حُٔويٍحص‬ٜٗ‫اىٓخ‬ٔ‫خ‬ 4-ٝ ٖ٤ٗ‫هٞح‬ٍَُٝٔ‫ح‬ ّ‫أكٌخ‬ 5-ْٓ‫حُٔٞح‬ ٝ ٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ًٍٞٔ ٚ‫حُٞؿ‬ ٖٓ ٠‫حُٞٓط‬ ‫حُٔ٘طوش‬ ًٍٞٔ َٔ٘‫ط‬ٝ ‫ح٧ٗق‬ ّ‫ػظخ‬ ًٍٞٔ‫هي‬ ‫ريٍٝٛخ‬ ٢‫حُظ‬ًٍٞٔ ‫ٗٔزش‬ ٠ِ‫ػ‬ َ‫طئػ‬ ٖٓ ‫ُحى‬ ‫حَُ٣ل٤ش‬ ‫حُٔ٘خ١ن‬ ٢‫ك‬ ‫ح٧كَحى‬ ٖ٤‫ر‬ ٢ٜ‫حُ٘و‬ ‫حُؼ٘ق‬ ‫ُ٣خىس‬ ً٬‫كٔؼ‬ .‫حُلخ٫ص‬ ٖٓ ٖ٤‫ٓؼ‬ ‫ػيى‬ ‫ىٍحٓش‬ ‫ػ٘ي‬ ‫حٌُِ٤ش‬ ٚ‫حُٞؿ‬ ّ‫ػظخ‬ ٝ ‫ح٧ٗق‬ ّ‫أهٔخ‬ ٢‫ك‬ ‫ُٞكيٛخ‬ ‫ح٧ٗق‬ ّ‫ػظخ‬ ًٍٞٔ ‫طؼخُؾ‬ ‫ٓخ‬ ً‫خ‬‫ؿخُز‬ ‫ر٤٘ٔخ‬ ٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ًٍٞٔ ‫كيٝع‬ ٍ‫ٓؼي‬ٝ ًٕ٧‫ح‬‫حُل٘ـَس‬. ( ٍٝٝ ّ‫هخ‬Rowe)( ٢ِ٤ً ٝKilleyّ‫ػخ‬ ٢‫ك‬ )1968َ٤ِ‫رظل‬ ّ1500‫ٛ٘خى‬ ٕ‫ًٝخ‬ ٚ‫حُٞؿ‬ ّ‫ػظخ‬ ًٍٞٔ ٖٓ ‫كخُش‬501ٌٙٛ ٖٓ ‫كخُش‬ ٝ ٚ‫حُٞؿ‬ ٖٓ ٠‫حُٞٓط‬ ‫حُٔ٘طوش‬ ّ‫ُؼظخ‬ ً‫ح‬ًٍٞٔ ١ٞ‫طل‬ ‫حُلخ٫ص‬128ٝ ٢ِ‫حُٔل‬ ‫حُلي‬ ّ‫ُؼظخ‬ ًٍٞٔ ٠ِ‫ػ‬ َٔ‫ط٘ظ‬ ‫كخُش‬‫حُؼِغ‬ ّ‫ػظخ‬ ٢ٓٝ٧‫ح‬ٕ‫أ‬ ١‫أ‬ ,ٚ‫حُٞؿ‬ ٖٓ629٠ِ‫ػ‬ َٔ‫ط٘ظ‬ ‫ًخٗض‬ ‫حُلخ٫ص‬ ٌٙٛ ٖٓ.ٚ‫حُٞؿ‬ ٖٓ ٠‫حُٞٓط‬ ‫حُٔ٘طوش‬ ّ‫ُؼظخ‬ ًٍٞٔ ( ٕ‫ٛخٍ٣وخ‬ ٝ ٢ِ٤ً ّ‫هخ‬ ‫ًٔخ‬Harriganّ‫ػخ‬ ٢‫ك‬ )1975َ٤ِ‫رظل‬ ّ3324ّ‫ػظخ‬ ٢‫ك‬ ًٍٞٔ ‫رٔزذ‬ ٠‫حُٔٔظ٘ل‬ ٠ُ‫ا‬ ‫أىهِض‬ ‫كخُش‬ ٝ ٚ‫حُٞؿ‬ٝ .‫ح٧ؿِحء‬ ‫ٓظؼيىس‬ ً‫ح‬ًٍٞٔ ‫ٓؼظٜٔخ‬ ‫ًخٗض‬‫ػيىٛخ‬ ‫ٝحُزخُؾ‬ ‫حُلخ٫ص‬ ٌٙٛ ٢‫ك‬ ٌٍُٞٔ‫ح‬ ‫ُـٔ٤غ‬ َ‫رخُ٘ظ‬4317‫ٛ٘خى‬ ٕ‫ًخ‬ ً‫ح‬ًَٔ 594.٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ ‫ٓ٘طوش‬ ٢‫ك‬ ً‫ح‬ًَٔ ( ‫اٗي‬ ٕٝ‫طخ‬ ‫ك٤٘ٔ٤ض‬ ّ‫هخ‬Vincent-Townend( ‫ٗ٤لَى‬ ٝ )Shepherdّ‫ػخ‬ ٢‫ك‬ )1994ٝ ٚ‫حُٞؿ‬ ًٍٞٔ ‫كيٝع‬ ٢ٔٗ َ٤ِ‫رظل‬ ّٖ٤ٌ‫حُل‬ ٝ .‫حٍُٔ٘٘ٞس‬ ‫ح٧رلخع‬ ٖٓ ‫ػيى‬ ٠ِ‫ػ‬ ً‫ح‬‫اػظٔخى‬٢‫ك‬ ٚ‫حُٞؿ‬ ٖٓ ٢ٓٝ٧‫ح‬ ‫حُؼِغ‬ ‫ٓ٘طوش‬ ّ‫ػظخ‬ ًٍٞٔ ‫كيٝع‬ ٍ‫ٓؼي‬ ٕ‫رؤ‬ ‫حُٔلخؿؤس‬ ‫ًخٗض‬ ٤ٗ‫رَ٣طخ‬‫حُلي‬ ٌٍٞٔ‫ر‬ ‫ٓوخٍٗش‬ ٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ًٍٞٔ ‫كيٝع‬ ٍ‫ٓؼي‬ ‫ُ٣خىس‬ ‫رٔزذ‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ّ‫ػظخ‬ ٌٍٞٔ‫ر‬ ‫ٓوخٍٗظٜخ‬ ‫ػ٘ي‬ ‫اٍطلغ‬ ‫هي‬ ‫خ‬ ٖ٤‫ر‬ ‫ٓخ‬ .٢ِ‫حُٔل‬60ٝ70.٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ًٍٞٔ ٢ٛ ٚ‫حُٞؿ‬ ٖٓ ٠‫حُٞٓط‬ ‫حُٔ٘طوش‬ ًٍٞٔ ٖٓ ‫رخُٔجش‬ ٠ِ‫ػ‬ ً‫ح‬َ٤‫ًؼ‬ َ‫أػ‬ ‫هي‬ ً‫خ‬‫ٓخرو‬ ‫حًٌُٔٞس‬ ‫حُٔوظِلش‬ َٓ‫حُؼٞح‬ َ٤‫طؤػ‬ ٢‫ك‬ َ٤‫حُظـ‬ ٕ‫ا‬( ‫رَٝى‬ ّ‫هخ‬ ‫كوي‬ .٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ‫كيٝع‬ ٍ‫ٓؼي‬Brook) ( ‫ٝٝى‬ ٝWoodّ‫ػخ‬ ٢‫ك‬ )1983٢‫ك‬ ‫ػوٞى‬ ‫أٍرؼش‬ ‫كظَس‬ ٠ِ‫ػ‬ ٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ ًٍٞٔ ‫كيٝع‬ ٍ‫ٓؼي‬ ٢ٔٗ ٢‫ك‬ َ٤‫حُظـ‬ ‫ٌٛح‬ ٚ‫رلل‬ ّ ٝ .‫آظَؿخػ٤ش‬ ‫ىٍحٓش‬٢ُ‫رلٞح‬ ٢ٜ‫حُ٘و‬ ‫حُؼ٘ق‬ ‫ُحى‬ ُِٖٓ‫ح‬ ٖٓ ‫حُؼوٞى‬ ٌٙٛ ٍ٬‫ه‬ ٕ‫أ‬ ‫ٝؿيح‬75ٝ %٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ًٍٞٔ ‫أٛزلض‬ ٝ ٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ٖٓ ‫ٗؼز٤ش‬ َ‫أًؼ‬ٝ .‫رزؼ٠ٜخ‬ ‫َٓطزطش‬ ‫كوخثن‬ ٌٙٛ٢ٛ ٢ِ‫حُٔل‬ ‫حُلي‬ ‫ُؤش‬ ْ‫ػظ‬ ًٍٞٔ ٕ‫أ‬ ٖٓ ْ‫حَُؿ‬ ٠ِ‫ػ‬ ‫حُلي‬ ٢‫ك‬ ٢‫كو‬ ‫ٝحكيح‬ ً‫ح‬ًَٔ ‫ٛ٘خى‬ ٌٕٞ٣ ‫ػ٘يٓخ‬ َ‫ح٧ًؼ‬ َ‫طؼظز‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ‫ُحٝ٣ش‬ ‫ٓ٘طوش‬ ًٍٞٔ ٕ‫كب‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ٖ٤‫ر‬ َ‫ح٧ًؼ‬ .٢ِ‫حُٔل‬ ٝ ‫ٗ٤لَى‬ ‫ٝؿي‬ّ‫ػخ‬ ٢‫ك‬ َٕٝ‫آه‬1990٩ ‫طؼَٟٞح‬ ٖ٣ٌُ‫ح‬ ٠َُٟٔ‫ح‬ ٖ٤‫ر‬ ٕ‫أ‬ ّ‫ٛ٘خى‬ ٕ‫ًخ‬ ‫ػخٓش‬ ‫ٛخرخص‬83٢ٜ‫حُٞؿ‬ ٌَ٤ُِٜ ً‫ح‬ًٍٞٔ % ٝ66ّ‫ػخ‬ ‫آظؼخى٣ش‬ ‫ىٍحٓش‬ ٢‫ٝك‬ .ٚ‫حُٞؿ‬ ‫أٗٔـش‬ ٢‫ك‬ ً‫خ‬‫طِٔه‬ %1995( ٕٝ‫ُيح‬ ّDownٝ )‫ىٍحٓش‬ ْ‫ط‬ َٕٝ‫آه‬1088‫طؼَٟٞح‬ ً‫خ‬٠٣َٓ ٝ ٚ‫حُٞؿ‬ ٢‫ك‬ ً‫ح‬ًٍٞٔ ْٜ٣‫ُي‬ ٖ٣ٌُ‫ح‬ ‫ٗٔزش‬ ‫ًخٗض‬ .‫هٞ٣ش‬ ‫٩ٛخرخص‬ٖ٤ٌ‫حُل‬15ْٜ‫ػِؼ‬ ,%ٝ ‫حُلخىع‬ ٕ‫ٌٓخ‬ ٢‫ك‬ ‫ٓخطٞح‬21%‫رؼي‬ ‫ٓخطٞح‬ ٝ .٠‫حُٔٔظ٘ل‬ ُْٜٞ‫ىه‬ٝ ‫ح٩ٛخرش‬ ‫هٞس‬ ٞٛ ً‫خ‬‫ؿخُز‬ ‫حُٞكخس‬ ‫ٓزذ‬ ٕ‫أ‬ ٖٓ ْ‫حَُؿ‬ ٠ِ‫ػ‬ٕ‫كب‬ ‫ٛؼٞرظٜخ‬32‫رٔزذ‬ ْٜ‫ٓٞط‬ ٕ‫ًخ‬ ْٜ٘ٓ % .‫حُٔلظَٟش‬ ‫رخُطَ٣وش‬ ْٜٗ‫اٗؼخ‬ ّ‫ػي‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 10 ٢‫حُـَحك‬ ‫حُظَ٘٣ق‬: ٝ ٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ ‫ُٔ٘طوش‬ ٢‫حُـَحك‬ ‫حُظَ٘٣ق‬ ٕ‫ا‬‫رٜخ‬ ‫حُٔل٤طش‬ ‫ح٧ٗٔـش‬ٝ ٌٍُٞٔ‫ح‬ ٢ٔٗ ْٜ‫ك‬ ٢‫ك‬ ً‫ح‬‫ؿي‬ ْٜٓ‫أؿِحء‬ ‫اِٗ٣خف‬ ‫١َ٣وش‬ ٝ ‫حٌٍُٔٔٞس‬ ّ‫حُؼظخ‬.‫حُٔ٘طوش‬ ٌٙٛ ٢‫ك‬ ‫ٓؼوي‬ َ٤‫ؿ‬ ّ‫اُظجخ‬ ٠ُ‫ا‬ ٍُٞٛٞ‫ح‬ ٢‫ك‬ ‫حُٜٔٔش‬ َٓ‫حُؼٞح‬ ٌَ٤ُٜ‫ح‬ ْ٤ٔ‫طو‬ ‫١َ٣وش‬ ٕ‫ا‬‫ح‬ٝ ١ِٞ‫ػ‬ ‫ػِغ‬ ٠ُ‫ا‬ ٢ٜ‫ُٞؿ‬ٝ ٢ٓٝ‫أ‬ ‫ػِغ‬ٍ‫ح٩ػظزخ‬ ٖ٤‫رؼ‬ ٌ‫ح٧ه‬ ‫ػ٘ي‬ ‫ٓل٤يس‬ ‫١َ٣وش‬ ٢ٛ ٢ِ‫ٓل‬ ‫ػِغ‬ ٤‫ٓؼ‬ ٌٍُٞٔ ‫حُؼ٬ؽ‬ َ٤ٛ‫طلخ‬‫ك‬ .‫حُٔ٘طوش‬ ٌٙٛ ٢‫ك‬ ‫٘ش‬ٔ‫رٔ٘طوش‬ ً‫ح‬‫ٓليٝى‬ ٌٕٞ٣ ‫كَرٔخ‬ ١ِٞ‫حُؼ‬ ‫حُؼِغ‬ ٢‫ك‬ ًَٔ ‫ٛ٘خى‬ ٕ‫ًخ‬ ‫اًح‬ ً٬‫ؼ‬ ٝ ‫حُؼِ٤خ‬ ‫حُـٔـٔش‬ً‫ء‬ِ‫ؿ‬ ٍٙ‫اػظزخ‬ ٌٖٔ٣‫ح‬ٝ ٚ‫حُٞؿ‬ ‫اٛخرخص‬ ّٖٓ‫ُؼظخ‬ ًٍٞٔ ٠ِ‫ػ‬ َٔ٘٣ ‫ػ٘يٓخ‬ ٖ٤ٌ‫حُل‬ٝ‫حُلـخؽ‬ ‫كٞحف‬ٝ‫ح٧ٗق‬ ّ‫ػظخ‬ ٝ٢ُ‫حُـَرخ‬ ْ‫حُؼظ‬. ٌٖٔ٣ ‫رخُـٔـٔش‬ ٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ ‫ػ٬هش‬ ٕ‫ا‬ٝ ٢ٔ‫ٓز‬ ‫ًٗٔٞؽ‬ ٢‫ك‬ ‫اهظٜخٍٛخ‬‫أٓخٓ٤خص‬ ٝ ‫ح٩ٛخرخص‬ ٢ٔٗ ْٜ‫ك‬ ٠ِ‫ػ‬ ‫٣ٔخػي‬ ١ٌُ‫ح‬ ٝ . ‫حُؼ٬ؽ‬ٍ‫ا١خ‬ ‫ًحص‬ ‫رٍٜٞس‬ ٚ‫ٓوخٍٗظ‬ ٌٖٔ٣ ّ‫ح٧ٓخ‬ ٖٓ ٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ ٠ُ‫ا‬ َ‫رخُ٘ظ‬٢‫ك‬ ٢ٓ‫حُوخ‬ ‫حُـزٜش‬ ْ‫ػظ‬ ٖٓ ٌٕٞٓ ٍ‫ح٩١خ‬ ‫ٌٛح‬ . ٝ ٠ِ‫ح٧ػ‬ٝ ّ‫ػظخ‬ ٖٓ ٖ٤ٌٗٞٓ ٖ٤‫ؿخٗز‬ ُٚ‫كخكش‬ُ‫ح‬‫لـخؽ‬ٝ ‫حُـخٗز٤ش‬.٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ٖٓ ٢‫ح٧كو‬ ٢ِ‫حُٔل‬ ٍ‫ح٩١خ‬ ‫ؿِء‬ ٌٕٞ‫٣ظ‬ ‫ر٤٘ٔخ‬ ٝ ٢ِ‫حُٔل‬ ‫حُلي‬ ّ‫ػظخ‬.‫ٝحكيس‬ ‫ًٌظِش‬ ‫طظلَى‬ ‫ريٍٝٛخ‬ ٢‫حُظ‬ ٝ ٢ِ‫حُٔل‬ ‫حُؼِغ‬ ّ‫ػظخ‬ ٖٓ ‫ٓظؼيىس‬ ّ‫ػظخ‬ ٖٓ ٌٕٞ‫طظ‬ ‫ٓؼويس‬ ‫ٍٛٞس‬ ٠ِ‫ػ‬ ١ٞ‫٣لظ‬ ٍ‫ح٩١خ‬‫حُلـخؽ‬ٝٝ ‫ح٧ٗل٤ش‬ ‫حُـ٤ٞد‬‫ًٔخ‬ .ٕ‫ح٧ٓ٘خ‬ ٌٙٛ ٢‫طـط‬ ٢‫ح٧ٗل‬ ٌَ٤ُٜ‫ح‬ ‫ؿ٠َٝف‬ َ‫ٓؼ‬ ‫حُِ٤٘ش‬ ‫ح٧ٗٔـش‬ ٕ‫أ‬.‫حٍُٜٞس‬ ‫ٌٓٞٗخص‬ ٌَٔ‫ُظ‬ ‫حُٔ٘طوش‬ ٕ‫ا‬ٌُٙٛ‫ح‬‫ٔوخٍرش‬ٍ‫ح٩١خ‬ ‫اٛ٬ف‬ ْ‫ك٤ظ‬ .ٖ٤‫ٓؼ‬ ‫رظَط٤ذ‬ ٌٕٞ٣ ٕ‫أ‬ ‫٣ـذ‬ ‫اٛ٬كٜخ‬ ٕ‫كب‬ ٍ‫ح٩١خ‬ ‫ًحص‬ ‫حٍُٜٞس‬ ٌَٔ‫ط‬ ‫طو٤ِ٘خ‬ ‫كبًح‬ ‫ٓل٤يس‬ ‫ػِٔ٤ش‬ ٝ ‫حُٔلظٞ٣خص‬ َ٤ٛ‫طلخ‬ ‫ر٘خء‬ ‫اػخىس‬ ْ‫٣ظ‬ ْ‫ػ‬ ً٫ٝ‫أ‬‫ٍُِٜٞس‬ ٢‫حُٞحه‬ ‫حُِؿخؽ‬ ٍ‫آظزيح‬ ْ‫٣ظ‬ ً‫ح‬َ٤‫أه‬ٝ ٚ‫حُٞؿ‬ ‫اٛخرخص‬ ‫ػ٬ؽ‬ ٕ‫ا‬ .‫ح‬ْ‫ر٘ل‬ ْ‫٣ظ‬ ٖ٤ٌ‫ُل‬ ٝ ‫حُطَ٣وش‬‫حُظَط٤ذ‬ ْ‫ر٘ل‬. ٢‫حُ٘ؼخػ‬ ٚ٤‫حُظ٘و‬: ‫ح٩ٗخٍس‬ ٖٓ ‫٫ري‬‫ح‬ ٞ‫ُزؼ‬‫كظخص‬ ٬ُٔ: ‫ٗؼخػ٤خ‬ ‫حُٞؿٜ٤ش‬ ‫ح٧ً٣خص‬ ٚ٤‫ط٘و‬ ٚ٤‫طٞؿ‬ ٝ ْٜ‫ُل‬ ‫أ‬‫وال‬: *٩‫ح‬ َ‫هز‬ ‫٣ـذ‬، ‫حُ٘ؼخػ٤ش‬ ‫حُٔلَىحص‬ ٠ِ‫ػ‬ ‫١٬ع‬‫أ‬٢٤‫ٗل‬ ٕ‫ػِٔخ‬٤‫حُظَ٘٣ل‬ ‫رخُٔ٘خ١ن‬ٝ ‫ٗؼخػ٤خ‬ ‫حُٔيٍٝٓش‬ ‫ش‬ٌَُٔ‫ح‬ ١ٞ‫روط‬‫أ‬ٝ ‫ٓ٘خ١ن‬‫حُولل٤ش‬ ‫حُٞؿٜ٤ش‬ ‫حُ٠ؼق‬. *ُٔ‫ح‬ ٠‫حُطزو‬ َ٣ٜٞ‫حُظ‬ ‫ٗطزن‬ ‫هخٛش‬ ٚ‫حُٞؿ‬ ًٍٞٔ ٠َٟٓ ٢‫ك‬ٝ ٍٟٞ‫ل‬‫ٓلٍٞ٣ش‬ ‫ٓوخ١غ‬ ٖ‫ػ‬ ‫ػزخٍس‬ ٞٛ‫أ‬ٝ ‫١زو٤ش‬ ٝ‫ا‬‫ؿزٜ٤ش‬ ‫ًِ٤ِ٤ش‬ ٛٝ٢‫ر٤ٜ٘خ‬ َٜ‫٣ل‬ ‫حَُٝط٤٘٤ش‬ ‫حُٔوخ١غ‬3–5ٝ ْٓ‫ٍرٔخ‬‫أ‬ٝ ، َ‫ه‬٣٧‫ح‬ ُِٕٞ‫ح‬ ٍ‫ي‬ٝ ، ‫حُؼظ٤ٔش‬ ‫حُٔخىس‬ ٠ِ‫ػ‬ ٞ٤‫ر‬‫ح‬٧‫ح‬ ُِٕٞ٠ِ‫ػ‬ ‫ٓٞى‬ ‫حُ٘لٔ٤ش‬ ‫حُٔخىس‬‫أ‬‫حَُهٞس‬ ‫حُ٘ٔؾ‬ ٝ. ‫ًؼخكخ‬ ‫٣َ٣٘خ‬ ‫ًٔخ‬ِٚ‫ريحه‬ ‫حُٜٞحء‬ ‫ٓغ‬ ٠ٌ‫حُل‬ ‫حُـ٤ذ‬ ‫ص‬‫أ‬‫ح‬ َ‫ريحه‬ ٝ‫ُلـخؽ‬‫أ‬ٍٞٓ‫ٗخ‬ ‫ٗظ٤ـش‬ ‫حُولق‬ ٌٖٝٝٔ٣‫ا‬‫حُٔوخ١غ‬ ٌٙٛ ٍ‫ٍٓخ‬‫ا‬٠ُ ٝ ‫ُ٘خ‬ ‫ُ٤ـٜٔٔخ‬ َ‫حٌُٔز٤ٞط‬ٝ ‫ٓـٔٔخ‬ ‫ٓ٘ظَح‬ ‫٣ؼط٤٘خ‬ٝ ‫حُـَحكش‬ َ‫هز‬ ٚ‫حُٞؿ‬ َ‫ط٘خظ‬ ‫ُ٘خ‬ ْ٤‫٣و‬ ‫ٌٛح‬‫حُـَحك٤ش‬ ‫رؼي‬ ٚ‫ٟٝؼ‬ٝ‫أ‬ٟ‫ٓٔخإ‬ ْٛ ُ‫ح‬ ‫ٌٛح‬٧‫ح‬ ٠‫حُؼ٬ػ‬ ٍٟٞ‫حُٔل‬ ٠‫حُطزو‬ َ٣ٜٞ‫ظ‬‫رؼ‬‫ٌُٔ٤ش‬ ٞ٣َُٔ‫ح‬ َٝ‫طؼ‬ ٢ٛ ْٔ‫حُٔـ‬ ‫خى‬‫أ‬‫ح٫ٗؼش‬ ٖٓ َ‫ًز‬. ‫ثاٍّا‬: *٠ٔ٤١‫حُٔـ٘خ‬ ٖ٤َُٗ‫ح‬ٍُٚٝ‫ى‬‫أ‬ٝ ‫حُِٔٓ٘ش‬ َُٟٝٞ‫ح‬ ٢‫ك‬ َ‫ًز‬‫حُلخىس‬ ‫ُ٤ٔض‬. ٝ٧‫ح‬ ٚ٤‫ك‬ ‫٣ظ٠ق‬ٌَ٘‫ر‬ ‫حُـ٠َٝك٤ش‬ ّ‫هٔخ‬‫أ‬ٖٓ َ‫ًز‬CTٝ٠ٌ‫حُل‬ َٜ‫حُٔل‬ ٢‫ك‬ َٙ‫حُو‬ ‫هخٛش‬. *ٕ‫حَُٔٗخ‬ َ٠‫٣ل‬٠ِ‫ػ‬C Tٝ ، ‫حُؼ٠٬ص‬ ٙٞ٘‫ط‬ ‫ٓؼَكش‬ ٢‫ك‬ٝ ‫حُلـخؽ‬ َ‫ىحه‬ ‫حُِ٘ف‬ ‫طلي٣ي‬ٝ ‫حُٔٔلخم‬ ‫طلض‬٩‫ح‬ٝ ‫ٜٗزخرخص‬‫طلي٣ي‬ ٧‫ح‬٧‫ح‬ ّ‫ؿٔخ‬‫حُٔؼيٗ٤ش‬ َ٤‫ؿ‬ ‫ؿ٘ز٤ش‬‫أ‬ًٔ ‫طلي٣يٛخ‬ ْ‫ك٤ظ‬ ‫حُٔؼيٗ٤ش‬ ‫ٓخ‬‫خ‬٢‫ك‬C T *َ٠‫٣ل‬MRI٢‫ك‬‫أ‬‫ػخٓش‬ ٕ‫حُِٔخ‬ ٝ‫َٓح‬ٝ٧‫ح‬ّ‫ٍٝح‬ُٝ‫ح‬‫ظ٘ٞٛخص‬.
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 11 ‫ثاىثا‬: ‫٣ل٤ي‬ٕ‫حَُٔٗخ‬٢‫ك‬ٝ ‫حُلخىس‬ ‫حُلخ٫ص‬ٝ َُٟٝٞ‫ح‬ٝ ٚ‫حُٞؿ‬ ًٍٞٔٝ ٖ٤ٌ‫حُل‬ٝ ، ‫حُؼظٔ٤ش‬ ‫حُظوَرخص‬٢‫ك‬‫أ‬ٝ ْ‫حُؼظ‬ ٝ‫َٓح‬٠‫حُؼ٘خر‬ ‫حُـٞف‬، ٝٝ ‫حُظٌ٘ٔخص‬ ‫كخ٫ص‬ ٢‫ك‬ ‫٣ل٤ي‬ٝ ‫حُِٔٓ٘ش‬ ‫حُلخ٫ص‬٩‫ح‬ٝ ‫ٜٗزخرخص‬‫آ‬ٝ ٠‫حُٜيؿ‬ ٠ٌ‫حُل‬ َٜ‫حُٔل‬ ‫كخص‬ٞ٣َُٔ‫ح‬ َٝ‫٣ؼ‬ ٫ َ٣ٜٞ‫حُظ‬ ‫ٌٛح‬ ٧‫ٗؼش‬,ٝ َٜٓ‫ٓؼِٞٓخص‬ ‫ػيس‬ ٠‫٣ؼط‬. ًَٝ ٠ِ‫ػ‬ٝ ، ٍٟٞ‫حُٔل‬ ٠‫حُطزو‬ َ٣ٜٞ‫كخُظ‬ ٍ‫كخ‬‫حُلخ٫ص‬ ٞ‫رؼ‬ ٢‫ك‬ ٕ٬ٓ‫ٓظٌخ‬ ، ٕ‫حَُٔٗخ‬. ‫ساتؼا‬: ٩‫ح‬ ‫٣ـذ‬‫ٗخٍس‬‫ا‬٠ُDENTAL SCANٝ‫ططز٤و‬ٚ‫خط‬٢‫ك‬ ‫هخٛش‬٢‫ك‬ ‫٣ل٤ي‬ ٜٞ‫ك‬ ٖ٤ٌ‫ٝحُل‬ ْ‫حُل‬ ‫ؿَحكش‬‫أ‬٧‫ح‬ ‫ه٤خٓخص‬ ٌ‫ه‬‫حُٔ٘خٓزش‬ ًٖ‫ٓخ‬ ٝ ٠ُ٘ٔ‫ح‬ ‫ٍُِِع‬ٝ ْ‫حُؼظ‬ ‫ٓٔخًش‬٧‫ح‬٧‫ح‬ ًٖ‫ٓخ‬ٝ ‫حُلي‬ َُ٘٘ ‫ٗٔذ‬‫ا‬٬ٛ‫حُلي‬ ٢‫ك‬ ‫هخٛش‬ َُٝ‫حُز‬ ‫ف‬‫ح‬‫ُِٔ٘خ١ن‬ َٝ‫حُظؼ‬ ٕٝ‫ى‬ ٢ِ‫ُٔل‬ ٣َ٘‫حُظ‬‫ل‬‫٤ش‬٧‫ح‬ ٝ‫ػٜخد‬٧‫ح‬ ٝ‫ٝػ٤ش‬.‫ٍإ٣ش‬ ٖٓ ‫٣ٌٔ٘٘خ‬ ‫ًٔخ‬‫أ‬ٝ ٚ‫حُٞؿ‬ ٢‫ك‬ ْ‫حُؼظ‬ ّ‫هٔخ‬‫ر‬ ٖ٤ٌ‫حُل‬‫ؤر‬‫حُؼ٬ػش‬ ‫ؼخىٛخ‬ًٝ ‫ٓـٔٔش‬ ‫ـٔـٔش‬ ٝ َ‫حٌُٔز٤ٞط‬ ٠ِ‫ػ‬ ‫حُـٜخص‬ ٌَ‫ر‬ ‫طيٝ٣َٛخ‬ ٌٖٔ٣ٝ ‫ريهش‬ ٌَُٔ‫ح‬ ‫ٓٞهغ‬ ‫طلي٣ي‬ ٠ُ‫رخُظخ‬٩‫ح‬ ‫طلي٣ي‬ُ‫ح‬ َ‫ىحه‬ ٙ‫ٗؤخ‬٤‫ـ‬‫ٞد‬ٝ‫ُحٝ٣ش‬ ًٍٞٔ ٝ ‫حُلي‬ٝ ‫حُلـخؽ‬‫ػ‬ َ٠‫طل‬٢‫حُظ‬ َ‫ٝٝط‬ ‫رٟٞؼ٤ش‬ ‫حُـ٤ٞد‬ ‫ٍٛٞس‬ ٖ‫أ‬٠‫طؼط‬ ٫ ‫ٛزلض‬‫ا‬ٝ ‫ٓليٝىس‬ ‫ٓؼِٞٓخص‬ ٫٠ُ‫رخُظخ‬‫أ‬٩‫رخ‬ ‫ٛزق‬ٕ‫ٌٓخ‬ ‫ً٘ق‬‫أ‬ّ‫ٍٝح‬‫ػخىس‬ ‫طٌ٘ق‬ ٫ ٢‫حُظ‬ ٠ٌ‫حُل‬ ‫حُـ٤ذ‬‫ا‬‫ٓظ‬ ٌَ٘‫ر‬ ٫‫ؤ‬‫رؼي‬ َ‫ه‬‫ا‬ٝ ‫طوَد‬ ‫كيحع‬‫ا‬َ٤‫ًز‬ ٠ٔ‫ػظ‬ ٙ‫ٓظٜخ‬. ١ِٞ‫حُؼ‬ ٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ ‫حُؼِغ‬ ٕ‫ا‬ٝ ‫حُـزٜش‬ ْ‫ػظ‬ ٖ‫ػ‬ ‫ػزخٍس‬ ٞٛ ٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ ٖٓ ١ِٞ‫حُؼ‬‫ط‬ ٢‫حُظ‬ٌٖٓ ١ِٞ‫حُؼ‬ ‫حُـِء‬ ٕٞ‫كٞحف‬‫حُلـخؽ‬ٝٚ‫ٓطل‬١ِٞ‫حُؼ‬. ‫رِحٝ٣ش‬ ‫حُوِق‬ ٠ُ‫ا‬ ‫حُـٔـٔش‬ ‫هخػيس‬ ‫طٔظي‬45ْ‫حُؼظ‬ ‫ٓغ‬ ‫حُـزٜش‬ ْ‫ػظ‬ ‫ك٤ٜخ‬ ٌِ‫٣َط‬ ٢‫حُظ‬ ‫حُٔ٘طوش‬ ٢‫ك‬ َ‫ح٧ٓل‬ ٠ُ‫ا‬ ً‫خ‬‫طوَ٣ز‬ ‫ىٍؿش‬ ١‫حُٞطي‬ٝ ٚ‫حُٞؿ‬ ٖٓ ٢ٓٝ٧‫ح‬ ‫حُـِء‬ ٕ‫ا‬ .‫ٌٓٞٗخ‬٠٘‫حُٔ٘ل‬ ‫ٌٛح‬ ٠ِ‫ػ‬ ٌِ‫طَط‬ ٚ‫ط‬ٝ ,٠ُ‫ا‬ ٢ُ‫حُـَرخ‬ ْ‫ُِؼظ‬ ‫حُظخرغ‬ ١ٞ‫حُٜٔل‬ ْ‫حُؼظ‬ ‫٣ٔظي‬ ٝ ‫حُٔن‬ ‫ٓلخ٣خ‬ ْٓ٬٣ ٠‫كظ‬ ٠ِ‫ح٧ػ‬ُْ٘‫ح‬ ‫أػٜخد‬ َٔ‫ط‬ ٚ٘ٓٝ ‫حُـزٜش‬ ْ‫ػظ‬ ٕ‫ا‬ .ٝ ْٔ‫حُـ‬ُ‫ح‬ ‫حُـ٘خف‬َ٤‫ٌز‬ُٝ‫ح‬ ‫حُـ٘خف‬َ٤‫ٜـ‬ْ‫ُِؼظ‬ ٌٍُِٞٔ َٝ‫طظؼ‬ ٫ ً‫خ‬‫ؿخُز‬ ١‫حُٞطي‬‫رٞحٓطش‬ ‫ًز٤َس‬ ‫ريٍؿش‬ ٕٞ٤ٔ‫ٓل‬ ْٛ ‫حُلو٤وش‬ ٢‫ك‬ .ٚ‫حُٞؿ‬ ٖٓ ٢ٓٝ٧‫ح‬ ‫ُِـِء‬ ‫حُٞٓخى٣ش‬ ‫حُوخٛ٤ش‬ ‫حُٜيٓخص‬ ‫هٞس‬ ٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ ٖٓ ٢ٓٝ٧‫ح‬ ‫حُؼِغ‬ ّ‫ػظخ‬ ٚ‫طٔظ‬ ‫ك٤غ‬ٝ‫ح‬ ٠ُ‫ا‬ ‫حُوٞس‬ ٌٙٛ َ‫ط٘و‬ ٕ‫أ‬ َ‫هز‬ ٌَٔ‫طظ‬.َٟ‫ح٧ه‬ ّ‫ُؼظخ‬ ‫طليع‬ ‫ػ٘يٓخ‬ُ‫ح‬ٌٍٞٔ٢‫ك‬ُ‫ح‬ٝ ‫طليع‬ ‫ٜٓٔش‬ ً‫خ‬‫ػٞحهز‬ ‫ٛ٘خى‬ ٕ‫كب‬ ٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ ‫ٓ٘طوش‬ ٖٓ ‫حُولل٤ش‬ ‫ٌٔٞٗخص‬٢ٛ: 1-‫حُٔن‬ َٝ‫٣ظؼ‬ ‫ٍرٔخ‬‫ٓزخَٗس‬ ‫ُٜيٓش‬, 2-‫حٌٍُٔٔٞس‬ ‫حُٔ٘طوش‬ ٢‫ك‬ ً٬‫ٓؼ‬ ‫ُِِ٘٣ق‬ ‫ٗظ٤ـش‬ ‫ٓزخَٗس‬ َ٤‫حُـ‬ ‫ح٩ٛخرخص‬ َ‫ُوط‬ ً‫خ‬َٟ‫ٓؼ‬ ‫حُٔن‬ ٌٕٞ٣ ‫ٍرٔخ‬, 3-ٖٓ ٢‫حُوِل‬ ٍ‫حُـيح‬ ٌَُٔ‫ح‬ َٔ٘٣ ‫ٍرٔخ‬‫ٓطق‬ ٝ‫أ‬ ‫حُـزٜ٤ش‬ ‫حُٜٞحث٤ش‬ ‫حُـ٤ٞد‬ٓ‫و‬‫ِش‬ٝ ١ٞ‫حُٜٔل‬ ْ‫حُؼظ‬ ٝ‫أ‬ ٖ٤‫حُؼ‬‫ٍرٔخ‬ ‫ريٍٝٛخ‬ ٢‫حُظ‬ ٝ‫أ‬ ‫حُيٓخؿ٤ش‬ ‫حُـخك٤ش‬ ّ٧‫ح‬ ٢‫ك‬ ‫رظِٔم‬ ‫طٜخكذ‬٢‫حُ٘وخػ‬ َ‫حُٔخث‬ ٢‫ك‬ ‫طَٔد‬ 4-ٝ ‫ح٩ِٗ٣خف‬.٢‫حُطز٤ؼ‬ ‫ُٟٞؼٜخ‬ ٌٍُٞٔ‫ح‬ ‫اػخىس‬ ‫ٓغ‬ ٍٝ‫٣ظؼخ‬ ‫هي‬ ‫حُوِق‬ ٠ُ‫ا‬ ‫هخٛش‬ ٢ٓٝ٧‫ح‬ ٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ ٖٓ َّٞٓٓ ٢‫ه‬ ٠ِ‫ح٧ػ‬ ٢‫ك‬ ‫٣ليٛخ‬ ٢‫حُظ‬ ‫حُٔ٘طوش‬ ٚٗ‫رؤ‬ ٢ٓٝ٧‫ح‬ ٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ ‫طؼَ٣ق‬ ٌٖٔ٣ً‫ح‬ٍَٝٓ ٢٘‫حُٞؿ‬ ٢ٜ‫حُـز‬ ٍُ‫حُي‬ ‫ٓ٘طوش‬ ‫ر‬ٝ ٢‫ح٧ٗل‬ ٢ٜ‫حُـز‬ ٍُ‫خُي‬‫ح‬ ٍُ‫حُي‬ُ‫ح‬ ٢ٜ‫ُـز‬٢ٌ‫ل‬َ‫ح٥ه‬ ‫حُـخٗذ‬ ٢‫ك‬ ٢٘‫حُٞؿ‬ ٢ٜ‫حُـز‬ ٍُ‫حُي‬ ٠ُ‫ا‬.ٟٝٞ‫ٓٔظ‬ َ‫ح٧ٓل‬ ٖٓ ‫٣ليٛخ‬ ْ‫ػظ‬ ٖٓ ‫ٌٓٞٗش‬ ‫حُٔلِ٤ش‬ ٙ‫كيٝى‬ ٌٕٞ‫كظ‬ ٕ‫أٓ٘خ‬ ٕٝ‫ري‬ ٞ٣َُٔ‫ح‬ ٕ‫ًخ‬ ‫اًح‬ ٝ .ٕ‫أٓ٘خ‬ ‫ٛ٘خى‬ ٕ‫ًخ‬ ‫اًح‬ ١ِٞ‫حُؼ‬ ‫حُلي‬ ٢‫ك‬ ٕ‫ُ٨ٓ٘خ‬ ‫ح٩١زخم‬ ١ِٞ‫حُؼ‬ ‫ُِلي‬ ‫حُيٍى‬ٝ .٠ُ‫ا‬ ‫حُوِق‬ ٠ُ‫ا‬ ٢ٓٝ٧‫ح‬ ٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ ‫٣ٔظي‬ٝ ١‫حُٞطي‬ ْ‫ُِؼظ‬ ‫حُـ٘خك٤ش‬ ‫حُٜلخثق‬ ‫ٓ٘طوش‬‫ٓخ‬ ً‫خ‬‫ؿخُز‬ ٢‫حُظ‬ .‫حُوٞ٣ش‬ ‫ح٩ٛخرخص‬ ٢‫ك‬ ٌَٔ‫ط‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 12 ٌٕٞ‫طظ‬٢ٓٝ٧‫ح‬ ٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ ‫ٓ٘طوش‬‫حُظخُ٤ش‬ ّ‫حُؼظخ‬ ٖٓ -2ْ‫حُؼظ‬ ٖٓ٢ٌ‫حُل‬ -2٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ٖٓ -2٢‫حُٜيؿ‬ ْ‫ُِؼظ‬ ٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ‫ٗظٞءحص‬ ٖٓ -2‫حُل٘ي‬ ْ‫ػظ‬ ٖٓ -2‫ح٧ٗق‬ ْ‫ػظ‬ ٖٓ -2ٖٓ٢‫حُيٓؼ‬ ْ‫حُؼظ‬ -ْ‫ػظ‬‫حُٔ٤ٌؼش‬ -ٝ ٢ُ‫حُـَرخ‬ ْ‫حُؼظ‬‫حُوَ٣٘خص‬‫رٜخ‬ ‫حُٔظِٜش‬ -2ٖٓ‫حُوَ٣٘خص‬‫حُٔلِ٤ش‬ -١‫حُٞطي‬ ْ‫ُِؼظ‬ ‫حُـ٘خك٤ش‬ ‫حُٜلخثق‬ )*ٚ‫حُٞؿ‬ ٢ٓٝ ‫ُٔ٘طوش‬ ٢ٔ‫حُؼظ‬ ٌَ٤ُِٜ ‫حُل٤ِ٣خث٤ش‬ ‫حُٜلخص‬ 1-ٝ ٌَ٤ٛ ٌٕٞ‫٣ظ‬ٝ ّ‫حُؼظخ‬ ٖٓ ‫ػيى‬ ٖٓ ٢ٔ‫حُؼظ‬ ٚ‫حُٞؿ‬ ٢ًٓ‫ح‬ٍ‫ٗخى‬ ٢ٛ‫ٓ٘لَىس‬ ٌٍُٞٔ َٝ‫طظؼ‬ ‫ٓخ‬ 2-ٝ ‫حًَُٔذ‬ ‫حُز٘خء‬ٝ َ‫ح٧ٓل‬ ٖٓ ‫حُٔ٠ؾ‬ ٟٞ‫ه‬ َٔ‫طل‬ ٠ِ‫ػ‬ ‫حُويٍس‬ ُٚ َ‫٣ـؼ‬ ٌَ٤ُٜ‫ح‬ ‫ٌُٜح‬ ْ‫حُٔ٘ظ‬ٞ‫رؼ‬ ٢‫ك‬ ‫حُلٔخ٣ش‬ َ‫٣ٞك‬ ‫ًٌُي‬ .ٖ٤‫حُؼ‬ ‫هخٛش‬ ‫حُٔـخٍٝس‬ ‫حُل٤ٞ٣ش‬ ‫ُ٨ؿِحء‬ ‫حُٔ٘خ١ن‬ ٢‫حُِل‬ ‫حُلي‬ ‫ُـ٤ٞد‬ ٢‫حُوخٍؿ‬ ٍ‫حُـيح‬ ‫ٓ٘طوش‬ ٢‫ك‬ ‫حُلي‬ ْ‫ػظ‬ ٖٓ ‫ؿِء‬ ‫اُحُش‬ ْ‫ط‬ ُٕٞ‫أ‬ َٟ٤ٖٓٓ ٌٕٞ‫٣ظ‬ ٚ‫حُٞؿ‬ ٢ٓٝ ٌَ٤ٛ ّ‫ػظخ‬ ٝ ‫ٓظظخرؼش‬ ّ‫ػظخ‬‫حُـٔـٔش‬ ّ‫ػظخ‬ ٠ُ‫ا‬ ‫ح٧ٓخٓ٤ش‬ ٕ‫ح٧ٓ٘خ‬ ٖٓ ٠ِ‫ح٧ػ‬ ٠ُ‫ا‬ ‫ٓظـٜش‬ ‫ىحػٔش‬ٝ .ٌٙٛ ٠ِ‫ػ‬ ّ‫حُطؼخ‬ ‫ٓ٠ؾ‬ ‫هٞس‬ ‫طظُٞع‬ ٝ ‫ح٧ٗق‬ ٍٞ‫ك‬ ‫حُٜ٘ش‬ ‫حُٔ٘طوش‬.‫حُـٔـٔش‬ ‫هخع‬ ٠ُ‫ا‬ ‫ُ٨ٗق‬ ‫حُٔـخٍٝس‬ ‫حُـ٤ٞد‬ 3-َ‫ح٧ٓل‬ ٖٓ ٟٞ‫ه‬ َٔ‫طل‬ ٌٚ٘ٔ٣ ‫حُز٘خء‬ ٖٓ ‫حُ٘ٞع‬ ‫ٌٛح‬،ٌُٖ‫اطـخٛخص‬ ٖٓ ٟٞ‫ه‬ ١‫أ‬ ‫ٗظ٤ـش‬ ‫رُٜٔٞش‬ ٌَٔ‫طظ‬ ‫حُز٘خء‬ ‫ٌٛح‬ ّ‫ػظخ‬ .َٟ‫أه‬ ّ‫ػخ‬ ٢‫ك‬1975( ْٛ‫ٗخ‬ َٟ‫أؿ‬ ّNahumٝ ٚ‫حُٞؿ‬ ٢ٓٝ ٌَ٤ٛ ًٍٞٔ ٠ِ‫ػ‬ ‫طـخٍد‬ )٢‫ك‬ ًَٔ ‫٩كيحع‬ ‫حُ٬ُٓش‬ ‫حُوٞس‬ ٍ‫ٓويح‬ ٕ‫أ‬ ‫ٝؿي‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ّ‫ػظخ‬ ٌَُٔ ‫حُ٬ُٓش‬ ‫حُوٞس‬ ٍ‫ٓويح‬ ‫ػِغ‬ ٝ‫أ‬ ْٔ‫ه‬ ٞٛ ٚ‫حُٞؿ‬ ٢ٓٝ ٌَ٤ٛ‫ًِٜخ‬ ٚ‫حُٞؿ‬ ّ‫ػظخ‬ ٕ‫ا‬ .‫ٟؼ٤ق‬ َٔ‫طل‬ ‫ُي٣ٜخ‬ ‫حُ٠خؿطش‬ ٟٞ‫ُِو‬ُ‫ح‬ ‫حُلي‬ ‫ر٤٘ٔخ‬ ,٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ّٞ‫ه‬ ‫طِ٤ٜخ‬ ٌَُِٔ ‫ح٧ٟؼق‬ ‫ٓوخٝٓظٜخ‬ ‫ُٜخ‬ ‫ح٧ٗق‬ ّ‫ػظخ‬ ٕ‫أ‬ ‫ًٔخ‬ .١ِٞ‫ؼ‬‫كٔخٓ٤ش‬ ُٚ ( ‫ح٧كو٤ش‬ ‫ُ٪ٛخرخص‬ ‫رخُـش‬Huelke AndCompton, 1983.) 4-ٔ‫ر‬ ٌَٔ‫طظ‬ ّ‫حُؼظخ‬ ٌٙٛ ٕ‫كب‬ ٚ‫حُٞؿ‬ ٢ٓٝ ٌَ٤ٛ ّ‫ػظخ‬ ‫رٜخ‬ ِ٤ٔ‫طظ‬ ٢‫حُظ‬ ‫حُٜ٘خٗش‬ ‫ٛلش‬ ‫رٔذ‬ٝ ‫ُٜٞش‬‫ٝحه٤ش‬ ‫ًٞٓخىس‬ َٔ‫طؼ‬ ‫ٟٓٞٞع‬ ‫حُؼوخد‬ ‫ػٞى‬ ‫رٜ٘يٝم‬ ‫حُٟٞغ‬ ‫ٌٛح‬ ٚ٤‫ط٘ز‬ ٌٖٔ٣ .٢‫حُـخٗز‬ ٢ٓ‫ح٧ٓخ‬ ٙ‫ح٩طـخ‬ ٖٓ ٝ‫أ‬ ّ‫ح٧ٓخ‬ ٖٓ ‫ح٩ٛخرخص‬ ٢‫ك‬ ‫هخٛش‬ ‫ُِولق‬ ٝ ‫طلض‬٩‫ح‬ ٌٙٛ .‫أٓلِٜخ‬ ٢ِ‫حُٔل‬ ‫حُلي‬ َُٝ‫ر‬ ٖ‫ػ‬ ‫ٝطوظِق‬ ‫حُٔن‬ ١ٞ‫طل‬ ٢‫حُظ‬ ‫حُِٜزش‬ ‫حُٔ٘طوش‬ ّ‫أٓخ‬ً‫ح‬‫ؿي‬ ‫ٜٓٔش‬ ‫حُل٤ِ٣خث٤ش‬ ‫هظ٬كخص‬ ‫حُل٤خس‬ ٢‫ك‬ّ‫حَُأ‬ ‫اٛخرخص‬ ‫رؼي‬. ‫حُٞكخس‬ ‫طٔزذ‬ ‫هي‬ ٝ‫أ‬ ‫حُٔن‬ ٢‫ك‬ ‫هط٤َس‬ ٍ‫أَٟح‬ ‫٩كيحع‬ ‫ًخك٤ش‬ ٌٕٞ‫ط‬ ‫هي‬ ‫حُولق‬ ‫ٓ٘طوش‬ ٠ِ‫ػ‬ ‫حُٔزخَٗس‬ ‫حُٜيٓش‬ْ‫ٝر٘ل‬ ‫حُٜيٓش‬ ْ‫ٗل‬ . ْ‫ٓ٤ظ‬ ٚ‫حُٞؿ‬ ‫ٓ٘ظٜق‬ ٌَ٤ٛ ٠ُ‫ا‬ ‫ٝؿٜض‬ ‫ٓخ‬ ‫اًح‬ ‫حُوٞس‬‫ا‬ٝ ‫ٓظٜخٜٛخ‬ٚ٤‫ٝػ‬ ‫حُٜٔخد‬ ‫٣لوي‬ ٫ ‫ٍرٔخ‬ َ‫ر‬ ٍ‫ح٧َٟح‬ ْ‫ٗل‬ ٠ُ‫ا‬ ١‫طئى‬ ٫ ‫ٍرٔخ‬ ٓ‫حُٜي‬ ٌٙٛ ‫رٔزذ‬ٝ ٚ‫حُٞؿ‬ ّ‫ػظخ‬ ‫ٓ٘طوش‬ ٢‫ك‬ ً‫ح‬ٍ‫ىٓخ‬ ‫طٔزذ‬ ‫ٌُٜ٘خ‬ ,‫ش‬١‫حُٔظٜي‬ ٞٛ ٢ِ‫حُٔل‬ ‫حُلي‬ ٕ‫ًخ‬ ‫اًح‬ .‫رٜخ‬ ‫حُٔل٤طش‬ ‫ح٧ٗٔـش‬ ‫ٛلش‬ ٕ‫كب‬ ‫حُٜيٓش‬ ٌُٜٙ‫ا‬ٝ َ‫طو‬ ‫حُٜيٓخص‬ ٙ‫ٓظٜخ‬.‫حُٔ٬ًٔش‬ ‫ٍ٣خٟش‬ ٢‫ك‬ ‫حُوخٟ٤ش‬ ‫حُ٠َرش‬ ٢‫ك‬ ‫٣ليع‬ ‫ُٔخ‬ ‫ٓ٘خرٜش‬ ‫حُٔن‬ ‫اٛخرش‬ ٌٕٞ‫ط‬ )*٩‫ح‬‫حُـٔـٔش‬ ‫هخػيس‬ ‫ٓغ‬ ١‫ٍطزخ‬ -ّ‫ػظخ‬ ‫اُحُش‬ ْ‫ط‬ ‫اًح‬ٝ ٢ٜ‫حُـز‬ ْ‫حُؼظ‬ ٕ‫أ‬ ‫ٍإ٣ش‬ ٌٖٔ٣ ‫حُـٔـٔش‬ ٖٓ ٚ‫حُٞؿ‬ ٢ٓٝ ٌَ٤ٛ٠ُ‫ا‬ ٚ‫٣ظـ‬ ٠٘‫ٓ٘ل‬ ٕ‫٣ٌٞٗخ‬ ١‫حُٞطي‬ ْ‫حُؼظ‬ ‫ٓويحٍٛخ‬ ‫رِحٝ٣ش‬ ‫حُوِق‬ ٠ُ‫ٝا‬ َ‫ح٧ٓل‬45. ‫حُؼِٞ٣ش‬ ٕ‫ح٧ٓ٘خ‬ ‫ا١زخم‬ ٢‫ه‬ ‫ٓغ‬ ‫ىٍؿش‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 13 -ٝ ‫ُِـٔـٔش‬ ‫حُوٞ٣ش‬ ‫رخُوخػيس‬ ٚ‫حُٞؿ‬ ٢ٓٝ ٌَ٤ٛ ّ‫ػظخ‬ ٌِ‫طَط‬ّ‫حُؼظخ‬ ٌٙٛ ٕ‫كب‬ ًَٔ ‫كيٝع‬ ‫ػ٘ي‬ٖ‫ػ‬ َٜ‫ط٘ل‬ ‫هي‬ٕ‫ا‬ .‫حُولق‬ ‫هخػيس‬ ٍ‫ٓويح‬‫ا‬ٝ ٢٤ٔ‫ر‬ ‫حُوِق‬ ٠ُ‫ا‬ ّ‫حُؼظخ‬ ٌٙٛ ‫ِٗ٣خف‬١ِٞ‫حُؼ‬ ‫حُلي‬ ٢‫ك‬ ‫حُوِل٤ش‬ ّ‫ح٧َٟح‬ ٕ‫كب‬ ‫حُـٔـٔش‬ ‫هخػيس‬ ٢‫ك‬ ٠٘‫حُٔ٘ل‬ ‫رٞؿٞى‬ ٌُٖ ‫ٓلظٞكش‬ ‫أٓخٓ٤ش‬ ‫ػ٠ش‬ ‫ػٜ٘خ‬ ‫٣٘ظؾ‬ ‫ٓٔخ‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ٢‫ك‬ ‫حُوِل٤ش‬ ّ‫ح٧َٟح‬ ‫ٓغ‬ ٢‫١ز٤ؼ‬ َ٤‫ؿ‬ ‫ٟٝغ‬ ٢‫ك‬ ‫ططزن‬,ٕ‫ح٧ك٤خ‬ ٞ‫رؼ‬ ٢‫ك‬ ٩‫ح‬ ٌٕٞ٣٤ُ ً‫خ‬٤‫ًخك‬ ‫ِٗ٣خف‬‫ا‬ ‫ٔزذ‬‫ٓظ‬ٝ ٚ‫حُٞؿ‬ ٢‫ك‬ ‫طخُش‬ٌٔ٣ ‫حُلخ٫ص‬ ٞ‫رؼ‬ ٢‫ك‬ٝ ٞ‫حَُه‬ ‫حُل٘ي‬ ‫٣يكغ‬ ٕ‫أ‬ ٖ‫ر‬ ٕ‫حُِٔخ‬‫ب‬ٝ ‫حُوِق‬ ٙ‫طـخ‬‫٣ظٔززخ‬ ‫حُٜٞحث٤ش‬ ١ٍ‫ُِٔـخ‬ ‫اػخهش‬ ٢‫ك‬٣ .ٝ ‫حَُهٞس‬ ‫ُ٨ٗٔـش‬ ٍّٞ‫رظ‬ ‫ٌٛح‬ ‫ٜخكذ‬‫ا‬‫حُيٓٞ٣ش‬ ‫رخُوؼَس‬ ‫ح٧ٗق‬ ‫كظلخص‬ ‫ٗٔيحى‬٠ِ‫ػ‬ ٚٗ‫أ‬ ًٌَ‫ط‬ ‫٣ـذ‬ . ‫حُٜٞحث٤ش‬ ١ٍ‫ُِٔـخ‬ ‫حُل٤ِ٣خث٤ش‬ ‫ح٩ػخهش‬ ٕ‫أ‬ ٖٓ ْ‫حَُؿ‬٠‫ٝ٣زو‬ ‫ٌٛح‬ ٝٞ‫٣ؼ‬ ٕ‫أ‬ ‫٣ٔظط٤غ‬ ٢‫حُٞػ‬ ‫كخهي‬ َ٤‫ؿ‬ ‫حُٜٔخد‬ ٕ‫كب‬ ,‫حُل٤خس‬ ‫طٜيى‬ ‫هي‬ .‫حُل٤خس‬ ‫ه٤ي‬ ٠ِ‫ػ‬ٕ‫ا‬َ‫حُوط‬٢‫حُلو٤و‬١ٌُ‫ح‬‫٣ٜيى‬‫حُل٤خس‬‫٣ظٞحؿي‬‫ػ٘ي‬‫كيٝع‬‫اٛخرش‬ّ‫َُِأ‬‫ٜٓخكزش‬ٝ‫ربٗولخ‬٢‫ك‬ٟٞ‫ٓٔظ‬٢‫حُٞػ‬ ٟ‫ُي‬‫حُٜٔخد‬.٢‫ك‬ٌٙٛ‫حُلخُش‬‫ٓ٤وظ٘ن‬ٞ٣َُٔ‫ح‬‫ا‬‫ًح‬ُْْ‫٣ظ‬ٚ‫ٟٝؼ‬٠ِ‫ػ‬ٚ‫ؿخٗز‬ٝ‫أ‬٢‫ك‬‫ٟٝغ‬‫ح٩ٌٗزخد‬(‫حُٟٞغ‬٢٘‫حُزط‬)‫ُِٔلخكظش‬ ٠ِ‫ػ‬١ٍ‫حُٔـخ‬‫حُٜٞحث٤ش‬‫ٓلظٞكش‬. )*‫هٞس‬ ‫ُ٣خىس‬ ٠ِ‫ػ‬ َٔ‫طؼ‬ ٢‫حُظ‬ ٝ ‫حُلٔخ٣ش‬ ‫ريػخٓخص‬ ‫ًٌُي‬ ‫طؼَف‬ ٢‫حُظ‬ ٝ ‫حُؼظٔ٤ش‬ ‫رخُيػخٓخص‬ ٠ٔٔ٣ ‫ٓخ‬ ٠ِ‫ػ‬ ٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ ١ٞ‫٣ل‬ . ٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ : ‫حُيػخٓخص‬ ٌٙٛ ٖٓ ٖ٤‫ٗٞػ‬ َٜ‫ٗل‬ ٕ‫أ‬ ‫ٗٔظط٤غ‬ 1)‫ىػخٓخص‬‫ػٔٞى٣ش‬ -٢‫أٗل‬٢ٜ‫ؿز‬ -ٝ٢٘‫ؿ‬٢ٜ‫ؿز‬ -٢٘‫حُٞؿ‬ٌ‫حُل‬٢٢٘‫حُٞك‬٢ٔٗ٩‫ٝح‬ -٢‫ؿ٘خك‬٢ٌ‫ك‬١ِٞ‫ػ‬ 2)‫ىػخٓخص‬‫أكو٤ش‬ -ُ‫ح‬‫لخكش‬ُ‫ح‬‫لـخؿ٤ش‬‫حُؼِٞ٣ش‬ -ُ‫ح‬‫لخكش‬ُ‫ح‬‫لـخؿ٤ش‬‫حُٔلِ٤ش‬ -‫هزش‬‫حُل٘ي‬ -‫حُٞؿ٘٤ش‬ ‫حُلخكش‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 14 )*ًَ ٠ُ‫ا‬ َ‫حُ٘ظ‬ ‫ػ٘ي‬ ‫ٓظؼيىس‬ ٌٕٞ‫ط‬ ‫ٓخ‬ ً‫خ‬‫ؿخُز‬ ٚ‫حُٞؿ‬ ٢ٓٝ ٌَ٤ٛ ًٍٞٔ .‫كيس‬ ٠ِ‫ػ‬ ‫ػظٔش‬ ٝ ٚ‫حُٞؿ‬ ٢‫ك‬ ‫حُ٠ؼ٤لش‬ ١ٞ‫حُوط‬ ‫٣ظزغ‬ ّ‫حُؼظخ‬ ٌٙٛ ٢‫ك‬ ٌٍُٞٔ‫ح‬ ٢ٔٗ ٕ‫ا‬ ( ٖ٣ٍ‫ؿخ‬ ‫ٝٛلٜخ‬ ٢‫حُظ‬Guerinّ‫ػخ‬ )1866ٝ ّ٤ُ( ‫لٍٞص‬Le Fortّ‫ػخ‬ ) 1901.ّ ٛ ًٍٞٔ ‫ُٞٛق‬ ‫حُٔٔظويٓش‬ ‫حٌُِٔخص‬‫حُٔؼَٝكش‬ ٚ‫حُٞؿ‬ ٢ٓٝ ٌَ٤ ٌٍٞٔ‫ر‬٤ٍُٞ‫ل‬‫ص‬ْ‫ٍه‬1ْٝ‫ٍه‬2ْٝ‫ٍه‬3ٌَُٔ‫ح‬ ٟٞ‫ٓٔظ‬ ٠ُ‫ا‬ َ٤٘‫ط‬ ٝ ‫حُـٔـٔش‬ ‫ُوخػيس‬ ‫رخُ٘ٔزش‬ٖٓ ‫ٓ٘ظوش‬ ٢ٛ‫حُظوِ٤ي٣ش‬ ‫ح٧ٍٝحم‬ ٌٙٛ ‫حٍُٔ٘٘ٞس‬. ‫ػظخ‬ ٢‫ك‬ ً‫خ‬‫طلظظ‬ ‫حُوط٤َس‬ ‫ح٩ٛخرش‬ ‫طٔزذ‬‫كخُش‬ ٢‫ك‬ ‫حُٔطل٤ش‬ ٚ‫حُٞؿ‬ ّ ٤ُ ًٍٞٔٝ .‫حُظوِ٤ي٣ش‬ ‫لٍٞص‬ٝ ‫ح٧ٗق‬ ّ‫ػظخ‬ َ‫طظؤػ‬‫ٝأ٣٠خ‬ ٢ُ‫حُـَرخ‬ ْ‫حُؼظ‬ ‫حُلي‬ ْ‫ػظ‬ ٖٓ ٢ٓ‫ح٧ٓخ‬ ‫حُـِء‬٢ِ‫حُٔل‬ٝ‫٣ؼَف‬ ‫ٓخ‬ ‫طلظظٜخ‬ ‫٣ٔزذ‬ ( ٢٘‫حُٜل‬ ٚ‫حُٞؿ‬ ٙٞ٘‫رظ‬Dish Face٤‫ك‬ )ً‫خ‬‫ٗخطـ‬ ٙٞ٘‫حُظ‬ ‫ٌٛح‬ ٌٕٞ٣ ٫ ‫غ‬ ٖ‫ػ‬‫ا‬. ‫حُوِق‬ ٠ُ‫ا‬ ّ‫حُؼظخ‬ ٌٙٛ ‫ِٗ٣خف‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ٢ٓٞ‫حُٔظ‬ ٚٔٔ‫ه‬ ٌ‫٣ؤه‬ ‫ٓلَى‬ ْ‫ػظ‬ ٢ِ‫حُٔل‬ ‫حُلي‬"ٝ َّ‫حُل‬ َ‫ٗؼ‬ ٌَٗ "ْ٤ٔ‫حُـ‬ٚ‫طظـ‬‫رٟٞغ‬ ٠ِ‫ح٧ػ‬ ٞ‫ٗل‬ "ٕ‫"حُ٘ؼزظخ‬ ٙ‫ٜٗخ٣ظخ‬ ٝ ْ٤ٔ‫حُـ‬ ‫ٓغ‬ ‫ُحٝ٣ش‬ ٕ٬ٌ٘٤‫ك‬ ً‫خ‬‫طوَ٣ز‬ ٢ُٞ‫ٗخه‬ٝ ،‫حُوخػي٣ش‬ ‫حُٔلِ٤ش‬ ٚ‫كخكظ‬ ٖٓ ‫أٍم‬ ْ‫حُؼظ‬ ‫ٌُٜح‬ ‫حُٔ٘و٤ش‬ ‫حُؼِٞ٣ش‬ ‫حُلخكش‬ ٌٕٞ‫ط‬ ٝ ،‫حٌُه٘٤ش‬ ‫رخُ٘خٓوش‬ َ‫رخ٧ٓل‬ ٢ٜ‫ط٘ظ‬ ٢٘‫حٌُه‬ ‫ح٩ٍطلخم‬ ٢ٛ ‫هِ٘ػش‬ ٢ٓٞ‫حُٔظ‬ ٢‫حُو‬ ٠ِ‫ػ‬ ٢‫حُوخٍؿ‬ ٚ‫ٓطل‬ ٠ِ‫ػ‬ َٜ‫٣ظ‬ٖٓ ‫٣٘٘ؤ‬ ُ‫ح‬‫َُِأى‬ ‫ح٧ٓخٓ٤ش‬ ‫حُلخكش‬ ٠‫كظ‬ ‫ُ٤ٔظي‬ َٛ‫حُظخ‬ ‫حُٔ٘لَف‬ ٢‫حُو‬ ‫حٌُه٘٤ش‬ ‫٘خٓوش‬ٕ‫حٌُه٘٤خ‬ ٕ‫حُؼوزخ‬ ٢‫حُوخٍؿ‬ ‫حُٔطق‬ ٠ِ‫ػ‬ ‫ٗ٘خٛي‬ ‫ًٔخ‬ ، ً‫خ‬٠٣‫أ‬. ‫ٗظٞء‬ ‫أٍرؼش‬ ٢ٓٞ‫حُٔظ‬ ٢‫حُو‬ ‫ٓ٘طوش‬ ٢‫ك‬ ٚ٤ِ‫ػ‬ َٜ‫ك٤ظ‬ ٖ١‫حُزخ‬ ٚ‫حُٞؿ‬ ‫أٓخ‬‫حٌُه٘٤ش‬ ‫حُ٘ظٞءحص‬ ٠‫طيػ‬ ‫ٛـ٤َس‬ ‫حص‬‫ا‬‫ػِ٤ٜٔخ‬ ٌِ‫طَط‬ ٕ‫ػِٞ٣خ‬ ٕ‫ػ٘خ‬ ُِٔ‫ح‬ ‫حٌُه٘٤ش‬ ‫حُؼ٠ِش‬ٝ ‫خٗ٤ش‬‫ا‬‫حُ٬ٓ٤ش‬ ‫حٌُه٘٤ش‬ ‫حُؼ٠ِش‬ ‫ػِ٤ٜٔخ‬ ٌِ‫طَط‬ ٕ‫ٓلِ٤خ‬ ٕ‫ػ٘خ‬ٝ ،‫حُٔ٘لَف‬ ٢‫حُو‬ ‫حٌُه٘٤ش‬ ‫حُ٘ظٞءحص‬ ٖٓ ‫٣٘٘ؤ‬ ٝ ،ٌْ٤‫ٓز‬ ‫ٗٞى‬ ٢‫ك‬ ‫حُؼخُؼش‬ ٠‫حَُك‬ ‫هِق‬ ٢ٜ‫٣٘ظ‬ ١ٌُ‫ح‬ ٖ١‫حُزخ‬ٝ ،‫حُ٬ٓ٤ش‬ ‫حُ٠َٓ٤ش‬ ‫حُؼ٠ِش‬ ٚ٤ِ‫ػ‬ ٌِ‫طَط‬٢‫حُو‬ ‫ٌٛح‬ ٠ِ‫أػ‬ ٢‫ك‬ ٝ ٕ‫حُِٔخ‬ ‫طلض‬ ‫حُللَس‬ ‫طٞؿي‬.ٕ‫حُِٔخ‬ ‫طلض‬ ‫حُـيس‬ ‫ك٤ٜخ‬ ٌٖٔ‫ط‬‫ك٤غ‬ ‫حُلٌ٤ش‬ ‫طلض‬ ‫حُللَس‬ ‫كظٞؿي‬ ٖ١‫حُزخ‬ ‫حُٔ٘لَف‬ ٢‫حُو‬ َ‫أٓل‬ ‫أٓخ‬ ‫طل‬ ‫حُـيس‬ ٌٖٔ‫ط‬٩‫ح‬ ‫٣ٞؿي‬ ‫ٜٓ٘خ‬ ّ‫ح٧ٓخ‬ ٠ُ‫ا‬ ،‫حُلي‬ ‫ض‬ٖ٤٘٤‫حُزط‬ ‫ًحص‬ ‫ُِؼ٠ِش‬ ٢ٓ‫ح٧ٓخ‬ ُ‫ٍطٌخ‬. ُ٘‫ح‬ ٢ٜ‫ط٘ظ‬‫ؼ‬ٖ٣‫ر٘ظٞأ‬ ‫حُٜخػيس‬ ‫ش‬,ٝ ١ٍ‫حُٔ٘وخ‬ ‫حُ٘ظٞء‬ ٠‫٣يػ‬ ٢ٓ‫أٓخ‬ٝ ٢‫هِل‬٢ٔ‫حُِو‬ ‫رخُ٘ظٞء‬ ٠‫٣يػ‬ٌَ٘٣ ٜٞ‫ك‬ ١ٍ‫حُٔ٘وخ‬ ‫حُ٘ظٞء‬ ‫أٓخ‬ ، ‫ا‬‫حُٜيؿ٤ش‬ ‫ُِؼ٠ِش‬ ً‫ح‬ُ‫ٍطٌخ‬ٝ ،‫حُؼ٘ن‬ ٢ٛ ‫ٟ٤وش‬ ‫روطؼش‬ ‫حَُأى‬ ‫ٓغ‬ َٜ‫ك٤ظ‬ ٢ٔ‫حُِو‬ ‫حُ٘ظٞء‬ ‫ر٤٘ٔخ‬ ،ٝ َ‫ٓوؼ‬ ٢ٔٗ٧‫ح‬ ‫ؿٜش‬ٚ٤ِ‫ػ‬ ٌِ‫طَط‬ ٝ ‫حُٞك٘٤ش‬ ‫حُـ٘خك٤ش‬ ‫حُؼ٠ِش‬ٝ ‫ؿِ٤ظش‬ ‫حُٞك٘٤ش‬ ٚ‫كخكظ‬َٜ‫ُِٔل‬ ‫حُلٌ٤ش‬ ‫حُؼٌحٍ٣ش‬ ٝ‫أ‬ ‫حُٞك٘٤ش‬ ‫حُـخٗز٤ش‬ ‫ح٧ٍرطش‬ ‫ػِ٤ٜخ‬ ٌِ‫طَط‬.
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 15 ‫ا‬ًٍٞٔ ‫ٛخرش‬ٝ ٖ٤ٌ‫حُل‬ ّ‫ػظخ‬ٝ ٚ‫حُٞؿ‬‫ٓلخِٜٛخ‬ ٧‫ح‬ ٌٕٞ‫ط‬ ٚ‫حُٞؿ‬ ّ‫ػظخ‬ ًٍٞٔ ‫ػ٘ي‬ٝ ٌَُٔ‫ح‬ ‫رٔ٘طوش‬ ‫ؿخُزخ‬ ٚ‫َٓطزط‬ ٝ‫ػَح‬ٝ ٚ‫ٗيط‬‫أ‬‫ٜٛٔخ‬: : ‫َٓ٣َ٣خ‬ * -ٝ ‫ح٩ٛخرش‬ ٕ‫ٌٓخ‬ ُْٔ ‫ػ٘ي‬ ُْ‫أ‬‫ح٩ٛخرش‬ ٕ‫ٌٓخ‬ ٢‫ك‬ ‫كخى‬ ُْ‫أ‬, -‫ك‬‫ط‬ ٢‫ك‬ ٚ‫حُٜؼٞر‬ َ‫ٓؼ‬ ٚ‫حُٞظ٤ل‬ ٕ‫ويح‬٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ‫ػ٘ي‬ ‫حُلي‬ ‫لَ٣ي‬‫ا‬‫ٟخكش‬‫ا‬٧‫ح‬ ٠ُُْ, -ٚ‫حُ٘ل‬ ٢‫ك‬ ٍ‫هي‬ ‫٣ليع‬ ‫هي‬, -ٝ ٕ‫ح٧ٓ٘خ‬ ‫طلَى‬ ‫ٓغ‬ ُْ٧‫ح‬ ‫٣ليع‬ٝ ّ‫طخ‬ ٌَ٘‫ر‬ ‫ا١زخهٜخ‬ ‫آٌخٗ٤ش‬ ّ‫ػي‬٧‫ح‬٩‫ح‬ ‫ػ٘ي‬ ‫حُ٘ي٣ي‬ ُِْٗ ، ‫١زخم‬ّ‫ػي‬ ‫ٓغ‬ ْ‫حُل‬ َ‫ىحه‬ ‫ف‬ ‫كظلش‬ ‫آٌخٗ٤ش‬ْ‫حُل‬, -٧‫ح‬ٝ ُْ٧‫ح‬ ٍّٞ‫ط‬‫ٗٔـ‬١ِٞ‫حُؼ‬ ‫حُلي‬ ًٍٞٔ ‫ػ٘ي‬ ٚ‫حُٔل٤ط‬ ٚ‫أ‬ٔ‫حُـٔـ‬ ‫هخػيس‬ ٝ, ‫ش‬ -ٌَُٔ‫ح‬ ٕ‫ًخ‬ ‫اًح‬ ‫ٝحٟق‬ ٙٞ٘‫ط‬ٝ ً٬ٓ‫ًخ‬ٝ ‫ٌٓخٜٗخ‬ ٖٓ ‫طلًَض‬ ‫حٌٍُٔٔٞس‬ ّ‫حُؼظخ‬ ‫أؿِحء‬ٙٞ٘‫ط‬ّ‫ػظخ‬ ًَٔ ‫ػ٘ي‬ ٚ‫حُٞؿ‬ ٢‫ك‬‫حُلـخؽ‬ ٝ٧‫ح‬ ّ‫ػظخ‬ٝ ٍّٞ‫حُظ‬ ٖ‫ػ‬ ٬٠‫ك‬ ‫ٗق‬ٝ ‫حٌُيٓخص‬‫حُِ٘ف‬. *‫حُٔ٠خػلخص‬ -‫حُِ٘ف‬ ‫ٗيس‬ ‫رٔزذ‬ ٚٓ‫حُٜي‬, -‫ا‬ٖ٤‫حُؼ‬ ‫ٛخرش‬ٝ‫أ‬ ‫حُوَ٣زش‬ ‫ح٧ػٜخد‬ ٝ‫أ‬ ‫ح٧ٗق‬ ,ٝ ‫ح٧ٍرطش‬ ( ٚ‫حُٔل٤ط‬ ‫حُظَحً٤ذ‬ٍ‫ح٧ٝطخ‬ٝ‫حُٔل‬ ‫ح٧ٗٔـش‬ ٝ‫أ‬ ‫حُيٓٞ٣ش‬ ‫ح٧ٝػ٤ش‬)‫٤طش‬, -ْ‫حُظ٘ل‬ ٢‫ك‬ ‫اػخهش‬, -ٝ‫ٓخ‬ ‫ٓ٠خػلخص‬ َٜ‫طل‬ ‫هي‬‫حُ٘ي٣ي‬ ‫ًخُِ٘ف‬ ٚ‫حُـَحك‬ ‫رؼي‬‫أ‬‫حُظِٞع‬ ‫ٗظ٤ـش‬ ٝ‫أ‬‫ك‬ ‫ٓٞص‬ ٝ‫حُظ‬ ‫هطغ‬ ‫رٔزذ‬ ّ‫حُؼظخ‬ ‫ه٬٣خ‬ ٢. ‫حُيٓٞ٣ش‬ ‫َٝ٣ش‬ *ٍٙٞ‫حُوط‬: ‫ا‬ٝ ‫حُظـٌ٣ش‬ ‫ٟؼق‬ ٕ٤ُٔ‫حٌُخ‬ ٚ‫ٗو‬ ‫هخٛش‬٢‫ك‬ ‫ٓٔخػيح‬ ٬ٓ‫ػخ‬ ‫٣ؼي‬ ّٞ٩‫ح‬ ‫ُٜٓٞش‬ٌٍُٞٔ‫رخ‬ ٚ‫ٛخر‬ ٝ ٖ٤‫حُظيه‬ ‫ٓغ‬ ‫حُوطٍٞس‬ ‫طِىحى‬ َ٣‫حُظوي‬ ٝ‫أ‬ ‫حُـَحكش‬ ‫كخُش‬ ٢‫ك‬ ‫ًٌُي‬‫ا‬ٝ , ‫ُِؼ٠٬ص‬ ‫حَُٔه٤ش‬ ‫ح٧ىٝ٣ش‬ ( َ‫ٓؼ‬ ‫ح٧ىٝ٣ش‬ ٞ‫رؼ‬ ٍ‫ٓظؼٔخ‬ ‫حُٜٔيثش‬ ‫ح٧ىٝ٣ش‬ٝ ,ٝ ٢‫حُ٠ـ‬ ‫أىٝ٣ش‬ٝ ‫حُٔ٘ٞٓخص‬ٝ ‫حٌُٔٔ٘خص‬ٝ ٖ٤ُٞٔٗ٧‫ح‬. )ِٕٝ٤‫حٌٍُٞط‬ *٣‫حُٞهخ‬: ‫ش‬ +‫ا‬ٚ‫حُٞؿ‬ ‫ُلٔخ٣ش‬ ٚ٤‫ٝهخث‬ ّ‫ُُٞح‬ ‫ٍطيحء‬ٝ٩‫ح‬ ٖٓ ْ‫حُل‬ٝ ٟٚ‫حَُ٣خ‬ ٢‫ك‬ ٚ‫ٛخر‬٩‫ح‬٤ٗ‫رخُوٞح‬ ّ‫ُظِح‬ٖ، +‫ا‬ّ‫ٓظويح‬‫أ‬‫كِٓش‬‫ػِٔخ‬ ‫حُٔ٤خٍص‬ ‫ه٤خىس‬ ‫ػ٘ي‬ ‫حُٔوخػي‬‫أ‬ُٜٞ‫ح‬ ‫حُٞٓخثي‬ ٕ‫ُ٤ٔض‬ ‫حُٔ٤خٍحص‬ ٢‫ك‬ ٙ‫حُٔٞؿٞى‬ ٚ٤‫حث‬‫آ‬٢‫ك‬ ‫طٔخٓخ‬ ٚ٘ٓ‫ا‬‫ٛخرخص‬ ٚ‫حُٞؿ‬,‫٣ـذ‬ ‫ًٔخ‬‫ا‬‫حُو‬ ‫ٍطيحء‬٣ٍ‫حُ٘خ‬ ‫حُيٍحؿخص‬ ‫ه٤خىس‬ ‫ػ٘ي‬ ‫ًٞحص‬‫ش‬, +٢‫ك‬ ٖ٤ٌ‫ٝحُل‬ ٚ‫حُٞؿ‬ ‫اٛخرخص‬ ٖٓ ‫حُٞهخ٣ش‬ ‫ً٤ل٤ش‬‫ح‬ٟ‫َُ٣خ‬‫ش‬ ‫ا‬ٕ‫ا‬‫حُٞح‬ ّ‫ٓظويح‬١‫حُ٘٘خ‬ ‫ُ٘ٞع‬ ‫حُٔ٘خٓزش‬ ‫ه٤خص‬‫٣ٔظط٤غ‬‫أ‬٩‫ح‬ ‫ٗٔذ‬ ٖٓ َِ‫٣و‬ ٕ٧‫ح‬ ٢‫ك‬ ‫ٛخرخص‬ٝ ‫ُؼخد‬٩‫ح‬ ‫ًحص‬ ً‫ش‬ٛ‫هخ‬‫ح‬ ‫كظٌخى‬َٗ‫ُٔزخ‬ ٖ٤‫حُ٬ػز‬ ٖ٤‫ر‬‫أ‬ّ‫حُظٜخى‬ ٝ‫أ‬٠ُ‫ح‬ ‫طلظخؽ‬ ٢‫حُظ‬ ‫ح٫ُؼخد‬ ٝ‫هٞس‬‫ػخُ٤ش‬،ٝ‫ُٞهخ٣ش‬ٝ ٖ٤ٌ‫حُل‬٧‫ح‬ٕ‫ٓ٘خ‬‫أ‬ٝ ‫ٓ٬ثٔش‬ ‫ٝحه٤خص‬ ‫هظَكض‬َ‫ٓؼ‬ ‫ىه٤وش‬ ٢‫ٝحه‬(Custom mouthgard)ٝ٩‫ح‬ ٖٓ ٢‫حُٞحه‬ ‫ٌٛح‬ َِ‫٣و‬ ‫هي‬‫حُيٓخؿ٤ش‬ ‫ٍطـخؿخص‬‫ا‬ٚ‫ٟخك‬‫ا‬٧‫ح‬ ‫ٝهخ٣ش‬ ٠ُ٩‫ح‬ ٖٓ ٕ‫ٓ٘خ‬٧‫ح‬ ٢‫ك‬ ‫ٛخرخص‬‫ُؼخد‬ ‫حَُ٣خٟ٤ش‬،ٝ‫ى‬ ‫هي‬‫ٍَٟٝس‬ ٠ِ‫ػ‬ ٚ٤ٗ‫حُٔ٤يح‬ ‫حُظـخٍد‬ ‫ُض‬‫ا‬‫ػ٘ي‬ ْ‫حُل‬ ٢‫ٝحه‬ ‫ٍطيحء‬‫أ‬ٝ ‫حُٔ٘خُ٫ص‬ ‫ُؼخد‬‫حُ٠َرخص‬ ‫ك٤ٜخ‬ ٌٕٞ‫ط‬ ٢‫حُظ‬‫أ‬٩‫ح‬ ٝ‫كظٌخى‬ ٝ٩‫ح‬‫حُليٝع‬ ٌٖٔٓ َٗ‫حُٔزخ‬ ّ‫ٛطيح‬. ‫حُـٔؼ٤ش‬ ‫أٛيٍص‬ ‫ٝهي‬‫حُؼخُٔ٤ش‬‫ٍَٟٝس‬ ٍٞ‫ك‬ ‫طؼِ٤ٔخص‬ ٕ‫ح٧ٓ٘خ‬ ‫ُطذ‬‫ا‬ٍ٥‫ح‬ ‫ح٧ُؼخد‬ ٢‫ك‬ ٕ‫ح٧ٓ٘خ‬ ٢‫ٝحه‬ ‫طيحء‬ٚ٤‫ط‬:٧‫ح‬‫ًَٝرخط٤ي‬‫ًَس‬ ، ُِٔ‫ح‬‫ش‬‫حُٔ٬ًٔش‬ ،،٢ًُٜٞ‫ح‬،، ّ‫حُوي‬ ‫ًَس‬‫حُـٔ٘خٓظي‬،‫حُ٤ي‬ ‫ًَس‬ٖ٤‫حُٔظُِـ‬ ،،‫حُوظخُ٤ش‬ ٕٞ٘‫حُل‬،ُ‫ح‬٢‫ًَز‬،‫حَُٓخ٣ش‬،‫حُٔظ٬ص‬، ٧‫ح‬ٕ‫ٌٓٞح‬،ٍ‫ح٧ػوخ‬ ‫ٍكغ‬،‫ح‬‫ُٜٔخٍػ‬‫ش‬،‫حُطخثَس‬ ‫ًَس‬،ٍٝٞ‫حُز٤ٔز‬...... +‫أ‬ْ‫حُل‬ ‫ٝحه٤خص‬ ‫ٗٞحع‬: -‫حُـخِٛس‬ ‫حُٞحه٤ش‬(Stock Mouth Guard)‫حٍُٜٞس‬ (1، ٖ٤ٌ‫حُل‬ ١ٞ‫طل‬ ٕ‫أ‬ ‫طٔظط٤غ‬ ‫ٝحكيس‬ ‫ٓطخ١٤ش‬ ‫هطؼش‬ ٖ‫ػ‬ ‫ػزخٍس‬ : )
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 16 -‫طًَ٤زش‬‫هخٛش‬Mouth Formed boil and bite‫حٍُٜٞس‬ (2: )ْ‫حُل‬ ٌَٗ ٌ‫طؤه‬ ‫هخٛش‬ ‫طًَ٤زش‬ ٌٙٛ‫أ‬‫حُٔخء‬ ٢‫ك‬ ‫طٟٞغ‬ ( ْ‫حُل‬ ‫ٛ٤جش‬ ٝ ٍ‫حُلخ‬‫ط‬ ٢ٌُ ْ‫حُل‬ ٢‫ك‬ ‫طٟٞغ‬ ْ‫ػ‬‫ؤ‬) ٌِٚٗ ٌ‫ه‬ٝ ْ‫حُل‬ ٢‫ك‬ ‫طؼزض‬ ‫ك٤غ‬٧ ٚ‫رَٔػ‬ ‫طوَؽ‬ْ‫حُٔ٬ث‬ ٌَُ٘‫ح‬ ٌ‫ه‬ Custom Made –‫(حٍُٜٞس‬3)٧‫ح‬ ‫١ز٤ذ‬ َ‫هز‬ ٖٓ ‫طٜ٘غ‬ ‫ٝحه٤ش‬‫ك٤غ‬ ٕ‫ٓ٘خ‬ٝ ٚ‫١زؼ‬ ٌ‫طئه‬‫١َ٣ن‬ ٖ‫ػ‬ ٌَٔ‫ط‬ٝ ، َ‫حُٔوظز‬ٌٙٛ ‫طؼي‬ ٧‫ح‬ ٚ٤‫حُٞحه‬‫رو٤ش‬ ٖٓ َ٠‫ك‬‫أ‬ٝ ٢ٟ‫حَُ٣خ‬ ‫ٍحكش‬ ‫ك٤غ‬ ٖٓ ‫حُٞحه٤خص‬ ‫ٗٞحع‬ٝ ٖ٤‫ٓ٘ظ‬ ‫ُٔيس‬ ٠‫طزو‬‫ًخك٤ش‬ ‫ٝهخ٣ش‬ َ‫طٞك‬ ‫حُٞهض‬ ْ‫ر٘ل‬ +ْ‫حُل‬ ‫ٝحه٤خص‬ ْ٤٤‫طو‬: ٚ‫حُٞؿ‬ ٝ ‫ا‬‫حُـٔؼ٤ش‬ ‫طٞٛ٤خص‬ ٠ِ‫ػ‬ ً‫ح‬‫ػظٔخى‬‫حُؼخُٔ٤ش‬٧‫ح‬ ‫٧١زخء‬٠ِ‫ػ‬ ‫أًيص‬ ٕ‫ٓ٘خ‬‫أ‬٠‫أك‬ ٕ‫٣ـذ‬ ً‫ح‬َ٤‫طؤػ‬ َ‫ٝح٧ًؼ‬ ‫حُٞحه٤خص‬ َ‫أ‬ٌٕٞ‫ط‬ ٕ: -، ‫َٓٗش‬ ‫َٓ٣لش‬ -٫ًَ‫طظؤ‬ -‫أ‬ٝ ْ‫حُل‬ ٢‫ك‬ ‫ػخرظش‬ ٌٕٞ‫ط‬ ٕ‫حُظ٘ظ٤ق‬ ‫ِٜٓش‬ -٫ٌِْ‫حُظ‬ ٠ِ‫ػ‬ َ‫طئػ‬‫أ‬ْ‫حُظ٘ل‬ ٝ -‫أ‬١‫أ‬ ‫ىحثٔ٤ش‬ ٌٕٞ‫ط‬ ٕ‫أ‬ِٚ٣ٞ١ ‫ُلظَس‬ ّٝ‫طي‬ ٕ. ٞ٣ ٝ‫ر‬ ٢ٛ‫ب‬٥‫ح‬ ‫حُٞحه٤خص‬ ٖ٤ٟ‫حَُ٣خ‬ ‫ٍطيحء‬ٚ٤‫ط‬ٍٚٓ‫حُٔٔخ‬ ٚ‫حُِؼز‬ ‫ٗٞع‬ ‫كٔذ‬ -ّ‫حُوي‬ ‫ًَس‬(ٝ ٚ‫ٝؿ‬ ٢‫ٝحه‬ ‫ٓغ‬ ًٙٞ‫ه‬ٕ‫حٓ٘خ‬ ٢‫ٝحه‬) -‫حُٔ٬ًٔش‬(ْ‫حُظ٘ل‬ ‫٫٣ؼ٤ن‬ ‫رل٤غ‬ ٙ‫هخ‬ ٌَ٘‫ر‬ ْٜٔٓ ٕ‫حٓ٘خ‬ ٢‫ٝحه‬) -ٚ‫حُٜٔخٍػ‬(ًٙٞ‫ه‬–ٚ‫ٝؿ‬ ٢‫ٝحه‬) -ٍٞ‫حُز٤ِر‬(ًٙٞ‫ه‬–ٚ‫ٝؿ‬ ٢‫ٝحه‬) -ًٙٞ‫رو‬ َٜ‫ٓظ‬ ٚ‫ٝؿ‬ ٢‫ٝحه‬ ( ‫حُـِ٤ي‬ ٢ًٞٛ) -٢ًُٜٞ‫ح‬(ٕ‫حٓ٘خ‬ ٢‫ٝحه‬) -‫ًَس‬‫ح٫َٓ٣ٌ٤ش‬ ّ‫حُوي‬(Soccer)(ًٙٞ‫ه‬ ‫ٓغ‬ ٢‫ٝحه‬) 123
‫الوجه‬ ‫عظام‬ ‫كسور‬ ‫كساب‬ ‫جودت‬ ‫فراس‬ .‫د‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 17 ًٔٞ٠ِ‫حُٔل‬ ‫حُلي‬ ٍ A-:‫ٓويٓش‬ ٝ ْٔ‫حُـ‬ ّ‫ػظخ‬ ًٍٞٔ ٢‫ك‬ ً‫ح‬َٗ‫ػخ‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ‫طٜ٘ق‬ٚ‫حُٞؿ‬ ّ‫ػظخ‬ ًٍٞٔ ٢‫ك‬ ‫ح٧ٗق‬ ْ‫ػظ‬ ‫رؼي‬ ً‫خ‬٤ٗ‫ػخ‬ٝ‫ًُي‬ ‫٣ؼٞى‬: ٠ُ‫ا‬ 1-‫ٓٞهغ‬٢ِ‫حُٔل‬ ‫حُلي‬. 2-‫ٝحُؼ٘ن‬ ٚ‫حُٞؿ‬ ّ‫ػظخ‬ ٖ٤‫ر‬ َُٙٝ‫ر‬. 3-‫ا‬ٚ‫ٗل٘خث‬ٕ‫حُلٜخ‬ ‫ُلٌٝس‬ ٚ‫حُٔ٘خر‬ ٌِٚٗ ٝ. ٝ ٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ٍ‫طزي‬ ٢‫ك‬ ً‫ح‬َ٤‫ًز‬ ً‫ح‬ٍٝ‫ى‬ ‫حُؼ٠٬ص‬ ‫طِؼذ‬ٝ ‫حُلي‬ ‫٣ئى٣ٜخ‬ ٢‫حُظ‬ ‫حُلًَخص‬ ْٛ‫أ‬ ًٌَٗ ‫ٓٞف‬ ٢ِ٣ ‫ك٤ٔخ‬‫حُؼ٠٬ص‬ ‫ػٜ٘خ‬ ‫حُٔٔئُٝش‬: 1 -‫حَُحكؼش‬ ‫حُؼ٠٬ص‬ ‫طئى٣ٜخ‬ ّ‫ح٧ٓخ‬ ٞ‫ٗل‬ ‫طويٓ٤ش‬ ‫كًَش‬.ٕٝ‫حُٔخٟـظخ‬ ٕ‫حُؼ٠ِظخ‬ ‫أٜٛٔخ‬. 2 -‫كًَش‬ٝ ٠ِ‫ح٧ػ‬ ٞ‫ٗل‬ ‫اؿ٬م‬ٝ ‫حَُحكؼش‬ ‫حُؼ٠٬ص‬ ‫طئى٣ٜخ‬٢ٛ: ٬٠‫حُؼ‬: ‫ص‬-ُ‫ح‬‫ـ٘خك٤ش‬٧‫ح‬‫ٗٔ٤ش‬,ُ‫ح‬‫ٜيؿ٤ش‬. -‫حُٞك٘٤ش‬ ‫حُـ٘خك٤ش‬ ‫حُؼ٠ِش‬. 3 -ٝ َ‫ح٧ٓل‬ ٞ‫ٗل‬ ‫كظق‬ ‫كًَش‬ٝ ‫حُوخك٠ش‬ ‫حُؼ٠٬ص‬ ‫طئى٣ٜخ‬‫أٜٛٔخ‬: -ٖ٤٘‫حُزط‬ ‫ًحص‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 18 ‫حُ٬ٓ٤ش‬ ‫حٌُه٘٤ش‬ ‫ـ‬ ‫ح٧ٓخٓ٤ش‬ ‫حُ٠َٓ٤ش‬ ‫ـ‬ B-‫حُظٜ٘٤ق‬: ٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ‫طٜ٘٤ق‬ ٌٖٔ٣٠ُ‫ا‬: ‫أ‬٢ٔ‫حُؼظ‬ ‫حُٜيع‬ .Greenstick Fracture:ٖٝٞٛ‫ػ‬ ‫ػزخٍس‬ًَّٔ‫طخ‬ َ٤‫ؿ‬ٌٖٔ٣ ‫ٓخ‬ ‫ؿخُزخ‬ ٝ‫حُِ٤٘ش‬ ٍ‫ح٧١لخ‬ ّ‫ػظخ‬ ٢‫ك‬ ٚ‫ٜٓخىكظ‬ )َ٤‫حُ٘ظ‬ ٖٜ‫حُـ‬ ًَٔ(ٖ٤‫حُزخُـ‬ ّ‫ػظخ‬ ٢‫ك‬ ٚ‫ٜٓخىكظ‬ ٌٖٔ٣ ‫ًٔخ‬ ، ْٜٓ‫ػظخ‬ ٢‫ك‬ ٌِْ‫حُظ‬ ٚ‫ُ٘و‬ ‫ٗظ٤ـش‬ٕ‫ًخ‬ ٍ‫كخ‬ ٢‫ك‬١‫حُٔئى‬ ‫حُٔزذ‬ ‫ًخف‬ َ٤‫ؿ‬ ٌَُٔ‫ح‬ ‫ُليٝع‬. ‫د‬٢ٔٔ‫حُو‬ ٌَُٔ‫ح‬ .Partial F.ْ‫حُؼظ‬ ٖٓ ‫ؿِء‬ ٍ‫اٗلٜخ‬ ٖ‫ػ‬ ‫ػزخٍس‬ ٞٛ ٝ :) ٢‫ٓ٘و‬ ٌٕٞ٣ ‫ؿخُزخ‬ (‫ح٧ٓخ‬ ‫حُؼظٔ٤ش‬ ‫حُوطؼش‬ ٖ‫ػ‬ٓ‫٤ش‬ ‫كيٝع‬ ٕٝ‫ى‬ّ‫طخ‬ ٍ‫اطٜخ‬ ‫اٗوطخع‬. ‫ح٧ه٤َس‬ ٢‫ك‬ ‫ص‬ّ‫حُظخ‬ ٌَُٔ‫ح‬ .Completely F.‫حُؼظٔ٤ش‬ ‫حُوطؼش‬ ٢‫ك‬ ّ‫طخ‬ ٍ‫اطٜخ‬ ‫اٗوطخع‬ ٞٛ ٝ :. 1-‫اىنسش‬ ‫ىْىع‬ ً‫ا‬‫وفق‬ ‫اىراٍح‬ ‫اىنسىس‬ ‫ذصٍْف‬: ٢٤ٔ‫حُز‬ ٌَُٔ‫ح‬ .‫أ‬Simple F. :٢ُٓٞ‫ح‬ ٝ‫أ‬ ١ٞٔ‫حُل‬ ٢ُٓٞ‫ح‬ ‫ٓغ‬ َٜ‫ٓظ‬ َ٤‫ؿ‬ ٌَُٔ‫ح‬ ٌٕٞ٣ ‫ك٤غ‬.٢‫حُوخٍؿ‬ ٢‫ك‬٢‫ُِطز٤ؼ‬ ‫ٓٔخ٣َس‬ ‫حُلي‬ ‫ٝكيٝى‬ ْ‫حُؼظ‬ ٢‫هطؼظ‬ ٖ٤‫ر‬ ‫طَحًذ‬ ‫٣ٞؿي‬ ٫ ٢٤ٔ‫حُز‬ ٌَُٔ‫ح‬ ‫حًَُٔذ‬ ٌَُٔ‫ح‬ .‫د‬Compound F. :َٜٝ‫٣ظ‬ ٚ٤‫ك‬ٌَُٔ‫ح‬ ٢‫ه‬٢‫ك‬ ‫ؿَف‬ ‫رٞحٓطش‬ ٢‫حُوخٍؿ‬ ٢ُٓٞ‫ح‬ ٝ‫أ‬ ١ٞٔ‫حُل‬ ٢ُٓٞ‫ح‬ ‫ٓغ‬ ‫حُـِي‬ ٝ‫أ‬ ‫حُلٔٞ٣ش‬ ‫حُٔوخ١٤ش‬. ‫ؽ‬-‫حُٔظلظض‬ ٌَُٔ‫ح‬Comminuted F.. ‫حُ٘ظخ٣خ‬ ٖٓ ‫ػيى‬ ١ٞ‫٣ل‬ ١ٌُ‫ح‬ ٝ : ‫ى‬-٢َُٟٔ‫ح‬ ٌَُٔ‫ح‬Pathological F.:ٍ َ‫أه‬ ‫ػ٘ي‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ًَٔ ‫٣ليع‬ ٕ‫أ‬ ٌٖٔ٣٢َٟٓ ‫رٔزذ‬ ‫ٓ٠ؼق‬ ْ‫ُؼظ‬ ‫٣ليع‬ ٝ َٓ‫ؼ‬‫ا‬ٝ ْ‫ػظ‬ ‫ُظٜخد‬٢‫ٗو‬،ّ‫أٍٝح‬،‫ػخٓش‬ ٝ‫أَٓح‬،ّ‫أً٤خ‬ ٙ-‫حُٔوظِطش‬ ٌٍُٞٔ‫ح‬Compound Comminuted Fractures: 2-‫اىنسش‬ ُ‫ىَنا‬ ً‫ا‬‫وفق‬ ‫اىراٍح‬ ‫اىنسىس‬ ‫ذصٍْف‬: ٝ ‫حُؼ٬ٓخص‬ ٕ٧ ‫ُ٨ً٣ش‬ ٢‫حُظَ٘٣ل‬ ٕ‫حٌُٔخ‬ ٠ِ‫ػ‬ ‫٣ؼظٔي‬ ‫ػِٔ٤ش‬ ‫٧ٓزخد‬ ٌٍُِٞٔ ‫طٜ٘٤ق‬ َ٠‫أك‬ ٕ‫ا‬‫ػخثيس‬ ‫ٝحُٔؼخُـش‬ ٝ‫ح٧ػَح‬ٕ‫ٌُٔخ‬ ٝ ٌَُٔ‫ح‬٢ُ‫ًخُظخ‬ ٢ٛ: ٢‫ٓ٘و‬ ٢٘ٓ .‫أ‬Dental – Alveolar F.ٝ‫كيٝػٜخ‬ ‫ٗٔزش‬ ‫طزِؾ‬3.1% ٢ٔ‫ُو‬ .‫د‬Condylar F. .ٝ‫كيٝػٜخ‬ ‫ٗٔزش‬ ‫طزِؾ‬29.1% ١ٍ‫ٓ٘وخ‬ .‫ؽ‬Coronoid F. .ٝ‫كيٝػٜخ‬ ‫ٗٔزش‬ ‫طزِؾ‬1.3% ‫حَُأى‬ .‫ى‬Ramus F. .ٝ‫كيٝػٜخ‬ ‫ٗٔزش‬ ‫طزِؾ‬1.7% ّ‫حُِحٝ٣ش‬ .Angle F. .ٝ‫كيٝػٜخ‬ ‫ٗٔزش‬ ‫طزِؾ‬24.5% ْٙٔ‫حُـ‬ .Body F. .ٝ‫كيٝػٜخ‬ ‫ٗٔزش‬ ‫طزِؾ‬16% ٝ.ٝ ٖ‫حٌُه‬‫ا‬ٖ‫حٌُه‬ ‫ٍطلخم‬Symplysis F. .ٝ‫كيٝػٜخ‬ ‫ٗٔزش‬ ‫طزِؾ‬22%
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 19 ‫حُظَط٤ذ‬ ْ‫ٗل‬ ٠ِ‫ػ‬ ‫طظلن‬ ‫ٌُٜ٘خ‬ ٝ ‫حَُٔحؿغ‬ ‫كٔذ‬ ‫ِٔذ‬ُ٘‫ح‬ ٌٙٛ ‫طوظِق‬ 3-‫اىنسش‬ ‫ىسثة‬ ً‫ا‬‫وفق‬ ‫اىراٍح‬ ‫اىنسىس‬ ‫ذصٍْف‬: :ٌَُٔ‫ح‬ ‫ٓزذ‬ ٌٕٞ٣‫آخ‬‫ٛيٓش‬‫ٓزخَٗس‬ٝ‫أ‬‫ٓزخَٗس‬ َ٤‫ؿ‬ ‫ٛيٓش‬‫رٔزذ‬ ٝ‫أ‬‫حُِحثي‬ ٢ِ٠‫حُؼ‬ ِٚ‫حُظو‬. ٝ٠ُ‫ا‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ‫طٜ٘ق‬ ٢ُ‫رخُظخ‬: .‫أ‬‫حُـخٗذ‬ ‫ٝك٤ي‬ ًَٔUnilateral F . .‫د‬‫حُـخٗذ‬ ٢‫ػ٘خث‬ ًَٔBilateral F. .‫ؽ‬‫ٓظؼيى‬ ًَٔMultiple F. .‫ى‬‫ٓظلظض‬ ًَٔComminuted F. َٝ٤‫طؤػ‬ َٜ‫٣ظ‬ ‫ٛ٘خ‬ ٖٓ‫ا‬ٝ ٙ‫طـخ‬‫حُٜيٓش‬ ‫ٗٞع‬‫حُٔزخَٗس‬ ‫كخُٜيٓش‬ ،‫هي‬ٕ‫ٌٓخ‬ ٢‫ك‬ ‫ٓزخَٗس‬ َ٤‫ؿ‬ ٟٞ‫ه‬ ‫طُٞي‬ِ‫حُٔل‬ ‫حُلي‬ ٖٓ َ‫آه‬ٌٙٛ . ٢ ٟٞ‫حُو‬ُ‫ح‬‫ًخك‬ ‫حُٔزخَٗس‬ َ٤‫ـ‬‫٤ش‬ًَٔ ‫٩كيحع‬ٕ‫ػخ‬. ‫ػخُغ‬ ٝ‫أ‬ ٝ‫حُٔخرن‬ ‫حُظٜ٘٤ق‬ َٜ‫ظ‬ ‫حُٞؿٜش‬ ٌُٜٙ ‫ٗظ٤ـش‬. 1-‫حُـخٗذ‬ ‫ٝك٤ي‬ ٌَُٔ‫ح‬: 2-ٌَُٔ‫ح‬‫حُـخٗذ‬ ٢‫ػ٘خث‬: 3-ٌَُٔ‫ح‬:‫حُٔظؼيى‬ٝ ‫حُٔزخَٗس‬ ‫حُٜيٓش‬ ‫أِٓٞد‬ ْ‫ر٘ل‬ٝ ‫حُٔزخَٗس‬ َ٤‫ؿ‬‫ٓزخَٗس‬ ‫ٛيٓش‬ ٞٛ ً‫خ‬‫ٗ٤ٞػ‬ َ‫ح٧ًؼ‬ ‫حُٔظؼيى‬ ٌَُٔ‫ح‬ ‫حُٔظ‬ ‫حُٔ٘طوش‬ ٠ِ‫ػ‬ ١ٞ‫حُٔو‬ ‫ٗظ٤ـش‬٢‫ك‬ ًَٔ ‫ػٜ٘خ‬ ‫٣٘ظؾ‬ ٖ‫حٌُه‬ ٖٓ ‫ٞٓطش‬‫ا‬ٝ )‫ٓزخَٗس‬ ‫حٌُهٖ(ٛيٓش‬ ‫ٍطلخم‬ٖ٤‫حُِؤظ‬ ٬ً ٢‫ك‬ ًَٔ َ٤‫ؿ‬ ‫(ٛيٓش‬‫ٓزخَٗس‬.) 4-‫حُٔظلظض‬ ٌَُٔ‫ح‬:
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 20 4-‫إ‬ ‫حسة‬ ‫اىنسش‬ ‫ذصٍْف‬‫اىنسش‬ ‫خظ‬ ٓ‫ذجا‬: ‫ٓٔظلزش‬ ًٍٞٔ : ٠ُ‫ا‬ ٌَُٔ‫ح‬ ٢‫ُو‬ ً‫خ‬‫طزؼ‬ ٌٍُٞٔ‫ح‬ ‫طٜ٘ق‬ٟٞ‫ه‬ ‫ًخٗض‬ ٍ‫كخ‬ ٢‫ك‬ ( ) ٌَُٔ‫ح‬ ٢‫ه‬ ٖٓ َ٤‫طـ‬ ٫ ‫حُؼ٠٬ص‬َٝ٤‫ؿ‬ ًٍٞٔ‫ٓٔظلزش‬‫ٗي‬ ٟٞ‫ه‬ ‫ًخٗض‬ ٍ‫كخ‬ ٢‫ك‬ ( ) ٌَُٔ‫ح‬ ٢‫ه‬ ٢‫ك‬ َ٤‫طـ‬ ٠ُ‫ا‬ ١‫طئى‬ ‫حُؼ٠٬ص‬. ١‫حُؼٔٞى‬ ٙ‫ح٩طـخ‬ ٢‫ك‬ *(A): ٢‫ح٧كو‬ ٙ‫ح٩طـخ‬ ٢‫ك‬ *(B): ٢‫حُلَحؿ‬ ٙ‫ح٩طـخ‬ ٢‫ك‬ *(C): ‫ح٩ُظٞحء‬ : 5-‫حسة‬‫اىنسش‬ ‫خظ‬ ‫ذثذه‬: ٌَُٝٔ‫ح‬ ٢‫ه‬ ٙ‫اطـخ‬ ‫ٓغ‬ ٢ِ٠‫حُؼ‬ ‫حُ٘ي‬ ٟٞ‫ه‬ ٙ‫اطـخ‬ ٠ِ‫ػ‬ ‫٣ؼظٔي‬ ( ‫حُؼظٔ٤ش‬ ‫ح٩ٓظَٔحٍ٣ش‬ ٢‫ك‬ َ٤٤٤‫طـ‬ ‫٣ليص‬ : ‫ٓٔظلذ‬ َ٤‫ؿ‬ *Aٌَُٔ‫ح‬ ٢‫ُو‬ ‫ٓٞحُ٣ش‬ ‫حُ٘ي‬ ٟٞ‫ه‬ ٕ‫أ‬ ‫ك٤غ‬ ) ( ٌَُٔ‫ح‬ ٢‫ه‬ ٢‫ك‬ ‫طَحًذ‬ ‫٣ليع‬ ٫ : ‫ٓٔظلذ‬ *B)ٌَُٔ‫ح‬ ٢‫ُو‬ ‫ٓؼخًٔش‬ ‫حُلخُش‬ ٌٙٛ ٢‫ك‬ ‫حُ٘ي‬ ٟٞ‫ه‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 21 6-‫وجىد‬ ‫حسة‬ ‫اىنسش‬ ‫ذصٍْف‬ُ‫األسْا‬: ٝ ٚ‫اُحُظ‬ ‫٣ـذ‬ ٌَُٔ‫ح‬ ٢‫ه‬ ٢‫ك‬ ٖٓ ًٌَْ‫رل‬ ٕ‫اٗظخ‬ ٍ‫ٜٓي‬ ٕ‫ح٧ٓ٘خ‬ ٕ٧ ‫ًُي‬‫رٔزذ‬ ‫طٔٞص‬ ‫هي‬ ٢‫حُِز‬ ‫حُ٘ٔ٤ؾ‬ ًٕٞ‫ا‬‫حُظَٝ٣ش‬ ‫ٗوطخع‬ ‫ُليٝع‬ ‫٣ئٛذ‬ ‫ٓٔخ‬‫ا‬ٝ ْ‫ػظ‬ ‫ُظٜخد‬٢‫ٗو‬. ٝ٩‫ح‬ ‫٣ـذ‬ ٌُٖٙ‫ٗظزخ‬٠ِ‫ػ‬ ‫ُ٪روخء‬ٍ‫كخ‬ ٢‫ك‬ ُٖٔ‫ح‬‫ا‬ ‫حُلخؿش‬ٚ٤ُٝ ‫حُظؼز٤ض‬ ٢‫ك‬‫حُ٘لخء‬ ‫َٓحهزش‬‫ًٔخ‬٠ِ‫ػ‬ َٟ‫حُؼ‬ ‫ٟٝغ‬ ّ‫ػي‬ ‫٣ـذ‬ ٌَُٔ‫ح‬ ٢‫رو‬ ٍُٞٔ٘ٔ‫ح‬ ُٖٔ‫ح‬. ُ‫ح‬ ‫ح٩ٓظطزخرخص‬ *‫وطؼ٤ش‬: ٌَُٔ‫ح‬ ٢‫ه‬ ٖٓ ٕ‫ح٧ٓ٘خ‬ ‫٩ُحُش‬ . ٌٍ‫حُـ‬ َٔ٘٣ ٢ٗ٫ٞ١ ًَٔ .‫أ‬ ‫ا‬ .‫د‬‫ٗو٬ع‬ّ‫طخ‬ٖٓ ُٖٔ‫ح‬ٚ‫ٓ٘و‬. .‫ؽ‬‫ٝؿٞى‬‫ا‬١ًٍٝ ٍٞ‫ك‬ ‫ُظٜخد‬. .‫ى‬ٌَُٔ‫ح‬ ٢‫ه‬ ٕ‫اٗظخ‬. ٙ.ُٖٔ‫ح‬ ٍٞ‫ك‬ ‫طٞحؽ‬. ٝ. ‫حُؼ٬ؿ٤ش‬ ‫حُوطش‬ ‫اػخهش‬ . *٩‫ح‬ ‫أٓخ‬‫٩ُحُش‬ ‫حُ٘ٔز٤ش‬ ‫ٓظطزخرخص‬٢ٜ‫ك‬ ٌَُٔ‫ح‬ ٢‫ه‬ ٖٓ ٕ‫ح٧ٓ٘خ‬: .‫أ‬‫حُٜ٘خ٣ش‬ ٢‫ك‬ ‫ُِوِغ‬ ُٚ‫ٓآ‬ ٢‫ٝظ٤ل‬ َ٤‫ؿ‬ ٖٓ. .‫د‬ّ‫ٓظوي‬ َ‫ٗو‬. .‫ؽ‬ّ‫ٓظوي‬ ١ٞ‫ُؼ‬ َٝٓ. .‫ى‬ٝ ‫ك٤ٜخ‬ ‫ٌٓ٘ٞى‬ ٕ‫أٓ٘خ‬‫حُ٘لخء‬ ‫رؼي‬ ‫ػٜ٘خ‬ ٞ٣ٞ‫حُظؼ‬ ٌٖٔ٣. ٙ.َ٤‫ؿ‬ ًَٔ ٢‫ك‬ ‫ُٓ٘ٔٞش‬ ٕ‫أٓ٘خ‬ٖٓ َ‫أًؼ‬ ‫ٓؼخُؾ‬3‫ح٧ً٣ش‬ ‫رؼي‬ ّ‫أ٣خ‬. *٢ٜ‫ك‬ ٌَُٔ‫ح‬ ٢‫ه‬ ٢‫ك‬ ٖٓ ‫اروخء‬ ‫ػ٘ي‬ ‫ططز٤وٜخ‬ ‫٣ـذ‬ ٢‫حُظ‬ ‫ح٩ؿَحءحص‬ ‫أٓخ‬: .‫أ‬‫ًٍٝ٣ش‬ ‫ٍٛٞس‬. .‫د‬ٌَُٔ‫ح‬ ‫كيٝع‬ ‫ػ٘ي‬ ً‫خ‬٣ُ‫ؿٜخ‬ ‫حُل٤ٞ٣ش‬ ‫رخُٜخىحص‬ ‫ٓؼخُـش‬. .‫ؽ‬‫كًَظٜخ‬ ‫ػ٘ي‬ ٕ‫ح٧ٓ٘خ‬ ‫طؼز٤ض‬. .‫ى‬ً ‫اًح‬ ‫ُٜخ‬ ‫حُِز٤ش‬ ‫حُٔؼخُـش‬ِ٘‫حُِذ‬ ‫ق‬. ٙ.ٕ‫ربٗظخ‬ ٌَُٔ‫ح‬ ‫أٛخد‬ ‫اًح‬ ُِٖٔ َٗ‫ٓزخ‬ ‫هِغ‬. ٝ.ٝ ‫ٓ٘ش‬ ‫ُٔيس‬ ‫َٓحهزش‬‫حُل٤ٞ٣ش‬ ٕ‫كويح‬ ٍ‫كخ‬ ٢‫ك‬ ‫حُِز٤ش‬ ‫حُٔؼخُـش‬. C-٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ‫أٓزخد‬: ٠ُ‫ا‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ‫أٓزخد‬ ْ٤ٔ‫طو‬ ٌٖٔ٣: 1-‫حُوخٍؿ٤ش‬ َُٟٝٞ‫ح‬:َٝٔ٘‫ط‬ *َ٤ُٔ‫ح‬ ‫كٞحىع‬. *‫ٓ٘خؿَحص‬. *‫َٓطلؼش‬ ًٖ‫أٓخ‬ ٖٓ ١ٞ‫حُٔو‬. *َٔ‫حُؼ‬ ‫١ٞحٍة‬. *‫حُٔلِ٤ش‬ ‫حُؼخُؼش‬ ٠‫حَُك‬ ‫هِغ‬ ‫ػ٘ي‬.
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 22 2-‫حَُٟٔ٤ش‬ ٌٍُٞٔ‫ح‬:َٝٔ٘‫ط‬ *ُ‫ا‬ٝ ْ‫حُؼظ‬ ‫ظٜخد‬٢‫حُ٘و‬. *ٝ ‫حُِٔ٤ٔش‬ ّ‫ح٧ٍٝح‬‫حُوز٤ؼش‬. *ّ‫ح٧ً٤خ‬. *٢‫حُ٘ؼخػ‬ ٢ٔ‫حُؼظ‬ ‫حُظوَد‬. 3-‫حُؼخٓش‬ ٝ‫ح٧َٓح‬:َٝٔ٘‫ط‬ *ّ‫حُؼظخ‬ ٖ٤ِ‫ط‬. *٢‫حُ٘٤وٞه‬ ْ‫حُؼظ‬ ‫ٛ٘خٗش‬. *٢‫حُؼٜز‬ ُ‫حُـٜخ‬ ٝ‫أَٓح‬. *‫حُٔؼيٗ٤ش‬ ‫حُظٔٔٔخص‬. D-‫حُلي‬ ًٍٞٔ ٝ‫أػَح‬٢ِ‫حُٔل‬: )*٢ِ٣ ‫رٔخ‬ ٝ‫ح٧ػَح‬ ٚ٤‫طِو‬ ٌٖٔ٣: 1-‫ٝؿٞى‬‫هٜش‬ٝ ‫هي٣ٔش‬ ‫أً٣ش‬٢َٟٓ ًَٔ َ٤ُ‫ى‬ ٢ٛ ٝ‫ح٧ػَح‬ ٍٜٞ‫ظ‬. 2-٢ٔ‫ػظ‬ َ٤‫طـ‬ ٠ُ‫ا‬ ‫ػخثي‬ ‫ا١زخم‬ ‫ٓٞء‬. 3-ٝ ‫١ز٤ؼ٤ش‬ َ٤‫ؿ‬ ‫كًَش‬‫كًَش‬‫ػيس‬ٕ‫ح٧ٓ٘خ‬‫ٝحكيس‬ ‫ًٌظِش‬. 4-ْ‫حُـ‬ ٝ‫أ‬ ‫حُلًَش‬ ‫ػ٘ي‬ ُْ٧‫ح‬. 5-‫حُٞظ٤ل٤ش‬ ‫حُلًَش‬ ٝ‫أ‬ ْ‫حُـ‬ ‫ػ٘ي‬ ‫حُلَهؼش‬. 6-‫حُٔ٠ؾ‬ ٠ِ‫ػ‬ ‫حُويٍس‬ ّ‫ػي‬. 7-ُِٟ. 8-ٌَُٔ‫ح‬ ٕ‫ٌٓخ‬ ٢‫ك‬ ‫حُِؼش‬ ‫طِٔم‬. 9-‫ه‬ٝ ٍ‫ي‬٢‫ك‬ ‫هخٛش‬ٝ ‫حُِؼش‬٢ٓٞ‫حُٔظ‬ ٢‫حُو‬ ٠‫كظ‬ ‫حُ٘لش‬‫ًُي‬ ٝ٢ِ‫حُٔل‬ ٢ُ٘ٔ‫ح‬ ‫حُؼٜذ‬ ًٟ‫٣ئ‬ ‫ػ٘يٓخ‬. 10-ُ‫ح‬ ٝ‫أ‬ ‫حُِؼش‬ ٠ِ‫ػ‬ ‫ًيٓخص‬٘‫ـ‬ً‫خ‬٣ِ٤ِٛ‫ى‬ ٝ‫أ‬ ً‫خ‬٤ٗ‫ُٔخ‬ ٢١‫حُٔوخ‬ ‫خء‬. 11-ٝ ‫حُِؼخد‬ ٕ٬٤ٓٞ٣َُٔ‫ح‬ ْ‫ُ٘ل‬ ‫ٍحثلش‬. )*‫طوظِق‬ٝ ‫حُؼ٬ٓخص‬٢ِ‫حُٔل‬ ‫حُلي‬ ًَٔ ‫ُٔٞهغ‬ ‫رخُ٘ٔزش‬ ٝ‫ح٧ػَح‬: ‫أ‬-ٌَُٔ‫ح‬:٢‫حُٔ٘و‬ ٢ُ٘ٔ‫ح‬‫٣ليع‬ ٕ‫أ‬ ٌٖٔ٣ٗ‫ا‬ٝ ٢‫ٓ٘و‬ ًَٔ ‫ٓغ‬ ٕ‫ُ٨ٓ٘خ‬ ًَٔ ٝ‫أ‬ ٢‫ؿِث‬ ‫و٬ع‬ٕ‫أ‬ ٌٖٔ٣ٌٕٞ‫ط‬‫ٓغ‬ ٝ‫أ‬ ‫ٓلَىس‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ٢‫ك‬ ٌَُِٔ َ‫آه‬ ‫ٗٞع‬. 1-ٕ‫ح٧ٓ٘خ‬ ‫أً٣ش‬: ‫حُلـَس‬ ٍٝ‫طظ٘خ‬ ‫هي‬ ًٍٞٔ ‫طليع‬ ٕ‫أ‬ ٌٖٔ٤‫ك‬ ٕ‫ح٧ٓ٘خ‬ ٕ‫ط٤ـخ‬ ‫أً٣ش‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ٠ِ‫ػ‬ َُِٝ ‫حُظخُ٤ش‬ ً‫خ‬‫ٗ٤ٞػ‬ ‫ح٧ً٣خص‬ َ‫أًؼ‬٫ ٝ‫أ‬ ‫حُِز٤ش‬ ‫طظ٘خُٜٝخ‬ٝ ،ٝ ، ‫ُِ٘لش‬ ‫حَُهٞس‬ ‫حُ٘ٔؾ‬ ٍَ٠‫طظ‬ ٕ‫أ‬ ٌٖٔ٣ٕ‫أ‬ ٌٖٔ٣َُ‫ط٘ـ‬. ‫حُ٘لش‬ ٖٟٔ ‫حٌٍُٔٔٞس‬ ٕ‫ح٧ٓ٘خ‬ ٕ‫ط٤ـخ‬ ‫ليع‬‫ط‬ ٕ‫أ‬ ٌٖٔ٣ٕ‫ح٧ٓ٘خ‬ ٌٍٝ‫ؿ‬ ًٍٞٔ‫ط‬.‫حُِؼش‬ ٟٞ‫ٓٔظ‬ ‫طلض‬ ‫لظض‬ ٩‫ح‬ٕ‫ح٧ٓ٘خ‬ ٌٙٛ ٕ‫ط٤ـخ‬ ‫رلًَش‬ ‫٣٬كع‬ ٕ‫أ‬ ٌٖٔ٣ ٕ‫أٓ٘خ‬ ‫ػيس‬ ٝ‫أ‬ ُٖٔ ٢‫حُـِث‬ ‫ٗو٬ع‬. 2-ُ‫ح‬ ٌَُٔ‫ح‬٢‫ٔ٘و‬: ٝ ‫ؿَف‬ ‫ٓ٬كظش‬ ٌٖٔ٣‫حُٔلِ٤ش‬ ‫حُ٘لش‬ ٠ِ‫ػ‬ ‫ًيٓش‬,ٝ ‫حُِؼش‬ ٢‫ك‬ ‫ؿَٝف‬ٝ ‫ًيٓخص‬ٌٕٞ‫ط‬ ٕ‫أ‬ ٌٖٔ٣ ٢‫حُظ‬ ٕ‫ح٧ٓ٘خ‬ ‫ٓ٘ن‬ ٢‫ك‬ ٙٞ٘‫ط‬ ‫ٌٍٓٔٞس‬ ٝ‫أ‬ ‫ٓوِٞػش‬ ٝ‫أ‬ ‫ٓلوٞىس‬.
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 23 ٝ ٕ‫ح٧ٓ٘خ‬ ‫كًَش‬ ٚ‫ٗلل‬ٝ ‫ك٤ٞ٣ظٜخ‬ ٚ‫ٗلل‬ٖٟٔ ٕ‫ُ٨ٓ٘خ‬ ‫حُٔـٌ٣ش‬ ِّ‫حُل‬ ‫هطغ‬ ٠ُ‫ا‬ ١‫طئى‬ ‫حُٔ٘ن‬ ًَٔ ٠ُ‫ا‬ ‫أىص‬ ٢‫حُظ‬ ‫حُوٞس‬ ً‫خ‬‫ؿخُز‬ ‫حُوطؼش‬‫حُٔ٘و٤ش‬. ‫د‬-‫حُِؤش‬ ًَٔ: ٝ ً‫خ‬‫ٗ٤ٞػ‬ َ‫ح٧ًؼ‬ ٞٛ‫٣ٜ٘ق‬ ٕ‫أ‬ ٌٖٔ٣ًَٔ ٠ُ‫ا‬‫حُٔللظش‬ ‫هخٍؽ‬ ٝ‫أ‬ ‫حُٔللظش‬ ٖٟٔ،‫حُـخٗذ‬ ٢‫ػ٘خث‬ ٝ‫أ‬ ‫حُـخٗذ‬ ١‫أكخى‬. ٝ ً‫خ‬‫كيٝػ‬ َ‫ح٧ًؼ‬ ٢ٛ ‫حُٔللظش‬ ‫هخٍؽ‬ ٌٍُٞٔ‫ح‬ ‫أٓخ‬ ‫ٗخىٍس‬ ‫حُٔللظش‬ ٖٟٔ ٌٍُٞٔ‫ح‬‫ػ٘ن‬ ‫ٓ٘طوش‬ ٢‫ك‬ ‫هخٛش‬‫حُِؤش‬,١‫٣ئى‬ ‫هي‬ٌَُٔ‫ح‬ ‫حُٔللظش‬ ‫هخٍؽ‬٠ُ‫ا‬َ٤٤‫طـ‬‫حُِؤش‬ ٕ‫ٌٓخ‬ ٢‫ك‬ ‫طظَحًذ‬ ٕ‫أ‬ ٌٖٔ٣‫حُٔلِ٤ش‬ ‫حُ٘ظ٤ش‬ ٠ِ‫ػ‬ ‫حُؼِٞ٣ش‬ ‫حُ٘ظ٤ش‬‫حَُأى‬ ()ً‫خ‬٤ٗ‫ُٔخ‬ ٝ‫أ‬ ً‫خ‬٣ِ٤ِٛ‫ى‬ ‫طِ٘حف‬ ٕ‫أ‬ ٌٖٔ٣ ‫ًٔخ‬ٝ‫أ‬ ٢‫َٓطز‬ ٌٕٞ٣ ١ٌُ‫ح‬ ٝ ٖ‫ػ‬ ‫ٗخطؾ‬‫حُِؤش‬ ‫ػ٘ن‬ ٠ِ‫ػ‬ ‫طظؼزض‬ ٢‫حُظ‬ ‫حُٞك٘٤ش‬ ‫حُؼ٠ِش‬ َ‫ؿ‬. 1-‫حُـخٗذ‬ ‫حُٞك٤ي‬ ٌَُٔ‫ح‬: +ٚ‫حُلل‬ٝ ٢‫حُٜيؿ‬ ٢ٌ‫حُل‬ َٜ‫حُٔل‬ ‫ٓ٘طوش‬ ‫كٞم‬ ‫اٗظزخؽ‬ ً‫خ‬‫ؿخُز‬ ‫ٛ٘خى‬ :١ٞٔ‫حُل‬ ‫هخٍؽ‬‫حُـخٗذ‬ ٢‫ك‬ ًٕ٧‫ح‬ ٖٓ ‫ِٗف‬ ‫٣ليع‬ ٕ‫أ‬ ٌٖٔ٣ ‫حُٜٔخد‬. ٝ َ‫ح٧ٓل‬ ٞ‫ٗل‬ ‫حُِؤش‬ ‫٣يكغ‬ ٕ‫أ‬ ٌٖٔ٣ ‫حُؼِٞ٣ش‬ ‫حُ٘ظ٤ش‬ ٍٞ‫ك‬ ١ٞٓ‫حُي‬ ٍُّٞ‫ح‬‫حُٔٔغ‬ َٟ‫ٓـ‬ َ‫أٓل‬ ‫حُوِق‬ ٝ َٛ‫حُظخ‬ٝ ‫حُـخٗذ‬ ْ‫ٗل‬ ٠ِ‫ػ‬ ٢‫حُـ٘خث‬ ‫حُ٘خطت‬ َ‫أٓل‬ ٢‫كو‬ ‫حُـِي‬ ٠ِ‫ػ‬ ‫ًيٓخص‬ ‫ٗ٘ٞء‬ ‫٣ٔزذ‬ ‫ٌٛح‬ٌٙٛ ‫طؼَف‬ ‫ك٤غ‬ ‫حُـٔـٔش‬ ‫هخػيس‬ ٌٍٞٔ‫ر‬ ‫طليع‬ ‫ٗلٜٔخ‬ ‫حُؼ٬ٓش‬(َ‫رخط‬ ‫رؼ٬ٓش‬. ) ‫أٓخ‬ً٫ٝ‫أ‬ ٜٞ‫ك‬ ْ‫حُـ‬ُ‫حُِؤش‬ ‫ظلي٣ي‬‫حُٜٔخرش‬ٝ‫ا‬‫حَُأى‬ ‫ٓغ‬ ‫حُِؤش‬ ‫ػ٘ن‬ ٍ‫ٓظَٔح‬. +ٚ‫حُلل‬َ‫ىحه‬١ٞٔ‫حُل‬:ُ‫ح‬ ٢‫ك‬ َٜ‫ه‬ ٠ُ‫ا‬ ١‫٣ئى‬ ‫حُِؤش‬ ٕ‫ٌٓخ‬ َ٤‫طـ‬ ٝ‫أ‬ ‫ح٩ِٗ٣خف‬‫ٓٔخ‬ ‫حُـخٗذ‬ ْ‫ٗل‬ ٖٓ ‫َأى‬ ‫ا‬ ٠ُ‫ا‬ ١‫٣ئى‬٢‫كو‬ ‫ح٧ٍكخء‬ ٠ِ‫ػ‬ ‫ح٩١زخم‬ ‫٣ٜزق‬ ٝ ‫حُٜٔخد‬ ‫حُـخٗذ‬ ٞ‫ٗل‬ ‫حُلي‬ ‫ِٗ٣خف‬‫ٓغ‬ٕ‫ح٧ٓ٘خ‬ ْٓ٬‫ط‬ ّ‫ػي‬ ‫ح٧ٓخٓ٤ش‬ 2-ُ ‫حُـخٗذ‬ ٢‫ػ٘خث‬ ٌَُٔ‫ح‬ِٖ٤‫ِؤظ‬: +٢ٛ ْ‫حُل‬ ‫هخٍؽ‬ ‫حُؼ٬ٓخص‬ٝ ‫حُـخٗذ‬ ١‫ح٧كخى‬ ٌَُٔ‫ح‬ ٢‫ك‬ ‫ٗلٜٔخ‬٠ِ‫ػ‬ ٌُٖ.ٖ٤‫حُطَك‬ +‫ك‬ ْ‫حُل‬ َ‫ىحه‬ ‫أٓخ‬٬ًٍٞٔ ‫كيٝع‬ ‫ػ٘ي‬ ‫ح٩١زخم‬ ٢‫ك‬ َ٤‫طـ‬ ١‫أ‬ ‫ٗ٬كع‬‫٣ليع‬ ٫ ‫ػ٘يٓخ‬ ٝ‫أ‬ ‫حُٔللظش‬ َ‫ىحه‬‫ا‬ٝ ، ‫ُِ٘ظخ٣خ‬ ‫ِٗ٣خف‬٢‫ك‬ ِٞ‫حُؼ‬ ‫حُ٘ظ٤ش‬ ٢‫ك‬ ٍ‫طزي‬ ‫كيٝع‬ ٍ‫كخ‬‫أٓخٓ٤ش‬ ‫ٓلظٞكش‬ ‫ػ٠ش‬ ‫ك٤ليع‬ ‫٣ش‬‫ٓغ‬ٝ ُْ‫أ‬ٝ ْ‫حُل‬ ‫ُلظق‬ ‫طلي٣ي‬ٝ ‫ح٩ؿ٬م‬‫حُـخٗز٤ش‬ ‫حُلًَخص‬. ‫ؽ‬-١ٍ‫حُٔ٘وخ‬ ‫حُ٘خطت‬ ًٍٞٔ: ‫ر‬ ٠ِ‫ُ٨ػ‬ ‫حُ٘ظ٤ش‬ َ‫طـ‬‫ب‬ٝ ، ‫حُٜيؿ٤ش‬ ‫حُؼ٠ِش‬ ‫رٞحٓطش‬ ‫حُٜيؿ٤ش‬ ‫طلض‬ ‫حُللَس‬ ٙ‫طـخ‬ٝ ً‫خ‬٣َ٣َٓ ٌَُٔ‫ح‬ ‫ٌٛح‬ ٚ٤‫ط٘و‬ ‫حُٜؼذ‬ ٌُٖٖٓ ‫حُٔ٘طوش‬ ٢‫ك‬ ‫ًيٓخص‬ ‫ٓ٘خٛيس‬ ٌٖٔ٣ ْ‫حُل‬ ‫هخٍؽ‬ٝٝ ُْ‫أ‬ ‫ٝٛ٘خى‬ ‫حُٔ٘طوش‬ ‫كٞم‬ ْ‫رخُـ‬ ‫١َحٝس‬٢ِ‫حُٔل‬ ‫حُلي‬ ‫كًَش‬ ٢‫ك‬ ‫طليى‬ ‫ح٩ؿ٬م‬ ‫ػ٘ي‬ ‫هخٛش‬. ‫ى‬-‫حَُأى‬ ًٍٞٔ: ٝ ‫ٗخىٍس‬ ‫َُِأى‬ ‫طليع‬ ٢‫حُظ‬ ٌٍُٞٔ‫ح‬‫ٜٓ٘خ‬ ‫ٗ٬كع‬ٖ٤ٌِٗ: 1-‫َُِأى‬ ‫ٓلَى‬ ًَٔ. 2-‫َُِأى‬ ‫ٓظلظض‬ ًَٔ. ٝ ‫ٗ٬كع‬‫ؿٞى‬‫ا‬ٝ ‫ٗظزخؽ‬ٝ ،‫ًيٓخص‬‫ر‬ْ‫خُـ‬ُْ‫أ‬ ‫ٓغ‬ ‫حَُأى‬ ‫كٞم‬ ‫١َحٝس‬ ّ‫اكٔخ‬ ٢‫٣ؼط‬٢ِ‫حُٔل‬ ‫حُلي‬ ‫كًَخص‬ ‫أػ٘خء‬. ّ-‫حُِحٝ٣ش‬ ًٍٞٔ: ‫٣٘خٛي‬‫ا‬ٝ ‫حُلي‬ ‫ُحٝ٣ش‬ ٢‫ك‬ ٙٞ٘‫ط‬ ‫ٓغ‬ ‫ٗظزخؽ‬ْ‫رخُـ‬ ٍ‫هي‬ ‫كيٝع‬ ٌٖٔ٣‫ٓغ‬‫حُلي‬ ‫ُحٝ٣ش‬ ‫ػ٘ي‬ ‫رخُطَحٝس‬ ّ‫اكٔخ‬. ٙ-ًٍٞٔ‫ؿ‬( ‫حُلي‬ ْٔٝ ‫ح٧ٍكخء‬ ‫ٓ٘طوش‬‫حُ٠ٞحكي‬): ٝ ٝ‫ح٧ػَح‬ٗ ٢ٛ ‫حُؼ٬ٓخص‬‫حُِحٝ٣ش‬ ًٍٞٔ ٢‫ك‬ ‫لٜٔخ‬ٝ .‫٣ليع‬ ‫هي‬‫ا‬‫ِٗ٣خف‬‫ٓٔظلذ‬ ‫ٟٝغ‬ (ٝ )‫ٓٔظلذ‬ َ٤‫ؿ‬ ‫ٟٝغ‬ ٝ‫أ‬َ٤‫رظؤػ‬ ‫ًُي‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 24 ٝ ‫حُلي‬ ْٔ‫رـ‬ ‫حُٔظِٜش‬ ‫حُؼ٠٬ص‬‫ػ٘ي‬ٛ‫حُلخ٫ص‬ ٌٙٛ ٢‫ك‬ َ٣ِ‫ؿ‬ ‫ِٗف‬ ‫٣ليع‬ ‫خ‬‫حُلٌ٤ش‬ ‫حُٞػخث٤ش‬ ‫حُلِٓش‬ ‫اٗوطخع‬ ‫اكظٔخُ٤ش‬ ‫رٔزذ‬ ‫حُٔلِ٤ش‬. ٝ-ًٍٞٔ‫ا‬ٝ ٖ‫حٌُه‬ ‫ٍطلخم‬٩‫ح‬ ‫ؿخٗذ‬‫ٍطلخم‬: ٢‫ػ٘خث‬ ٝ‫أ‬ ‫حُـخٗذ‬ ‫ٝك٤ي‬ ‫حُِؤش‬ ‫ػ٘ن‬ ًٍٞٔ ‫ٓغ‬ ٌٍُٞٔ‫ح‬ ٌٙٛ ‫طظَحكن‬ ‫ٓخ‬ ً‫خ‬‫ؿخُز‬‫حُـخٗذ‬.ّ‫ح٩كٔخ‬ ٢ٛ ‫ظٍٜٞٛخ‬ َٔ‫حُٔلظ‬ ‫حُؼ٬ٓخص‬ ٝ ْ‫حُـ‬ ‫ػ٘ي‬ ‫رخُطَحٝس‬ُ ‫ِٗف‬٢ٗ‫ٔخ‬ٕ‫حُِٔخ‬ ‫طلض‬ ‫ًيٓش‬ ٝ.ٍٝ‫كخ‬ ٢‫ك‬‫حُـخٗذ‬ ٢‫ػ٘خث‬ ٌَُٔ‫ح‬ ٕ‫ًخ‬َ‫كٔ٤ظؤػ‬٩‫ح‬٢ٗ‫حُِٔخ‬ ٍ‫طٜخ‬ ٖ‫حٌُه‬ ‫ُٔ٘طوش‬ٕ‫ًخ‬ ٍ‫كخ‬ ٢‫كل‬ٝ َ‫ٓ٤ظؤػ‬ ٢ٔ‫حُظ٘ل‬ َٟ‫حُٔـ‬ ٕ‫كب‬ ‫ٝحع‬ َ٤‫ؿ‬ ٞ٣َُٔ‫ح‬‫ػٞح‬ َٜ‫ٓظظ‬ٍٝ‫ا‬‫هظ٘خه٤ش‬،ًٕٞ ٍ‫كخ‬ ٢‫ك‬ ‫أٓخ‬ ٝ ‫ٓؼخم‬ َ٤‫ؿ‬ ٢ٔ‫حُظ٘ل‬ َٟ‫حُٔـ‬ ‫اروخء‬ ‫٣ٔظط٤غ‬ ٚٗ‫كب‬ ً‫خ‬٤‫ٝحػ‬ ٞ٣َُٔ‫ح‬ٝ ٌِْ‫حُظ‬ ‫٣ٔظط٤غ‬‫حُؼٜذ‬ ًٟ‫طؤ‬ ‫اًح‬ ٫‫ا‬ ْ‫حُل‬ ٕ‫كويح‬ َٜ‫٣ل‬ ٫ ٝ‫أ‬ ٢٘‫حٌُه‬‫حُؼوزش‬‫حٌُه٘٤ش‬. E-ٚ‫حُلل‬١َ٣َُٔ‫ح‬: )**ٞ٣َٓ ًَٓٝ ٚ‫حُٞؿ‬ ٢‫ك‬ ‫ٍٟ٤ش‬ ‫رـَٝف‬ ‫ٜخد‬ٚ٤ٌ‫ك‬ ‫أكي‬ ٢‫ك‬ ًَٔ ‫رٞؿٞى‬ ‫٣٘ي‬ ٕ‫أ‬ ‫٣ـذ‬ ّ‫حَُأ‬.ٕٝ‫أ‬ ‫٣ـذ‬ ‫ٗ٢ء‬ ًَ َ‫هز‬ ٌُٖ ‫ك‬ ٞ٣َُٔ‫ح‬ ٚ‫٣لل‬‫اٛخرخص‬ ٍٜٞ‫ك‬ ّ‫ػي‬ ٖٓ ‫ُِظؤًي‬ ً‫ح‬‫ؿ٤ي‬ ً‫خ‬ٜ‫ل‬َٟ‫أه‬َ‫أًؼ‬‫أٛٔ٤ش‬‫حُٜٔخد‬ ‫ك٤خس‬ ٠ِ‫ػ‬ ‫هطَح‬ َ‫أًؼ‬ ٝ‫(حُؼٜز٤ش‬ٝ)‫حُِ٘ك٤ش‬ ‫ك‬ٌٌَُٜٙٔ‫ح‬ ‫ٓؼخُـش‬ َ‫هز‬ ‫ؿ٤ي‬ ٌَ٘‫ر‬ ‫طؼخُؾ‬ ٕ‫أ‬ ‫٣ـذ‬ َٟ‫ح٧ه‬ ‫ح٩ٛخرخص‬. ٞ٣َُِٔ ‫حُؼخٓش‬ ‫حُلخُش‬ ٚ‫كل‬ ٖٔ٠‫٣ظ‬: 1-١َ‫حُظل‬١‫أ‬ ‫ٝؿٞى‬ ٖ‫ػ‬‫هلل٤ش‬ ‫اٛخرخص‬. 2-ْ‫حُظ٘ل‬ َٟ‫ٓـ‬ ٚ‫كل‬: -ٞ٣َُٔ‫ح‬ ‫ػ٘ي‬ ٢‫١ز٤ؼ‬ ْ‫حُظ٘ل‬ ٕ‫أ‬ ٖٓ ‫حُظؤًي‬ ٖٓ ‫ري‬ ٫ -ٝ ‫حٌٍُٔٔٞس‬ ٕ‫ح٧ٓ٘خ‬ ‫هطغ‬ ٖ‫ػ‬ ْ‫حُل‬ ٢‫ك‬ ‫حُزلغ‬ ‫٣ـذ‬ٝ ‫حُٔوِٞػش‬ ٕ‫ح٧ٓ٘خ‬ٝ ‫حٌٍُٔٔٞس‬ ٕ‫حُظ٤ـخ‬ ٝ‫أ‬ ‫حُل٘ٞحص‬‫ٓغ‬ ‫ٓطخروظٜخ‬ ٝ ٍ‫كخ‬ ٢‫ك‬ ‫حٌٍُٔٔٞس‬ ‫ح٧ؿِحء‬‫ٍٛٞس‬ ‫اؿَحء‬ ‫ك٤ـذ‬ ‫حُوطغ‬ ٌٙٛ ٠ِ‫ػ‬ ٍٞ‫حُؼؼ‬ ّ‫ػي‬ ‫ػ٘ي‬ ‫أٓخ‬ ،‫ؿٞىٛخ‬‫هي‬ ‫ًخٗض‬ ‫اًح‬ ‫ك٤ٔخ‬ ‫ُٔؼَكش‬ ٍ‫ُِٜي‬ ‫أ‬ٞ٣َُٔ‫ح‬ َ‫هز‬ ٖٓ ‫ٓظ٘٘وض‬٩‫حُٔؼ‬ ‫ؿَحء‬‫حُ٬ُٓش‬ ‫ح٩ٓؼخك٤ش‬ ‫خُـش‬. 3-‫حُِ٘ف‬: ٝ ، َ٤‫هط‬ ‫ِٗف‬ ‫٣ليع‬ ٫ ً‫خ‬‫ؿخُز‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ٢‫ك‬‫ا‬‫حُ٘ٔؾ‬ ‫طِٔم‬ ‫رٔزذ‬ ‫٣ليع‬ ‫ٓخ‬ ً‫خ‬‫ؿخُز‬ ّ‫حُي‬ ٖٓ ‫ٓؼظزَس‬ ‫ًٔ٤ش‬ ٚ‫ٗو‬ ٕ ٝ ‫حَُهٞس‬ِ٤٤ٔ‫ط‬ ‫٣ـذ‬ ‫ػ٘يٛخ‬ٖٛ‫ػ‬ ‫خ‬ٝ ‫حُٞؿٜ٤ش‬ ‫ح٧ٝػ٤ش‬ َ‫ٓؼ‬ ‫حُ٘خُكش‬ ٢‫حُ٘و‬١‫ُظوخ‬ ‫ٗٔؾ‬ ٢‫رِٔو‬ ‫ُوطٜخ‬. 4-‫حُٜيٓش‬: ٢‫حُظ‬ ٝ. ٠ُٝ٧‫ح‬ ‫حُيٍؿش‬ ٖٓ ‫ح٩ٓؼخك٤ش‬ ‫حُلخ٫ص‬ ٖٓ َ‫طؼظز‬ )**ٚ‫رلل‬ ‫رؼيٛخ‬ ‫ٗزيأ‬‫ًحطٜخ‬ ‫رلي‬ ‫ح٩ٛخرش‬ٖٝ٤ٌ‫حُل‬ ًٍٞٔ ٖ‫ػ‬ ١َ‫حُظل‬. ‫أ‬-ٚ‫حُلل‬١ٞٔ‫حُل‬ ‫هخٍؽ‬: ‫ىح‬ ‫رٔخء‬ ‫رِطق‬ ٞ٣َُٔ‫ح‬ ٚ‫ٝؿ‬ ‫٣٘ظق‬ ً٫ٝ‫أ‬ٝ َ‫حُٔظوؼ‬ ّ‫حُي‬ ‫٩ُحُش‬ ٕ‫هٔخ‬ ‫روطؼش‬ ٝ‫أ‬ ‫كت‬..‫حُن‬ ‫حُطَ٣ن‬ ‫أٝٓخم‬‫ؿَٝف‬ ْ٤٤‫طو‬ ٖٓ ٌٖٔ‫ُ٘ظ‬ ‫ٝحٌُيٓخص‬ ‫حَُهٞس‬ ‫حُ٘ٔؾ‬ٝ ‫ًيٓخص‬ ‫ٛ٘خى‬ ٌٕٞ٣ ‫ٓخ‬ ً‫خ‬‫ؿخُز‬ ً‫ا‬‫ا‬ٌٖٔ٣ ‫ًٔخ‬ ٌَُٔ‫ح‬ ٕ‫ٌٓخ‬ ‫كٞم‬ ‫ٗظزخؽ‬ُٔ٘‫ٝح‬ ‫حُـِي‬ ٢‫ك‬ ‫رظِٔم‬ ‫٣ظَحكن‬ ٕ‫أ‬‫ؾ‬ ٞ‫حَُه‬‫س‬ٖ‫ػ‬ ‫ٗخطـش‬ ‫هخٛش‬ ‫ٍحثلش‬ ٢‫٣ؼط‬ ًَٔ ‫ٝؿٞى‬ ٍ‫كخ‬ ٢‫ك‬ ْ‫حُل‬ ٕ‫أ‬ ‫ًٔخ‬ .ٝ ‫حُ٘خُف‬ ْ‫حُل‬ ٖ٤‫ر‬ َٛ‫حُلخ‬ ‫حُِٔ٣ؾ‬‫حُِؼخد‬. ‫د‬-ٚ‫حُلل‬١ٞٔ‫حُل‬ َ‫ىحه‬: *ٝ ‫حُيٓٞ٣ش‬ ‫ٝحُؼِوخص‬ ّ‫حُطؼخ‬ ‫ك٠٬ص‬ ٍ‫طِح‬ ْ‫ػ‬ ،‫َٓحص‬ ‫ػيس‬ َُٜٔ‫رخ‬ ْ‫حُل‬ َٜ‫ٗط‬ ٖ٤‫حُ٘لظ‬ ‫ارؼخى‬ ‫رؼي‬‫ح٧ؿ٘٤ش‬ٝ ‫حُِٔٔهش‬١‫أ‬ ٍ‫٣ِح‬ ْ‫حُل‬ ٖٓ ‫رِطق‬ ٢٘‫حُٔو‬ ْ‫حُؼظ‬ ٝ‫أ‬ ٕ‫ح٧ٓ٘خ‬ ٖٓ ‫حٌٍُٔٔٞس‬ ‫ح٧ؿِحء‬ ٍ‫طِح‬ ‫ًٔخ‬ ٢‫ِٓو‬ ٠ِ‫ػ‬ َٔ‫٣ل‬ ٕ‫ر٘خ‬ ‫ٓظـٔغ‬ ّ‫ى‬. *‫حُٔ٘٤ش‬ ّٞ‫حُو‬ ٚ‫كل‬: ٝ ٕ‫ح٧ٓ٘خ‬ ٚ‫ٗلل‬ٝ ٌٍٞٔٓ ‫ؿِء‬ ١‫أ‬ َ٣ِٗ‫ٗ٢ء‬ ًَ َ‫هز‬ ٢١‫حُٔوخ‬ ‫حُـ٘خء‬ ٚ‫كل‬ ٖٓ ‫ري‬ ٫ ٞ٣َُٔ‫ح‬ ‫ػ٘ي‬ ٕ‫ح٧ٓ٘خ‬ ٕ‫كويح‬ ‫كخُش‬ ٢‫ك‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 25 ٤‫ك‬ ‫طِٔم‬ ١‫كؤ‬‫حًَُٔزش‬ ٌٍُٞٔ‫ح‬ ٢‫ك‬ ‫(هخٛش‬ ًَٔ ‫ٝؿٞى‬ ٠ِ‫ػ‬ ٍ‫٣ي‬ ‫هي‬ ٚ‫حُٜخػيس‬ ‫حُ٘ؼزش‬ ًٍٞٔ ٢‫ك‬ ‫ًٔخ‬ ‫حُٔـِوش‬ ٌٍُٞٔ‫ح‬ ٢‫ك‬ ‫أٓخ‬ ) ‫ًيٓش‬ ‫ك٤٘خٛي‬ ‫حُزٔ٤طش‬ ٌٍُٞٔ‫ح‬ ٝ‫أ‬ٝ‫أ‬١ٞٓ‫ى‬ ٍّٝ‫أ‬ٝ‫ا‬ٝ ‫ٍُهخم‬٠ُ‫ا‬ ‫حُِـٞء‬ ٖٓ ‫ري‬ ٫ ‫حُلخُش‬ ٌٙٛ ٢‫ك‬ٚ‫حُلل‬ْ‫حُـ‬ ‫رطَ٣وش‬،ٕ‫أ‬ ً‫ا‬ ٠ُ‫رخ‬ ٢٘‫٣ؼ‬ ٫ ‫حُيِٛ٤ِ٣ش‬ ‫حُـٜش‬ ٠ِ‫ػ‬ ‫حٌُيٓش‬ ‫ٝؿٞى‬‫ٝؿٞى‬ ‫ٍَٝس‬ ٝ‫أ‬ ‫ًيٓش‬ ‫ٝؿٞى‬ ‫أٓخ‬ ًَٔ‫ا‬ُ‫ح‬ ٢‫ك‬ ‫ٍُهخم‬ً‫خ‬‫كـخُز‬ ‫حُِٔخٗ٤ش‬ ‫ـٜش‬ ‫ٝؿٞى‬ ٢٘‫٣ؼ‬ًَٔ. ‫ٝحٟق‬ ٙٞ٘‫ط‬ ً‫خ‬ٗ‫أك٤خ‬ ‫ك٘٘خٛي‬ ٚٔ‫ك‬ ‫٣لظق‬ ٕ‫أ‬ ٞ٣َُٔ‫ح‬ ٖٓ ‫ٗطِذ‬ ٖ٤‫هطؼظ‬ ٠ُ‫ا‬ ‫ٓ٘ؤٔش‬ ّٞ‫حُو‬ ٌٕٞ‫ط‬ ً‫ا‬ ‫حُٔ٘٤ش‬ ّٞ‫حُو‬ ٢‫ك‬ ‫ا‬ ‫ٗٔزش‬ ‫حُٞحكيس‬ ٍ‫طظزي‬ٝ َٟ‫ح٧ه‬ ٠ٌُٕٞ٣ ‫هي‬ ٙٞ٘‫حُظ‬ ‫ٌٛح‬ ‫ر‬‫ب‬ٝ ٢ٗ‫ُٔخ‬ ١ِ٤ِٛ‫ى‬ ٝ‫أ‬ ٢٘‫ٝك‬ ٢ٔٗ‫أ‬ ٝ‫أ‬ ٢‫طخؿ‬ ١ٌٍ‫ؿ‬ ٙ‫طـخ‬ ٖٓ ‫ٓـٔٞػش‬ َٟٗ ً‫ا‬ ٢‫حُظخؿ‬ ١ٌٍ‫حُـ‬ ٍ‫حُظزي‬ ٞٛ ً‫خ‬‫ٟٝٞك‬ َ‫ح٧ًؼ‬ ٝ ‫َٓطلؼش‬ ٕ‫ح٧ٓ٘خ‬‫ٓ٘ول٠ش‬ َٟ‫ح٧ه‬‫ٌٛح‬ ٕ‫ا‬ .ٝ ٙٞ٘‫حُظ‬ ٩‫ح‬‫رخ٩ٛخرش‬ ٚ٤‫ط٘و‬ ‫رٟٞغ‬ ‫٣ٔٔق‬ ‫حُٔ٘٤ش‬ ّٞ‫حُو‬ ٢‫ك‬ ‫ٗلَحف‬ ‫رخ‬ٌَُٔ. ٝ٢‫ك‬ ‫ٓٞء‬ ‫ٗ٬كع‬ ٚٔ‫ك‬ ‫اؿ٬م‬ ٞ٣َُٔ‫ح‬ ٖٓ ‫ٗطِذ‬ ‫ػ٘يٓخ‬ ٝ ‫ح٫١زخم‬َ‫طوِو‬ ‫٣٘خٛي‬ ‫ًٔخ‬ ‫رؼ٠ٜخ‬ ‫ٓغ‬ ٕ‫ح٧ٓ٘خ‬ َٜ‫طٔل‬ ّ‫ػي‬ ٌَُِٔ ‫حُٔـخٍٝس‬ ٕ‫ح٧ٓ٘خ‬ٝ‫أك‬ٚٔ‫ك‬ ‫كظق‬ ٞ٣َُٔ‫ح‬ ٌٍَ٣ ٖ٤‫ك‬ ً‫خ‬ٗ‫٤خ‬ ٝ‫ا‬ٖ‫ػ‬ ٕ‫ح٧ٓ٘خ‬ ‫طظزخػي‬ ٚ‫ؿ٬ه‬ٝ ‫طظوخٍد‬ ْ‫ػ‬ ‫رؼ٠ٜخ‬‫طَطلغ‬ ً‫خ‬ٗ‫أك٤خ‬ ‫ا‬ٝ ‫كيحٛخ‬ٞ‫ط٘ول‬َٟ‫ح٧ه‬ٝ .‫ا‬‫كيع‬ ‫ًح‬‫حُ٘ظخ٣خ‬ ٕ‫ٌٓخ‬ ٢‫ك‬ َ٤‫طـ‬ ٝ ‫رؼ٠ٜخ‬ ‫ٓغ‬ ‫ح٧ٓخٓ٤ش‬ ٚٗ‫أٓ٘خ‬ ‫اؿ٬م‬ ٖٓ ٞ٣َُٔ‫ح‬ ٌٖٔ‫٣ظ‬ ٫ ً‫خ‬‫ٓلظٞك‬ ْ‫حُل‬ ٠‫٣زو‬.‫حُلًَش‬ ٢‫ك‬ ‫طليى‬ ٝ‫أ‬ ُْ‫أ‬ ‫ٝؿٞى‬ ‫ٗ٬كع‬ ‫ًٔخ‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ‫رلًَخص‬ ٞ٣َُٔ‫ح‬ ّ‫ه٤خ‬ ‫ػ٘ي‬. ‫ؽ‬-ْ‫حُـ‬: *‫رـخ٣ش‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ٢‫ك‬ ‫حُ٘خًس‬ ‫حُلًَخص‬ ٖ‫ػ‬ ‫حُطَ٣وش‬ ٌٜٙ‫ر‬ َٟ‫ٗظل‬ٝ ‫حُِطق‬ ّٖٓٞ‫حُو‬ ٢‫ك‬ ٌَُٔ‫ح‬ ‫ٝؿٞى‬ ‫ػزض‬ ‫ٓخ‬ ‫كبًح‬ ٖ٤ُِ‫ح‬ ٝ ‫حُٔزخرش‬ ٌٕٞ‫ط‬ ٕ‫أ‬ ٠ِ‫ػ‬ ٖ٣‫حُ٤ي‬ ٟ‫ربكي‬ ٌَُٔ‫ح‬ ٢‫هطؼظ‬ ٖٓ ٬ً ‫ٗٔٔي‬ ‫حُٔ٘٤ش‬ٝ ٕ‫ُ٨ٓ٘خ‬ ‫حُطخك٘ش‬ ‫حُٔطٞف‬ ‫كٞم‬ ٠‫حُٞٓط‬ٌٕٞ٣ ٝ ‫ُِلي‬ ‫حُوخػي٣ش‬ ‫حُلخكش‬ ً‫خ‬‫ٓؼخٗو‬ ْ‫حُل‬ ‫هخٍؽ‬ ّ‫ح٩رٜخ‬‫ك٤٘خ‬ ‫رؼ٠ٜٔخ‬ ٖ‫ػ‬ ٖ٤‫حُوطؼظ‬ ‫ارؼخى‬ ‫ٗـَد‬ ‫هل٤لش‬ َ‫كظ‬ ‫رلًَخص‬‫ٛي‬ٖ٤ُ٘ٔ‫ح‬ ‫طزخػي‬ ٌَُِٔ ٖ٤‫حُٔـخٍٝط‬‫ا‬ٝ َٟ‫ح٧ه‬ ٖ‫ػ‬ ‫كيحٛٔخ‬ُ‫ح‬ ٍ‫رِٝح‬ ٍِٝ٣ ‫ر٤ٜ٘ٔخ‬ ‫كَحؽ‬ ‫٣ليع‬‫حُٔطزوش‬ ‫وٞس‬ٝ .‫ا‬ٝ ً‫خ‬‫ٓلظٞك‬ ٌَُٔ‫ح‬ ٕ‫ًخ‬ ‫ًح‬ً‫خ‬‫ٓظَحكو‬ ٝ ٢ُِ‫ح‬ ‫كخُش‬ ٢‫ك‬ ً‫خ‬‫ٟٝٞك‬ َ‫أًؼ‬ َٜ‫٣ظ‬ ‫حُظِٔم‬ ‫ٌٛح‬ ٕ‫كب‬ ٢١‫حُٔوخ‬ ‫حُـ٘خء‬ ٢‫ك‬ ‫رظِٔم‬ٝ َ‫حُلظ‬‫طظوخٍد‬ ْ‫ػ‬ ً٫ٝ‫أ‬ ‫حُـَف‬ ٢‫ٗلظ‬ ‫طظزخػي‬ ْٔ‫ه‬ ‫ىحكؼش‬ٌُٔ‫ح‬ ٢‫ه‬ ٖٓ ‫حُٜٞحث٤ش‬ ‫ٝحُلوخػخص‬ ‫حُِؼخد‬ ٖٓ. َ *‫حُٔٔغ‬ َٟ‫ٓـ‬ ٝ‫أ‬ ‫حُـِي‬ ‫١َ٣ن‬ ٖ‫ػ‬ َٜ٘‫حُو‬ ‫رٞٓخ١ش‬ ‫حُِؤش‬ ْ‫ٗـ‬ ٕ‫أ‬ ٌٖٔ٤‫ك‬ ‫حُِؤش‬ ًٍٞٔ ٚ‫كل‬ ‫أٓخ‬َٛ‫حُظخ‬‫طظلَى‬ ُْ ‫كبًح‬ ‫حُِؤش‬٢ِ‫حُٔل‬ ‫حُلي‬ ‫طلَ٣ي‬ ‫ػِٔ٤ش‬ ٍ٬‫ه‬‫حُٔ٘طوش‬ ‫طِي‬ ٢‫ك‬ ًَٔ ‫ٝؿٞى‬ ٠ِ‫ػ‬ ٍ‫٣ي‬ ‫ٌٛح‬. *ّٝ‫رَإ‬ ً‫خ‬‫ُط٤ل‬ ً‫خ‬ٔ‫ؿ‬ ١َ‫ٗـ‬ ‫ًٔخ‬ٝ ٖ٤‫حُطَك‬ ٬ً ٢‫ك‬ ‫حُِؤش‬ ‫ٓ٘طوش‬ ٠ِ‫ػ‬ ‫ح٧ٛخرغ‬‫ُِلي‬ ‫حُٔلِ٤ش‬ ‫حُلخكش‬ ٍٞ١ ٠ِ‫ػ‬ َ‫ُ٨ٓل‬ ‫ٗظخرغ‬ ‫ًٔخ‬ ‫كَهؼش‬ ٝ‫أ‬ ٢ٔ‫حُؼظ‬ ‫حُظليد‬ َ٤‫طـ‬ ‫ٓغ‬ ‫ٓظَحكوش‬ ‫ىٍؿش‬ ‫رٞؿٞى‬ َ‫ٗ٘ؼ‬ ٝ‫أ‬ ٌَُٔ‫ح‬ ٕ‫ٌُٔخ‬ ‫َٓحكوش‬ ‫ُ٤ٞٗش‬ ‫ٗ٬كع‬ ٕ‫أ‬ ٌٖٔٓ ‫ك٤غ‬ ٢ِ‫حُٔل‬ ٠ٔٔ٣ ‫ٓخ‬ ْ‫حُـ‬ ‫رطَ٣وش‬ ٞ٣َُٔ‫ح‬ ٚ‫ٗلل‬ ‫ػ٘يٓخ‬ ٕ‫ح٧ك٤خ‬ ٖٓ َ٤‫ًؼ‬ ٢‫ك‬ ‫ٗٔٔغ‬‫حُؼظٔ٤ش‬ ‫رخُلَهؼش‬.
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 26 F-ٚ‫حُلل‬٢‫حُ٘ؼخػ‬: ُ‫ح‬ َ٣ٜٞ‫حُظ‬ ‫أٗٞحع‬ٔٓ‫ظٔظوي‬‫ش‬ًٔ ‫كخُش‬ ٢‫ك‬٢ِ‫حُٔل‬ ‫حُلي‬ ٍٞ٢ٛ: ‫أ‬)-‫هخٍؽ‬١ٞٔ‫ك‬: 1-)ٍ‫٣ٔخ‬ + ٖ٤ٔ٣ ( ً‫خ‬٤‫ؿخٗز‬ ‫ِٓحكش‬ ‫ٍٛٞس‬ٝ :ًٍٞٔ ٍ‫اظٜخ‬ ٢‫ك‬ ‫طل٤ي‬ٝ ‫حُ٘خد‬ ‫ٓ٘طوش‬ ٠‫كظ‬ ‫حُلي‬ ْٔ‫ؿ‬ًٍٞٔ ،‫حُِحٝ٣ش‬ ًٍٞٔ ‫حُِؤش‬ ًٍٞٔ ، ‫حَُأى‬. ) ‫ؿيح‬ ‫ٓليٝى‬ ٌَ٘‫ر‬ ( 2-‫أٓخٓ٤ش‬ ‫ٍٛٞس‬:‫هِل٤ش‬ٝ ‫حُلي‬ ًٍٞٔ ‫طليى‬ٝ ‫ٓٞ٣ش‬ ‫حُلي‬ ‫ُحٝ٣ش‬٩‫ح‬ ‫ٗٞع‬‫ِٗ٣خف‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 27 3-‫ٍٛٞس‬‫حُوِل٤ش‬‫ح٧ٓخٓ٤ش‬:ٜٓ ٢ٛٝ٩‫ح‬ ‫ٓ٘طوش‬ ًٍٞٔ ٢‫ك‬ ‫ٔش‬ٝ ٢٘‫حٌُه‬ ‫ٍطلخم‬‫حُ٘خد‬. ‫د‬)-َ‫ىحه‬ْ‫حُل‬: ٩‫ح‬ ًٍٞٔ ٢‫ك‬ ‫ٜٓ٘خ‬ ‫٣ٔظلخى‬‫طَح‬ ٕ‫أ‬ ً‫ا‬ ٢٘‫حٌُه‬ ‫ٍطلخم‬٩‫ح‬ ‫ٓ٘طوش‬ ٠ِ‫ػ‬ ‫حَُهز٤ش‬ ‫حُلوَحص‬ ‫ًذ‬ً ٢٘‫حٌُه‬ ‫ٍطلخم‬‫ؼ‬‫ٓ٘طوش‬ ٢‫طول‬ ‫ًٓخ‬ ‫٤َح‬ ٫ ‫ٌُح‬ ٌَُٔ‫ح‬٩‫ح‬ ٍُٜٞ‫رخ‬ ‫حُٔ٘طوش‬ َ٣ٜٞ‫ط‬ ٖٓ ‫ري‬‫حٌٍُٝ٣ش‬ ٝ‫أ‬ ‫١زخه٤ش‬. 1-ٝ ٕ‫رخ٧ٓ٘خ‬ ٌَُٔ‫ح‬ ٢‫ه‬ ‫ػ٬هش‬ ‫ُظلي٣ي‬ ‫ٜٓٔش‬ : ‫حٌٍُٝ٣ش‬ٕ‫ح٧ٓ٘خ‬ ‫أً٣خص‬ ٟ‫ٓي‬. 2-‫ا‬‫حُلي‬ ْٔ‫ُـ‬ ٌَُٔ‫ح‬ ٢‫ه‬ ‫ُظلي٣ي‬ : ‫١زخه٤ش‬. ‫ؽ‬)-‫حُٔٔظلزش‬ ٍُٜٞ‫ح‬ ٞ‫رؼ‬: 1-ٝ ‫حُلي‬ ْٔ‫ؿ‬ ٌٍُٞٔ ‫ٓلززش‬ : ‫حُزخٍٗٞحٓ٤ش‬‫حُِؤش‬ ‫ػ٘ن‬ ًٍٞٔ. 2-١ٍٞ‫ٓل‬ ٢‫١زو‬‫ح٧رؼخى‬ ‫ػ٬ػ٤ش‬ ‫ٛ٤ٌِش‬ ًٝ‫خ‬‫ِٓحك‬ ٢ٔ‫حُِو‬ ّ‫حَُأ‬ ٌٕٞ٣ ‫ػ٘يٓخ‬ ‫حُِؤش‬ ٌٍُٞٔ‫ح‬ ٢‫ك‬ ‫ٜٓٔش‬ :. G-:‫حُٔؼخُـش‬ 1-‫حُٔؼخُـش‬‫حُزيث‬:‫٤ش‬ ‫ػيس‬ ‫ٛ٘خُي‬‫ا‬‫ػظزخٍح‬‫ص‬ٕ‫رخُلٔزخ‬ ‫أهٌٛخ‬ ‫٣ـذ‬. -)‫طِٔم‬:‫حَُهٞس‬ ‫حُ٘ٔؾ‬ َ٠‫٣ل‬‫ا‬ٍ٬‫ه‬ ‫حُـَٝف‬ ‫ؿ٬م‬24ٌ٘ٔٓ ‫ًُي‬ ٕ‫ًخ‬ ‫اًح‬ ‫ح٧ً٣ش‬ ٖٓ ٠ُٝ٧‫ح‬ ‫ٓخػش‬‫خ‬ُٝ ْ‫حُؼظ‬ ‫ٗظخ٣خ‬ ‫ػزخص‬ ٢‫ك‬ ‫ُ٣خىس‬ ‫ٌٔذ‬‫اؿ٬م‬ َ‫هز‬ ٝ ‫ح٧ؿ٘ز٤ش‬ ّ‫ح٧ؿٔخ‬ ٖٓ ٚ‫ط٘ظ٤ل‬ ‫٣ـذ‬ ‫حُـَف‬‫حُـَف‬ ‫ٓٔق‬ ٌٖٔ٣ِٕٞ‫حُٔخك‬ َ‫ٓؼ‬ ‫رٔٞحى‬1%. -)ُْ٧‫ح‬ ٠ِ‫ػ‬ ‫حُٔ٤طَس‬: ‫حُل‬ ًٍٞٔ ٠َٟٓ ْ‫ٓؼظ‬‫ُحثي‬ ُْ‫أ‬ ٖٓ ٕٞٗ‫٣ؼخ‬ ٫ ٢ِ‫حُٔل‬ ‫ي‬‫ا‬ٝ ٢ِ‫حُٔل‬ ٢ٌ‫حُل‬ ‫ُؼٜذ‬ ‫ح٧ً٣ش‬ ٍ‫كخ‬ ٢‫ك‬ ٫ٌٍُٞٔ‫ح‬ ٞ‫رؼ‬ ٢‫ك‬ ‫حُلي‬ ْٔ‫ُـ‬ ‫حُٔظلًَش‬ُ‫ح‬٢‫ظ‬ٝ ‫َٓ٣لش‬ َ٤‫ؿ‬ ٌٕٞ‫ط‬‫طٔزذ‬‫ا‬َ‫حُٔظٞط‬ ٞ٣َُِٔ ‫ِٗػخؽ‬. ٕٝ‫أ‬ ًٌَ‫ٗظ‬ ٕ‫أ‬ ‫٣ـذ‬‫ا‬ّ‫ٓظويح‬ٔ‫حُظ‬‫ٓ٠خى‬ ٞٛ ٖ٤‫حٍُٔٞك‬ َ‫ٓؼ‬ ١ٞ‫حُو‬ ٖ٤ٌ‫ا‬‫ٓظطزخد‬. ‫َٓحكوش‬ ‫ػٜز٤ش‬ ‫اٛخرخص‬ ‫ٝؿٞى‬ ‫اكظٔخُ٤ش‬ ‫رٔزذ‬ -)ٕ‫ح٩ٗظخ‬ ٠ِ‫ػ‬ ‫حُٔ٤طَس‬: ْ‫حُل‬ ٠ِ‫ػ‬ ‫ٓلظٞكش‬ ًٍٞٔ ٢ٛ ٕ‫ح٧ٓ٘خ‬ َٔ٘‫ط‬ ٢‫حُظ‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ًَ)‫(ًَٓزش‬ٝ ،ٝ ٕ‫ُ٪ٗظخ‬ ١ٞ‫ه‬ ٍ‫ٜٓي‬ ٢ٛ ٢ُ‫رخُظخ‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 28 ٖ٤ِٔ٘‫حُز‬ ٢‫٣ؼط‬ ٕ‫أ‬ ‫٣ـذ‬V٢ِ٠‫حُؼ‬ ‫حُطَ٣ن‬ ٖ‫ػ‬1‫ٓخػخص‬ ‫ٓض‬ ًَ ‫ٝكيس‬ ‫ٓ٤ـخ‬‫ُٔيس‬2-3ْ‫حُل‬ ‫١َ٣ن‬ ٖ‫ػ‬ ْ‫ػ‬ ٠ُٝ٧‫ح‬ ّ‫ح٧٣خ‬ َ‫آه‬ ‫٧ٓزٞع‬ٝ .٣ ‫ح٧١زخء‬ ْ‫ٓؼظ‬ٕٞ‫٠٤ل‬ُ‫ح‬ٍُٝ‫ٔ٤ظَٝٗ٤يح‬400-800٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ٠َٟٓ ٌَُ ‫ِٓؾ‬ْ٤‫حُـَحػ‬ ‫ُظـط٤ش‬ ‫حُ٬ٛٞحث٤ش‬. ٝ‫اٗظ‬ ٠ِ‫ػ‬ ٚ‫رلؼخُ٤ظ‬ ِ٤ُٔٔ‫ح‬ ٖ٤ُ‫طظَحٌٓخ‬ ٢ًٔٝ٧‫ح‬ ٢‫ٗؼط‬ ٕ‫أ‬ ٌٖٔ٣ٖ٤ِٔ‫أٓز‬ + ٖ٤ٔ٤ٓ‫ؿ٘ظخ‬ ‫اػطخء‬ ٝ‫أ‬ ْ‫حُؼظ‬ ٕ‫خ‬. 2-ٕ‫ح٧ٓ٘خ‬ ٠ِ‫ػ‬ ١ٝ‫حُلخ‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ‫ٓؼخُـش‬: *)‫اىشد‬Reduction :: ٝ ،ّ‫حُؼخ‬ َ٣‫حُظوي‬ ‫طلض‬ ٙ‫اؿَحإ‬ َ٠‫ح٧ك‬ٌُٖ. ٢‫حُٟٔٞؼ‬ َ٣‫حُظوي‬ ‫طلض‬ ٙ‫اؿَحإ‬ ٌُٖٔٔ‫ح‬ ٖٓ ٝ ١‫حُٔطخ‬ ‫كِوخص‬ ‫رٞحٓطش‬ ٢‫طيٍ٣ـ‬ ‫ٍى‬ ٠ِ‫ػ‬ ٍٜٞ‫حُل‬ ٌٖٔ٣‫ُ٤ٔض‬ ٢َٛ‫ٓؼ‬ ‫كؼخُش‬‫طلض‬ ‫حَُى‬ّ‫حُؼخ‬ َ٣‫حُظوي‬ٝ‫آظطزخرٜخ‬ ‫طـي‬ ‫ٌُٜ٘خ‬ )َ‫أًؼ‬ ٝ‫أ‬ ‫أٓزٞع‬ ٌ٘ٓ ًَٔ( ‫ٗٔز٤خ‬ ‫حُوي٣ٔش‬ ٌٍُٞٔ‫ح‬ ‫كخ٫ص‬ ٢‫ك‬. ‫حُٜل٤ق‬ ‫ح٩١زخم‬ ٠ِ‫ػ‬ ٍُٞٛٞ‫ح‬ ٍ‫كخ‬ ٢‫كل‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ‫َٓآس‬ ٞٛ ١ِٞ‫حُؼ‬ ‫كخُلي‬ ،‫حَُى‬ ٢‫ك‬ ٚ٤ِ‫ػ‬ ‫ٗؼظٔي‬ ١ٌُ‫ح‬ َ٤ُ‫حُي‬ ٢ٛ ٕ‫ح٧ٓ٘خ‬ ‫ُِ٘ظخ٣خ‬ ‫حُٜل٤ق‬ ‫حَُى‬ ٢٘‫٣ؼ‬ ‫كٌٜح‬ ٞ٣َُِٔ‫حُؼظٔ٤ش‬٢‫ك‬ ‫أٓخ‬‫حُٔظؼيىس‬ ٌٍُٞٔ‫ح‬ٕ‫كب‬‫حُ٘ظخ٣خ‬ ‫اػخىس‬ٖ‫ػ‬‫ًخف‬ َ٤‫ؿ‬ ٕ‫ح٧ٓ٘خ‬ ‫١َ٣ن‬ ٝ‫ا‬ٗ‫كظق‬ ‫اؿَحء‬ ‫٣ـذ‬ ‫ٔخ‬َٗ‫ٓزخ‬)‫ر٘يس‬ ‫حُٔلظظش‬ ٌٍُٞٔ‫ح‬ ‫(ربٓظؼ٘خء‬ٝ‫ا‬‫حٌٍُٔٔٞس‬ ‫ُِ٘ظخ٣خ‬ ‫ٍى‬ ٠ِ‫ػ‬ َٜ‫ُ٘ل‬ ‫حُؼظٔ٤ش‬ ‫حُٔ٬هش‬ ّ‫ٓظوي‬ ‫حُٔلِ٤ش‬ ‫حُلخكش‬. *)‫اىرثثٍد‬Immobilization : +‫رٜخ‬ ٌْ‫٣ظل‬ ‫حُظؼز٤ض‬ ‫ٓيس‬ ٕ‫ا‬َٓ‫ػٞح‬ ‫ػيس‬: 1-ٌَُٔ‫ح‬ ‫ٓٞهغ‬. 2-ٌَُٔ‫ح‬ ٢‫ه‬ ُٖٔ‫ح‬ ‫ٝؿٞى‬. 3-ٞ٣َُٔ‫ح‬ َٔ‫ػ‬. 4-ٚ‫ؿ٤خر‬ ٝ‫أ‬ ٕ‫اٗظخ‬ ‫ٝؿٞى‬. ٝٚ٘‫ط‬ ‫هخػيس‬ ‫ٛ٘خى‬: ‫حُظؼز٤ض‬ ‫أٓخُ٤ذ‬: ْٔ‫٣٘و‬ ٕ‫ح٧ٓ٘خ‬ ‫ٝؿٞى‬ ‫ػ٘ي‬‫طؼز٤ض‬٢ِ‫حُٔل‬ ‫حُلي‬٠ُ‫ا‬ٖ٤‫ًز٤َط‬ ٖ٤‫ٓـٔٞػظ‬ ‫ح‬ ًٕٞ ٢‫ك‬ ٖ٣‫ٓؼظٔي‬َٗ‫حُٔزخ‬ ‫ُظؼز٤ض‬٫ ٝ‫أ‬ ٕ‫ح٧ٓ٘خ‬ ٠ِ‫ػ‬ 1-ٕ‫ح٧ٓ٘خ‬ ٠ِ‫ػ‬ ‫ٓؼظٔي‬ ‫طؼز٤ض‬: ‫أ‬-‫ٓزخَٗس‬ : ‫حُٔ٘٤ش‬ ‫حُو٤خ١ش‬ٝ‫أ‬‫حٌُِٔ٘ش‬ ‫حُلِوخص‬ ٠ِ‫ػ‬ ‫ٓؼظٔي‬. ‫م‬‫س‬ً‫قا‬ ً‫اىر‬ ‫تامشج‬ ‫ٍؼاىجح‬ ‫ذيقى‬ ‫اىضاوٌح‬ ً‫ف‬ ‫مسش‬ ‫ٍغ‬ ‫تاىغ‬ ‫شاب‬ ‫ػْذ‬ ‫ش‬‫أساتٍغ‬ ‫ثالز‬ / ‫اىنسش‬ ‫خظ‬ ٍِ ِ‫س‬ ‫تإصاىح‬ ‫تها‬ً‫ا‬‫إر‬: ‫أ‬-ً‫ا‬‫أسثىػ‬ ‫ّضٍف‬ ‫اىنسش‬ ‫خظ‬ ً‫ف‬ ِ‫اىس‬ ً‫تق‬. ‫ب‬-‫مسش‬‫وجىد‬ ‫ٍغ‬ً‫ا‬‫أسثىػ‬ ‫ّضٍف‬ ُ‫اإلّرا‬. ‫ج‬-‫ػَش‬40ٍِ‫أسثىػ‬ ‫إىى‬ ً‫ا‬‫أسثىػ‬ ‫ّضٍف‬ ‫فىق‬ ‫وٍا‬ ‫سْح‬. ‫د‬-‫ّح‬ ‫األطفاه‬‫ز‬ً‫ا‬‫أسثىػ‬ ‫ف‬.
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 29 ‫د‬-‫أ‬ ّٞ‫ه‬‫٣َى‬. ‫ؽ‬-: ‫حٍُِ٣ؼخص‬ ‫ى‬-ُ‫ح‬‫ـ‬‫حُوزؼ٤ش‬ َ‫زخث‬( ‫حُؤخٗ٤ش‬ ‫ح٧ٍرطش‬ ٝ‫أ‬Barton’s Bandage).
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 30 2-٢‫ك‬ َٗ‫حُٔزخ‬ ‫حُظؼز٤ض‬ْ‫حُؼظ‬: ‫أ‬-: ‫حُٔ٘٤ش‬ ‫حُو٤خ١ش‬‫آخ‬‫حُؼِٞ٣ش‬ ‫حُلخكش‬ ‫ه٤خ١ش‬ٝ‫أ‬‫حُٔلِ٤ش‬ ‫حُلخكش‬ ‫ه٤خ١ش‬ ‫د‬-‫حُيحثَ٣ش‬ ‫حُو٤خ١ش‬. ‫ؽ‬-‫حُؼظٔ٤ش‬ ‫حُٜلخثق‬. ‫ى‬-‫حُوخٍؿ٤ش‬ ‫حُظؼز٤ض‬ ْ٤‫ىرخر‬. ٙ-‫حُؼظٔ٤ش‬ ‫(حُٔوخُذ‬ ‫حُؼظٔ٤ش‬ ٍ‫ح٧ٝطخ‬. ) ٝ-‫رؤٓ٬ى‬ ٍٞ‫حُ٘و‬ ‫حُظؼز٤ض‬ًَٗٞ٘٤. ْ‫حُؼظ‬ ٢‫ك‬ َٗ‫حُٔزخ‬ ‫ُِظؼز٤ض‬ ‫اٟخكش‬ ٕ‫ح٧ٓ٘خ‬ ‫طؼز٤ض‬ َ٠‫حُٔل‬ ٖٓ ٚٗ‫ا‬. a)-ٕ‫ح٧ٓ٘خ‬ ٠ِ‫ػ‬ ‫حُٔؼظٔي‬ ‫حُظؼز٤ض‬: 1-٤‫ؿ‬ ٌَٗ ‫ًحص‬ ٕ‫ح٧ٓ٘خ‬ ًٕٞ ٍ‫كخ‬ ٢‫ك‬ ّ‫طٔظوي‬ :‫حُٔ٘٤ش‬ ‫حُو٤خ١ش‬ٝ ‫ي‬ٝ . ‫ٓ٘خٓذ‬٩‫ح‬ َ‫هز‬ ‫حُِٔي‬ ‫ٗي‬ ‫٣ـذ‬ّ‫ٓظويح‬ (ٚ‫طٔط٤ط‬)10%) ‫٫كوخ‬ ‫حُِٔي‬ ‫اٍطوخء‬ ‫ُٔ٘غ‬ (ٝ ،٢‫طٞه‬ ‫٣ـذ‬ُ ‫حُِٔي‬ ٢ٓ ٖٓ ٌٍ‫حُل‬ٝ ‫٣خىس‬‫ا‬ٝ ً‫خ‬٤ٓ‫هخ‬ ‫ٓ٤ٜزق‬ ٫٩‫ح‬ ‫َٓ٣غ‬‫ٗوطخع‬. ُ٘ٔ‫ح‬ ‫ُِو٤خ١ش‬ ‫١َم‬ ‫ػيس‬ ‫ٟٝؼض‬‫٤ش‬: ‫أ‬.ٍٞ‫رط‬ ‫ِٓي‬ ٌ‫٣ئه‬ :‫حُٔزخَٗس‬ ‫حُو٤خ١ش‬15ٝ ْٓٝ ٙ‫١َكخ‬ ‫٣ـٔغ‬ ْ‫ػ‬ ،ُٖٔ‫ح‬ ٍٞ‫ك‬ ‫٣ِق‬ٍٞ‫رط‬ ‫حُِٔي‬ ٌَ٘٣4-7 ٝ ْٓ، ٢ِ‫حُٔل‬ َٙ٤‫ٗظ‬ ‫ٓغ‬ ١ِٞ‫حُؼ‬ ٕ‫حُٔظًَٝخ‬ ٕ‫حُطَكخ‬ ‫٣ـٔغ‬ ٌَُٔ‫ح‬ ‫ٍى‬ ‫رؼي‬ ٞٛ ٚ‫ٓ٤جخط‬ُ ‫حُلخؿش‬ ‫ػ٘ي‬ًَ ‫اُحُش‬ ١‫أ‬ ‫حُظؼز٤ض‬ ًَ َٜ‫ك‬ ‫٣ـذ‬ َ‫أه‬ ‫١خٍة‬ ١٧ ٝ‫أ‬ ‫حُلًَش‬ ٚ‫ُلل‬ ٢ِ‫حُٔل‬ ٖ‫ػ‬ ١ِٞ‫حُؼ‬ ‫حُلي‬ َ٣َ‫ظل‬ ‫ح٧ٓ٬ى‬. ‫حُلِوخص‬ ‫ًحص‬ ‫حُٔ٘٤ش‬ ‫حُو٤خ١ش‬ .‫د‬(٢‫ا٣ل‬ َٟ‫ػ‬)ٍٞ‫رط‬ ‫ِٓي‬ ٌ‫٣ئه‬ :15ٝ ْٓ‫ٓ٘زِش‬ ٠ِ‫ػ‬ ‫٣ِق‬) ‫أىحس‬ ١‫أ‬ ٝ‫أ‬ ( ‫هطَٛخ‬3‫حُٔ٘٤ش‬ ‫رخُٔٔخكش‬ َ‫طيه‬ ْ‫ػ‬ ٖ٤‫ىٍٝط‬ ِْٓ‫حُِٔخٗ٤ش‬ ‫حُـٜش‬ ٖٓ(1)ٖٝ٤ُ٘ٔ‫ح‬ ٍٞ‫ك‬ ً‫خ‬٣ِ٤ِٛ‫ى‬ ‫حُِٔي‬ ‫٣ؼخى‬ٖ٣ٍٝ‫حُٔـخ‬(2)ْ‫ػ‬ ٖ٤ٌُِٔ‫ح‬ ‫٣ـٔغ‬(3-4)‫رؤٓ٬ى‬ ‫حُلِوخص‬ ‫طـٔغ‬ .‫حُظؼز٤ض‬ ‫ًِل٤ش‬ ‫ٓلِ٤ش‬ ‫كِوخص‬ ْٔ‫ٝه‬ ‫ػِٞ٣ش‬ ‫كِوخص‬ ْٔ‫ه‬ .‫حُظؤًي‬ ‫رؼي‬ َٟ‫أه‬ ٝ َُٝ‫ح‬ ‫رٔ٘طوش‬ ‫ٗزيأ‬ ، ‫ح٩١زخم‬ ‫ٟٝؼ٤ش‬ ٖٓٝ ‫ح٧ٓخٓ٤ش‬ ‫حُٔ٘طوش‬ ‫ٗؼزض‬ ْ‫ػ‬ ‫ٝحكي‬ ‫رطَف‬ ٖ٤‫حُطَك‬ ‫ٗ٘ي‬ٝ ‫حُِٔي‬ ٚ‫ٗو‬‫حُـِء‬ ٢٘‫ٗؼ‬ ‫حُلٔٞ٣ش‬ ‫حُ٘ٔؾ‬ ‫٣ـَف‬ ٫ ٠‫كظ‬ ٚ٘ٓ ٢‫حُٔظزو‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 31 2-‫أ‬ ّٞ‫ه‬‫٣َى‬‫ؿخِٛس‬ ّ‫أهٞح‬ ٢ٛ :‫ٓظلَهش‬ ِ٤ٓ‫ٜٓخ‬ ٟٞ‫طل‬ٍٞ‫حُط‬ ٚ‫ه‬ ْ‫٣ظ‬ ٝ ‫حُٔ٘خٓذ‬ٌَٗ ٠‫٣ؼط‬ّٞ‫ه‬‫٣ؼزض‬ ٝ ٟ‫كي‬ ٠ِ‫ػ‬ ًَ ٕ‫رخ٧ٓ٘خ‬ ٢‫٣َر‬ ٝ ‫رؼ٠ٜخ‬ ‫ٓغ‬ ‫حُٔظوخرِش‬ ِ٤ٓ‫حُٜٔخ‬ ٢‫رَر‬ ٖ٤ٌ‫حُل‬. 3-‫حُوزؼ٤ش‬ َ‫حُـزخث‬:٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ٍ‫أٌٗخ‬ ‫ؿٔ٤غ‬ ٢‫ك‬ ّ‫طٔظوي‬ ‫ٓغ‬ٝ ‫حُيحثٔش‬ ٕ‫ح٧ٓ٘خ‬ ‫ٝؿٞى‬‫كخ‬ ٢‫ك‬ ‫ٓٔظويٓش‬ َ٤‫ؿ‬ ٢ٛٝ‫أ‬ ‫ح٧ً٣ش‬ ‫رٔزذ‬ ٕ‫ح٧ٓ٘خ‬ ٕ‫كويح‬ ٍ‫ا‬ٝ ‫حُيحػٔش‬ ‫حُ٘ٔؾ‬ ‫ُظٜخد‬ٌَٙٛ‫حُـزخث‬ ‫حُٔظزيُش‬ ٌٍُٞٔ‫ح‬ ٢‫ك‬ ٌ٤‫حُظ٘ل‬ ‫ٛؼزش‬. b)-‫أٓخُ٤ذ‬ْ‫حُؼظ‬ ٢‫ك‬ َٗ‫حُٔزخ‬ ‫حُظؼز٤ض‬: 1-١‫حَُرخ‬١َ‫حُيحث‬. 2-ْٖٟٔ‫حُؼظ‬: ‫أ‬.‫حُو٤خ١ش‬‫حُؼظٔ٤ش‬. ‫د‬.‫حُٜل٤لش‬‫حُؼظٔ٤ش‬. ‫ؽ‬.‫أٓ٬ى‬َ٘٘٣ًَ. 3-ْ٤‫حُظطؼ‬٢ٔ‫حُؼظ‬. 4-‫هخٍؽ‬ْ‫حُؼظ‬: ‫أ‬.‫حُظؼز٤ض‬ْ٤‫رخُيرخر‬. ‫د‬.‫حُٔوخُذ‬‫حُؼظٔ٤ش‬. 1-َِ‫ض‬ ‫اىخٍاطح‬‫اىؼظٍَح‬: ٝ‫حَُى‬ ٠ٔٔ‫ط‬‫حُٔلظٞف‬.‫حُِحٝ٣ش‬ ً‫خ‬٘ٔ٠‫ٓظ‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ًَٔ ‫ُظؼز٤ض‬ ‫كؼخُش‬ ‫١َ٣وش‬ ٢ٛ ٌَُٔ‫ح‬ ٢‫ه‬ َ‫ػز‬ ‫حُؼظٔ٤ش‬ ‫حُو٤خ١ش‬‫أٓخ‬ . ‫حُٔزي‬‫ػوذ‬ ٖ‫ػ‬ ‫ػزخٍس‬ ٜٞ‫ك‬ ‫أ‬٬ً ٠ِ‫ػ‬ ْ‫حُؼظ‬‫ؿخٗز‬٢‫ح‬ُٝ ٌََٔ٣َٔ‫ط‬‫أٓ٬ى‬0.45‫حُ٬ٛية‬ ً٫ٞ‫حُل‬ ٖٓ َِْٓ‫ػز‬ُ‫ح‬‫كلَص‬ ٢‫حُظ‬ ‫ؼوٞد‬ ٌَُِٔ ‫حُيه٤ن‬ ‫حَُى‬ ‫رؼي‬ٝ ‫حُٜ٘خ٣خص‬ ٌٙٛ ‫ٗوطغ‬ ْ‫ػ‬ ّ‫ربكٌخ‬ ‫ح٧ٓ٬ى‬ ‫أ١َحف‬ ٝ‫أ‬ ‫ٜٗخ٣خص‬ ‫ٗ٘ي‬٘‫طؼ‬‫حُؼوٞد‬ ‫أكي‬ َ‫ىحه‬ ٢١‫ُظلخى‬ ( ) ٖ٣َ‫حُظو‬ٌَُٔ‫ح‬ ‫٣َى‬ .‫ا‬ٕ‫ح٧ٓ٘خ‬ ‫ا١زخم‬ ٠ِ‫ػ‬ ً‫ح‬‫ػظٔخى‬. ‫ػ‬ ‫٣ـذ‬ّ‫ي‬‫هط‬ ٖٓ ‫٣ِ٣ي‬ ‫حُو٤خ١ش‬ ‫ططز٤ن‬ ٕ٧ ٌَُٔ‫ح‬ ٕ‫ح٩ٗظخ‬ ‫٣ٜ٤ذ‬ ‫ػ٘يٓخ‬ ‫حُؼظٔ٤ش‬ ‫حُو٤خ١ش‬ ‫ططز٤ن‬ٝ ْ‫حُؼظ‬ ٢‫ٜٗخ٣ظ‬ ‫طٔٞص‬ ‫كيٝع‬ َ ‫كيٝع‬‫ا‬٢‫ٝٗو‬ ْ‫ػظ‬ ‫ُظٜخد‬.
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 32 2-ٌ‫اىذائش‬ ‫اىخٍاطح‬: ‫ح‬ ٝ ٕ‫ُ٨ٓ٘خ‬ َٓ‫حٌُخ‬ ‫حُلوي‬ ‫ػ٘ي‬ ٝ ٍ‫ح٧١لخ‬ ٟ‫ُي‬ َٔ‫طٔظؼ‬ ‫ٓخ‬ ‫ؿخُزخ‬‫حُ٬ٛية‬ ً٫ٞ‫حُل‬ ٖٓ ‫ِٓي‬ َ٣َٔ‫ط‬ ٠ِ‫ػ‬ ‫طؼظٔي‬ ٢ٛ0.5ٍٞ‫ك‬ ْٓ ٢‫ٛ٘خػ‬ ٞ٣ٞ‫طؼ‬ ٖٓ ‫رخ٩ٓظلخىس‬ ٝ‫أ‬ ‫ٓخروخ‬ ‫ٓؼي‬ ‫ا٣َى‬ ّٞ‫رو‬ ‫آخ‬ ٌَُٔ‫ح‬ ٢‫ٍر‬ ْ‫٣ظ‬ ٝ ٢ِ‫حُٔل‬ ‫حُلي‬ ٢٤‫ٓل‬‫ٓخرن‬‫ؿ٤ي‬. ٝ ‫أىٍى‬ ٞ٣َُٔ ‫أً٣ش‬ ‫كيٝع‬ ٍ‫كخ‬ ٢‫ك‬‫كيٝع‬ ٕٝ‫ى‬ ً‫خ‬ٔ٤ِٓ َٓ‫حٌُخ‬ ٢٠٣ٞ‫حُظؼ‬ ُٙ‫ؿٜخ‬ ٠‫٣زو‬ ٕ‫أ‬ ٌٖٔ٣ ٢ِ‫حُٔل‬ ‫حُلي‬ ٢‫ك‬ ًَٔ ٍٜٞ‫ك‬ ‫أً٣ش‬ ً‫خ‬ٗ‫أك٤خ‬ ً‫خ‬‫ٓليػ‬ ٚٔ‫ك‬ ٖٟٔ ٌَٔ٘٣ ٕ‫أ‬ ٝ‫أ‬ ٚ٤‫ك‬ ًَٔ‫حَُهٞس‬ ‫حُ٘ٔؾ‬ ٢‫ك‬ٌٖٔ٣ ً‫خ‬ٔ٤ِٓ ُ‫حُـٜخ‬ ٢‫رو‬ ‫اًح‬ .‫ا‬‫ُِو٤خ١ش‬ ٚٓ‫ٓظويح‬ ٢ُ‫ًخُظخ‬ ‫اًَ٣ِ٤ش‬ ‫ؿز٤َس‬ ‫اؿَحء‬ ٌٖٔ٣ ُ‫حُـٜخ‬ ‫ٌٛح‬ ٕ‫كويح‬ ٍ‫كخ‬ ٢‫ك‬ ‫أٓخ‬ ‫حُيحثَ٣ش‬: ٝ ‫ح٧ٓؼِش‬ ‫ىٍحٓش‬ ٍ‫كخ‬ ٢‫ك‬ ‫ح٧ىٍى‬ ‫حُلي‬ ‫١زؼخص‬ ٌ‫طئه‬‫كِٜٜخ‬) ٌَُٔ‫ح‬ ٢‫ك‬ ‫ًٔخ‬ (ٌٖٝٔٓ ٌَٗ ‫٧هَد‬ ‫اػخىطٜخ‬‫ػ‬ْٗ‫ٜ٘غ‬‫حُـز٤َس‬ ٠ِ‫ػ‬ َٜ‫ك٘ل‬‫ا‬ٝ ‫ُِٔ٤ِحد‬ ‫ٗطزخع‬ٝ ‫حُ٘ٔ٤ؾ‬٫ ٢ُ‫رخُظخ‬‫٣ليع‬١‫أ‬ ‫ُي٣٘خ‬‫اُػخؽ‬ُٞ٣َِٔ. ٝ ٌَُٔ‫ح‬ ٕ‫ٌٓخ‬ ‫ٓغ‬ ‫طظٞحكن‬ ٢ِ‫حُٔل‬ ُ‫حُـٜخ‬ ٠ِ‫ػ‬ ‫ػوٞد‬ ‫اؿَحء‬ ٌٖٔ٣ ُ‫حُـٜخ‬ ‫روخء‬ ٍ‫كخ‬ ٢‫ك‬ ‫أٓخ‬‫ح٧ٓخٓ٤ش‬ ‫حُٔ٘طوش‬ ٢‫ك‬ ‫كظلخص‬ ‫اؿَحء‬ َ‫ىحث‬ ‫رو٤خ١ش‬ ٢ِ‫حُٔل‬ ُ‫حُـٜخ‬ ‫طؼز٤ض‬ ٢‫٣ٌل‬ ً‫خ‬ٗٝ‫ٓظؼخ‬ ًٚٗٞ ٍ‫كخ‬ ٢‫كل‬ ٞ٣َُِٔ ‫رخُ٘ٔزش‬ ‫أٓخ‬ٝ ‫طؼز٤ض‬ ٕٝ‫ى‬ ١ِٞ‫حُؼ‬ ُ‫حُـٜخ‬ ‫روخء‬ ‫ٓغ‬ ‫٣ش‬ ٝ ٖ‫حٌُه‬ ّ‫كِح‬ ٝ‫أ‬ ّ‫حَُأ‬ ٍٞ‫ك‬ ١َ‫ىحث‬ ١‫ٍرخ‬ ‫ٗ٠غ‬ٗ ٢ً ‫ًُي‬‫ٔ٘غ‬ٖ‫ك٘ل‬ ٕٝ‫ٓظؼخ‬ َ٤‫ؿ‬ ٞ٣َُٔ‫ح‬ ًٚٗٞ ٍ‫كخ‬ ٢‫ك‬ ‫أٓخ‬ ،٢ِ‫حُٔل‬ ‫حُلي‬ ‫كًَش‬ ٝ ْ‫حُؼظ‬ ٖٟٔ ‫رو٤خ١ش‬ ١ِٞ‫حُؼ‬ ُ‫حُـٜخ‬ ‫ُظؼز٤ض‬ َٕٝ‫ٓ٠ط‬ً‫خ‬‫ٓخرو‬ ‫أؿَ٣ض‬ ٢‫حُظ‬ ‫حُؼوٞد‬ َ‫ػز‬ َٔ‫ط‬ ‫رؤٓ٬ى‬ ٖ٣ُ‫حُـٜخ‬ ‫٣ؼزض‬. ‫١َ٣وش‬َٔ‫حُؼ‬: ‫أٓ٬ى‬ ‫ٓغ‬ ٖ٤‫ػو‬ ‫ارَس‬ ّ‫ٍأ‬ ٝ‫أ‬ ٕ‫ٍ٣لَىح‬ ‫ارَس‬ ّ‫طٔظوي‬0.45ِْٓ،ٝ ٌَُٔ‫ح‬ ٕ‫ٌٓخ‬ ‫٣ليى‬٠ِ‫ػ‬ ٕ‫ح٧ٓ٘خ‬ ‫ا١زخم‬ ‫ػ٘ي‬ ‫ػوٞد‬ َٟ‫طـ‬ ٝ ٌَُٔ‫ح‬ ‫ؿٜش‬ ٖ٤‫١َك‬ ًَ ٠ِ‫ػ‬ ‫ػوذ‬ ، ٢ِ‫حُٔل‬ ُ‫حُـٜخ‬َٟ‫ح٧ه‬ ‫حُـٜش‬ ٢‫ك‬ ‫ػوذ‬ٝ ،ً‫خ‬ٓ‫ػخ‬ ً‫ح‬َ٣‫طوي‬ ٞ٣َُٔ‫ح‬ َ٣‫طوي‬ ‫رؼي‬‫ارَس‬ َ‫ٗيه‬ ٓ ٢ٔ٤ٔٛ ّ‫رظٔخ‬ ‫حُـِي‬ ٖٓ ٕ‫ٍ٣لَىح‬ْ‫حُؼظ‬ ‫غ‬ٝ ‫حُِٔخٗ٤ش‬ ‫حُـٜش‬ ٖٓ ‫طوَؽ‬ ٠‫كظ‬‫ح٩رَس‬ ‫حُؼوذ(ػوذ‬ ٖٟٔ ‫حُِٔي‬ َ‫٣يه‬ ‫ػ٘يٛخ‬ (1)ٝ )‫حُـِي‬ ‫ػزٍٞٛخ‬ ٕٝ‫ى‬ ٌٍ‫رل‬ ‫ح٩رَس‬ ‫طٔلذ‬(2)ُٝ‫ح‬ ‫حُـٜش‬ ٖٓ ‫طيكغ‬ ْ‫حُؼظ‬ ٖٓ ‫طلٍَٛخ‬ ‫ػ٘ي‬‫ي‬‫ِٛ٤ِ٣ش‬(3)ٝ‫هَٝؿٜخ‬ ‫ػ٘ي‬٢‫َٗر‬ ٞ٣َُٔ‫ح‬ ُ‫ؿٜخ‬ ‫ٓغ‬ ‫حُِٔي‬ ٢‫١َك‬ٖٝ٤‫ح٧ه٤َط‬ ٖ٤‫حُٔ٘طوظ‬ ٢‫ك‬ َٔ‫حُؼ‬ ٌٍَ٣. ‫حُؼِٔ٤ش‬ ‫١٤ِش‬ ْ‫حُؼظ‬ ‫ٓغ‬ ٢ٔ٤ٔٛ ّ‫رظٔخ‬ ٕ‫ٍ٣لَىح‬ ‫ارَس‬ ٠‫طزو‬ ٕ‫أ‬ ‫٣ـذ‬ ُِ ‫رخُ٘ٔزش‬١ِٞ‫حُؼ‬ ُ‫ـٜخ‬ٌٖٔ٣‫ح٧ٗق‬ ‫ٗٞى‬ ٠ِ‫ػ‬ ‫حُظؼز٤ض‬ ‫اؿَحء‬‫ك٤غ‬‫حُٔ٘طوش‬ ٢‫ك‬ ١ِ٤ِٛ‫حُي‬ ‫حُٔ٤ِحد‬ ٢‫ك‬ ١ٞٔ‫ك‬ َ‫ىحه‬ ‫ٗن‬ ١َ‫٣ـ‬ ٝ ‫ح٧ٓخٓ٤ش‬ٝ ‫ح٧ٗق‬ ‫ُ٘ٞى‬ َٜٗ ٠‫كظ‬ ‫حُٔ٘طوش‬ ‫طِٔن‬ٝ ‫ح٧ٗق‬ ‫ٗٞى‬ ٢‫ك‬ ً‫خ‬‫ػوز‬ ١َ‫ٗـ‬ْ‫ػ‬ ‫ِٓي‬ َٙ‫ػز‬ ٍَٔ٣ٖ٤‫ػوزظ‬ ٢‫ك‬ ‫حُِٔي‬ َٔ٣ ٝ ُ‫حُـٜخ‬ ‫ؿ٘خف‬ ٠ِ‫ػ‬ ‫أؿَ٣خ‬،‫حُِٔي‬ ‫ٗي‬ ْ‫٣ظ‬ ْ‫ػ‬ ‫حُ٘ن‬ ٢٤‫٣و‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 33 ‫حُظؼز٤ض‬ ‫اؿَحء‬ ‫ػ٘ي‬ ‫رخ٧ٓ٬ى‬ ‫ٓٞ٣ش‬ ٖ٣ُ‫حُـٜخ‬ ‫ٗؼزض‬ ‫حُ٘خر٤ش‬ ‫حُٔ٘طوش‬ ٢‫ك‬٢‫ك‬ ‫ػوذ‬ َ‫ٝ٣لل‬ ْ‫ُِؼظ‬ َٜٗ ٠‫كظ‬ ‫حُ٘ٔ٤ؾ‬ ‫ٝٗزؼي‬ ‫حُ٘خد‬ ‫ٓ٘طوش‬ ‫ػ٘ي‬ ١ِ٤ِٛ‫حُي‬ ‫حُٔ٤ِحد‬ ٢‫ك‬ ً‫خ‬‫ٗو‬ ١َ‫ٗـ‬ ، َٙ‫ػز‬ َٔ٣ٝ ‫حُوخٍؿ٤ش‬ ‫حُوَ٘س‬َ‫ح٥ه‬ ‫حُطَف‬ ٠ِ‫ػ‬ َٔ‫حُؼ‬ ٌٍَ٣ٝ ُ‫حُـٜخ‬ ‫ٝ٣ؼزض‬ ‫حُِٔي‬. ‫حُٔلِ٤ش‬ ‫حُلـخؽ‬ ‫كخكش‬ ‫ػ٘ي‬ َ٤‫ٛـ‬ ‫ٗن‬ ١َ‫٣ـ‬ ١ٍ‫حُؼٌح‬ ّٞ‫حُو‬ ٍٞ‫ك‬ ‫حُظؼز٤ض‬ ‫ػ٘ي‬ ‫أٓخ‬،‫طوَؽ‬ ٠‫كظ‬ ‫ح٩رَس‬ َٔ‫ٝط‬ ٕ‫ٍ٣لَىح‬ ‫ارَس‬ َ‫طيه‬ َٔ‫ط‬ ‫ًُي‬ ‫رؼي‬ ‫حُـِي‬ ٖٓ ‫هَٝؿٜخ‬ ٕٝ‫ى‬ ‫ٝطٔلذ‬ ‫ُ٪رَس‬ ‫حُِٔي‬ ْ٠٣ ْ‫ػ‬ ١ٍ‫حُؼٌح‬ ّٞ‫حُو‬ ٢ٔٗ‫أ‬ ١ِ٤ِٛ‫حُي‬ ‫حُٔ٤ِحد‬ ٖٓ٢٘‫ٝك‬ ‫ح٩رَس‬ ٝ ّٞ‫حُو‬ٝ ١ِ٤ِٛ‫حُي‬ ‫حُٔ٤ِحد‬ ٖٓ ‫طوَؽ‬َ‫ح٥ه‬ ‫حُطَف‬ ٠ِ‫ػ‬ َٔ‫حُؼ‬ ٌٍَ٣ٝ ُ‫حُـٜخ‬ ‫ؿ٘خف‬ ٠ِ‫ػ‬ ١َ‫أؿ‬ ‫ػوذ‬ ٢‫ك‬ ٕ‫حٌُِٔخ‬ ‫٣ـٔغ‬. 3-‫اىؼظٍَح‬ ‫اىصفائح‬: ًٍٞٔ ‫ٓؼخُـش‬ ٢‫ك‬ ‫حُؼظٔ٤ش‬ ‫ُِٜلخثق‬ ‫ح٧ٓخٓ٤ش‬ ‫حُلخثيس‬ ٝ ‫رَى‬ ‫طِٝىٗخ‬ ‫رؤٜٗخ‬ ٢ِ‫حُٔل‬ ‫حُلي‬‫طؼز٤ض‬‫طؼز٤ض‬ ٕٝ‫ى‬ َ٠‫أك‬ ٝ ، ٖ٤ٌ‫حُل‬ٌٖٔ٣‫ا‬ًٍٞٔ ًَ ٢‫ك‬ ‫حُطَ٣وش‬ ٌٙٛ ّ‫ٓظويح‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ‫٣ظطِذ‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ٠ِ‫ػ‬ ‫حُؼظٔ٤ش‬ ‫حُٜلخثق‬ ‫ططز٤ن‬ ٝ ‫ٓليىس‬ ‫طو٘٤خص‬ٝ ّ‫حُؼخ‬ َ٣‫حُظوي‬ ٖٓ َ٣ٞ١ ‫ٝهض‬ ً‫خ‬٠٣‫أ‬ ‫حُلخ٫ص‬ ْ‫ٓؼظ‬ ٢‫ك‬ ‫حُـَحك٤ش‬ ‫حُٜٔخٍس‬ ٖٓ ‫ٓؼظزَس‬ ‫ىٍؿخص‬ ‫ؿِي٣ش‬ ‫ٗوٞم‬ َ‫ػز‬ ‫حُٜلخثق‬ ‫ططزن‬. ‫ٛ٘خى‬‫أٗٞحع‬ ‫ػيس‬‫ُِٜلخثق‬: ‫أ‬-: ‫رٔ٤طش‬ ‫ػظٔ٤ش‬ ‫ٛلخثق‬ٗ‫ٔظوي‬‫ًٞرخُض‬ ‫هِ٤طش‬ ّ–ًَّٝ–ٍٞ١ ‫ًحص‬(1ٝ ٖٗ‫ا‬ )‫حُوَ٘٣ش‬ ‫حُٜل٤لش‬ ٠ِ‫ػ‬ ‫ططزن‬ ‫حَُى‬ ‫رؼي‬ ‫رَحؿ‬ ٖ٤ٓ‫ٓٔظوي‬ ‫حُوخٍؿ٤ش‬َ‫هط‬ ‫ًحص‬ ٢1.5ٝ ٍِْٓٞ١7. ِْٓ‫أ‬‫طٌ٤لٜخ‬ ٌٖٔ٣ ٢‫حُظ‬ ّٞ٤ٗ‫حُظ٤ظخ‬ ‫رٜلخثق‬ ‫حُٜلخثق‬ ٌٙٛ ‫ٓظزيُض‬ َٜٓ‫أ‬ ٌَ٘‫ر‬. ‫د‬-‫حُ٠خؿطش‬ ‫حُٜلخثق‬:َ‫حُوط‬ . ‫طَ٘٣ل٤ش‬ ‫٧ٓزخد‬ ٝ .ٌَُٔ‫ح‬ ٢‫ه‬ ‫هَد‬ ‫٣ظٟٞغ‬ ‫ُِؼوٞد‬ َٝ‫ح٧ػ‬َ‫٣يه‬ َ‫ػز‬ ٢‫حُزَؿ‬‫ٝػ٘ي‬ ‫حُزيح٣ش‬ ٢‫ك‬ َ‫ح٧ٛـ‬ َ‫حُوط‬‫ٜٗخ٣ش‬‫حُ٘ي‬ ٢‫حُزَؿ‬ ‫٣ٜزق‬ٝ َ‫ح٧ًز‬ َ‫حُوط‬ ‫ػ٘ي‬‫ُِؼوٞد‬ ٌٖٔ٣ ٠ِ‫ػ‬ ٝ‫أ‬ ٌَُٔ‫ح‬ ٢‫ه‬ ٢‫ؿخٗز‬ ٠ِ‫ػ‬ ‫طظٟٞغ‬ ٕ‫أ‬ ‫حُ٠خؿطش‬ . ٢‫كو‬ ‫ٝحكي‬ ‫ؿخٗذ‬ ‫ططٍٞص‬‫ح٧كو٤ش‬ ‫حُ٠خؿطش‬ ‫حُٜلخثق‬٠ُ‫ا‬‫ٛلخثق‬‫ًحص‬ ‫ؿخٗز٤ش‬ ‫ػوٞد‬‫رِحٝ٣ش‬ ‫ٓخثِش‬454ٝ‫ططزن‬ ٢‫حُظ‬‫ٓزخَٗس‬ ‫حُؼِٞ٣ش‬ ‫حُلخكش‬ ٠ِ‫ػ‬ٝ‫ػ٘ي‬ٓ٢‫ك‬ ّ‫ربكٌخ‬ ٢‫حُزَؿ‬ ‫٣٘ي‬ ‫خ‬ ٚٗ‫ٌٓخ‬٣ ٫‫ليع‬٩‫رخ‬ ٌَُٔ‫ح‬ ٢‫ُو‬ َ٤ٓ‫ٗلظخف‬.
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 34 ‫ؽ‬-‫ُؼ‬ ‫طلظخؽ‬ ٫ ٢‫حُظ‬ ٝ ‫حُٔٔظٜش‬ ‫حُٜلخثق‬. ‫٩ُحُظٜخ‬ ٢ٗ‫ػخ‬ ٢‫ؿَحك‬ َٔ )+‫ا‬‫هظ٬١خص‬‫ا‬ٝ ‫حُٜلخثق‬ ّ‫ٓظويح‬٢ٛ: *٩‫ح‬٢ٗ‫حُٔؼي‬ ‫ٍط٘خف‬) ‫حُوي٣ٔش‬ ‫حُ٘ٔخًؽ‬ ٢‫ك‬ (. *‫حُٜل٤لش‬ ًَٔ، *ْ‫حُؼظ‬ ٢‫ٜٗخ٣ظ‬ ‫طٔٞص‬. *٢‫حُزَحؿ‬ ٍ‫اىهخ‬ ‫ػ٘ي‬ ْ‫حُؼظ‬ ٢‫ٜٗخ٣ظ‬ ٖٓ ‫ٛـ٤َس‬ ‫ٗظخ٣خ‬ ًَٔ. ‫حُـٜي‬ ًَٔ * *ٝ ْ‫حُؼظ‬ ‫طٔٞص‬ ‫ٓغ‬ ٕ‫ح٩ٗظخ‬ َ‫هط‬ ٞٛ ٚ٘ٓ ٌٍ‫حُل‬ ٢‫طٞه‬ ‫٣ـذ‬ َ‫هط‬ ْٛ‫أ‬٢‫ح٧ؿ٘ز‬ ْٔ‫ُِـ‬ ٞ‫حَُك‬. 4-‫اىذتاتٍس‬:‫اىَثثرح‬ ‫اىخاسجٍح‬ ٝ .‫٣ليع‬ ‫هي‬ ‫حُلي‬ ْٔ‫ؿ‬ ٖٓ ‫ُـِء‬ ٝ‫أ‬ َٓ‫ٌُخ‬ ‫ٗي٣ي‬ ‫طلظض‬ ‫كخ٫ص‬ ‫ٛ٘خُي‬ِ‫ػ‬ ‫ٗلخكع‬ ٢ٌُ٠ٓ‫٬ٓش‬‫ك٤ٞ٣ش‬ َٟٝ‫حٌُز‬ ‫حُ٘ظ٤ش‬ ً‫خ‬‫ؿخُز‬ ٚ‫ططز٤و‬ ٌٖٔ٣ ْ٤‫رخُيرخر‬ ٢‫حُوخٍؿ‬ ‫كخُظؼز٤ض‬.
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 35 ‫طظ‬ ‫حُظو٘٤ش‬٢‫ك‬ ٚ‫ِو‬ّٞ٤ٗ‫حُظ٤ظخ‬ ْ٤‫حُيرخر‬ ٖٓ ‫ُٝؽ‬ ٍ‫اىهخ‬3‫حَُث٤ٔ٤ش‬ ‫حٌُز٤َس‬ ‫حُ٘ظخ٣خ‬ ٖٟٔ ‫حُ٬ٛية‬ ً٫ٞ‫حُل‬ ْ٤‫ىرخر‬ ٖٓ ‫ُٝؽ‬ ٝ‫أ‬ ِْٓ ٝ ٢ٔ٤‫ٍث‬ َٜ‫ٓل‬ ‫رٞحٓطش‬ ْ٤‫حُيرخر‬ ٌٙٛ ‫ٝطـٔغ‬ٖ٤ٌ‫حُل‬ ‫طؼ٤زض‬ ٠ُ‫ا‬ ‫طلظخؽ‬ ً‫خ‬‫ؿخُز‬. )+‫ح٫ٓظطزخرخص‬ ْٛ‫أ‬: ‫ح‬ ‫حُو٤خ١ش‬ ‫ك٤غ‬ ٕ‫رخ٩ٗظخ‬ ‫ٜٓخد‬ ًَٔ ٢‫ك‬ ‫طؼز٤ض‬ ٖ٤ٓ‫ُظؤ‬ .‫أ‬ٝ ‫ُؼظٔ٤ش‬٩‫ح‬ ‫ٓ٠خى‬ ‫حُؼظٔ٤ش‬ ‫حُٜلخثق‬‫ٓظطزخرخص‬. ‫حُٔظلظظش‬ ٌٍُٞٔ‫ح‬ ٢‫ك‬ .‫د‬. ٝ ١ِٞ‫حُؼ‬ ‫حُلي‬ ًٍٞٔ ‫ٓؼخُـش‬ ٢‫ك‬ .‫ؽ‬ُٔ‫ح‬" ٌَٗ ‫ًح‬ ‫حُظؼز٤ض‬ ّ‫٣ٔظوي‬ ‫ك٤غ‬ ٢ِ‫ل‬٢‫حُٜ٘يٝه‬ ‫حُظؼز٤ض‬" . 5-‫اىَخاىة‬:‫اىؼظٍَح‬ ‫كٔٞ٣ش‬ ‫هخٍؽ‬ ‫رطَم‬ ‫طـٔغ‬ ٢‫رَحؿ‬ ‫حُٔوخُذ‬ ٖٓ ‫٣وَؽ‬ ْ‫ػ‬ ٢ِ‫حُٔل‬ ‫ُِلي‬ ‫حُٔلِ٤ش‬ ‫حُؼظٔ٤ش‬ ‫حُٔوخُذ‬ ‫طٟٞغ‬ٝ‫طؼز٤ض‬. 6-‫مش‬ ‫أسالك‬ ‫تىاسطح‬ ‫اىْقىه‬ ‫اىرثثٍد‬ٌ‫ش‬ْ‫ش‬: ‫أ‬‫أٓ٬ى‬ ‫ٓظويٓض‬٘٣ًَ٘ٝ‫أ‬ ًٍَ‫ح٧١لخ‬ ‫ػ٘ي‬ ً‫خ‬٤ِٔ‫ػ‬ ‫َٗ٘ي‬ٝ .ٌٖٔ٣‫ا‬ٕ‫أٓ٘خ‬ ٠ِ‫ػ‬ ‫كخٝ٣ش‬ ‫حُ٘ظخ٣خ‬ ٍ‫كخ‬ ٢‫ك‬ ‫حُطَ٣وش‬ ٌٙٛ ّ‫ٓظويح‬ ً٫ٝ‫أ‬ٝ‫ح٧ٗٔذ‬ َٟ‫ح٧ه‬ ‫ح٧ٓخُ٤ذ‬ َ‫طٞك‬ ّ‫ػي‬. c-‫ا‬٤‫حُظؼز‬ ‫أِٓٞد‬ ٍ‫هظ٤خ‬: ‫ض‬ *‫٣ـذ‬‫ا‬ٖٓ‫طئ‬ ٢‫حُظ‬ ‫ُِظؼز٤ض‬ ٢ٔ‫ح٧ر‬ ‫حُطَ٣وش‬ ٍ‫هظ٤خ‬‫ػزخص‬‫ر‬ ٌَُٔ‫ح‬ٓ ٌَ٘ٝ ٢َْٟ‫٣ظ‬ ٢ً َ٣ٞ١ ‫ُٞهض‬ ‫ًُي‬‫ا‬ٌَُٔ‫ح‬ ّ‫ُظلخ‬. *ٝ ٕ‫أٓ٘خ‬ ٠ِ‫ػ‬ ١ٝ‫حُلخ‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ٢‫ك‬‫َٓ٣غ‬ ‫رظؼز٤ض‬ ٌٖٔ‫ط‬ ‫حُٔؼخُـش‬ ٕ‫كب‬ ٍ‫طزي‬ ‫٣ٞؿي‬ ٫ ‫ك٤غ‬ٞ٣َُٔ‫ح‬ ‫رب١زخم‬ ٖ٤ٌ‫ُِل‬ ٝ‫ٓطخ١٤ش‬ ‫كِوخص‬ ٞ٣َُِٔ ‫٣ٟٞغ‬ ٍ‫حُظزي‬ ٍ‫كخ‬ ٢‫ك‬ُ‫ٔيس‬24ٝ ‫ٓخػش‬ٍ‫كخ‬ ٢‫ك‬‫اهظلخء‬ٍ‫طٔظزي‬ ‫حُلي‬ ْٔ‫ؿ‬ ٢‫ك‬ َٛ‫حُلخ‬ ٍ‫حُظزي‬ ٍ‫كخ‬ ٢‫ك‬ ‫أٓخ‬ ، ‫ٓؼيٗ٤ش‬ ‫رؤٓ٬ى‬ ‫حُلِوخص‬ٌْٗٝ ‫حُٔلظٞف‬ ‫حَُى‬ ٠ُ‫ا‬ ‫٣ِـؤ‬ ‫ػ٘يٛخ‬ ٍ‫حُظزي‬ٝ ‫حُؼظٔ٤ش‬ ‫حُو٤خ١ش‬ٝ‫أ‬ ٖ٤ٌ‫حُل‬ ‫طؼز٤ض‬ُ‫ح‬‫ٜل٤ق‬ ُ‫ح‬‫طؼز‬ ٕٝ‫ى‬ ‫ؼظٔ٤ش‬ٖ٤ٌ‫حُل‬ ‫٤ض‬. *٩‫ح‬ ّ‫ػي‬ ‫هطٍٞس‬ ‫رٔزذ‬ُ‫ح‬ ٠ِ‫ػ‬ َ‫ُِظيحه‬ ‫حُؼخثي‬ ّ‫ُظلخ‬‫طزو‬‫حُٔٔلخه٤ش‬ ‫ش‬ٕ‫كب‬‫ٓل‬ ‫حُٔـِن‬ ‫حَُى‬٠ٚ‫اؿَحث‬ ٖٓ ٌٖٔ‫ٗظ‬ ‫ػ٘يٓخ‬ َ٠ِ‫ػ‬ ‫ٓظزيُش‬ َ٤‫ؿ‬ ًٍٞٔ ‫ػيس‬ٝٝ ‫ًز٤َس‬ ‫ٓؼخُـش‬ ٠ُ‫ا‬ ‫طلظخؽ‬ ٫‫ٓؼخُـش‬١‫حَُرخ‬‫ٓل‬ َ‫حُيحث‬٠‫ُِظؼز٤ض‬ ‫ح٧ىٍى‬ ‫حُلي‬ ٌٍُٞٔ‫ح‬ ‫كخ٫ص‬ ‫أؿِذ‬ ٢‫ك‬ َ. ٩‫ح‬ ‫ٌٛح‬ ‫٣ٔزذ‬ ‫ػ٘يٓخ‬‫حُٔلظٞف‬ ‫كخَُى‬ ً‫ح‬‫ٗي٣ي‬ ً‫خ‬ُٔ‫أ‬ ‫ِٗ٣خف‬‫ا‬.‫أً٤ي‬ ‫ٓظطزخد‬ *ٝ ‫ًَٗ٘ي‬ ‫رؤٓ٬ى‬ ‫حُظؼز٤ض‬ ‫أٓخ‬ٝ ‫حُؼظٔ٤ش‬ ‫حُٔوخُذ‬‫حُي‬‫ٓظلظض‬ ًَٔ ٍٜٞ‫ك‬ ٍ‫كخ‬ ٢‫ك‬ ّ‫طٔظوي‬ ٢ٜ‫ك‬ ‫حُؼظٔ٤ش‬ ْ٤‫رخر‬، *‫كخُش‬ ‫طٔٔق‬ ‫ػ٘يٓخ‬ ‫حُٔ٘٘ؤ‬ ‫حٌُحط٤ش‬ ‫حُؼظٔ٤ش‬ ّٞ‫حُطؼ‬ ‫أِٓٞد‬ ‫ططز٤ن‬ ‫ك٤ـذ‬ ،‫ُحثي‬ ٌَ٘‫ر‬ ً‫خ‬‫ٗل٤ل‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ٌٕٞ٣ ‫ػ٘يٓخ‬ ‫أٓخ‬ ‫رٌُي‬ ‫حُؼخٓش‬ ٞ٣َُٔ‫ح‬. *‫ح٧ىٍى‬ ‫حُلي‬ ‫ػ٬ؽ‬: ‫ٛ٘خُي‬‫ح٧ىٍى‬ ‫حُلي‬ ٢‫ك‬ ‫حُوٜٞٛ٤خص‬ ٞ‫رؼ‬‫ٜٓ٘خ‬٩‫ح‬ٕ‫كويح‬ ‫رؼي‬ َٛ‫حُلخ‬ ٢ٔ‫حُؼظ‬ ٙ‫ٓظٜخ‬ٞ‫٣٘ول‬ ‫ك٤غ‬ ٕ‫ح٧ٓ٘خ‬‫ا‬٠ُ‫ا‬ ْ‫حُؼظ‬ ‫ٍطلخع‬ ٝ ً‫خ‬‫طوَ٣ز‬ ‫حُٜ٘ق‬‫ًُي‬ ٠ِ‫ػ‬ ‫٣ِ٣ي‬ ‫حُلخ٫ص‬ ٞ‫رؼ‬ ٢‫ك‬. ٢ُ٘ٔ‫ح‬ ٕ‫حَُ٘٣خ‬ ‫١َ٣ن‬ ٖ‫ػ‬ ْ‫حُؼظ‬ ‫كظَٝ٣ش‬ ‫حُٞػخث٤ش‬ ‫حُٜ٘يٓش‬ َ٤‫طظـ‬ ‫ك٤غ‬ َٔ‫حُؼ‬ ّ‫طوي‬ ‫رٔزذ‬ ‫ُِٜيٓخص‬ ْ‫حُؼظ‬ ‫ٓوخٝٓش‬ ‫طوظِق‬ ٝ ‫رخُظيٍ٣ؾ‬ َ‫طو‬ ٢ِ‫حُٔل‬ً‫ح‬‫ٓؼظٔي‬ ْ‫حُؼظ‬ ‫٣ٜزق‬ٝ ‫حُٔٔلخم‬ ٢‫ك‬ ‫حَُ٘٣خٗ٤ش‬ ‫حُ٘زٌش‬ ٠ِ‫ػ‬ ٚ‫طَٝ٣ظ‬ ٢‫ك‬ٝ ْ٤َٓ‫حُظ‬ ‫آُ٤ش‬ َ‫طظؤػ‬ ً‫خ‬٠٣‫أ‬ ٝ .ٌ‫حُيٗز‬ ٌَ٘‫ط‬‫ٛ٘خى‬ ٌُٖٝ ‫ح٧ىٍى‬ ‫ُِلي‬ ‫حُلٞحثي‬ ٞ‫رؼ‬٢ٛ: -ٕ‫أ‬‫ا‬ًَٔ ‫كيٝع‬ ٍ‫كظٔخ‬َ‫أه‬ٝٝ ٕ‫أٓ٘خ‬ ‫ٝؿٞى‬ ّ‫ػي‬ َ‫ح٧ه‬ ٠ِ‫ػ‬ ‫حُٔزذ‬٢‫ك‬ ٕ‫ح٩ٗظخ‬ ‫كيٝع‬ ‫ٗٔزش‬ ٕ‫أ‬ ‫ًُي‬ ٖ‫ػ‬ ‫٣٘ظؾ‬ ‫ٓٔخ‬ ‫حُلخثيس‬ َ‫أه‬ ٌَُٔ‫ح‬ ٢‫ه‬. -ٕ‫أ‬ٌٔ٣ ٚٗ٧ ‫ٓطِٞد‬ َ٤‫ؿ‬ ‫حُيه٤ن‬ ‫حَُى‬٢‫ٟٞحر‬ ٕ‫أ‬ ‫ك٤غ‬ ‫حُ٘لخء‬ ‫رؼي‬ ٞ٣َُِٔ ‫ؿي٣ي‬ ُ‫حُـٜخ‬ ٞ٣َُِٔ ‫ؿي٣ي‬ ‫ا١زخم‬ ‫ر٘خء‬ ‫اػخىس‬ ٖ ٝ ‫ح٩١زخم‬‫ٓٞؿٞىس‬ َ٤‫ؿ‬ ٕ‫ح٧ٓ٘خ‬ ٢ٛ. ‫حُٔلظٞف‬ ‫حَُى‬ ٠ُ‫ا‬ ‫ِٗـؤ‬ َ٘‫حُل‬ ٍ‫كخ‬ ٢‫ٝك‬ ،‫حُٔلظٞف‬ ‫حُطَ٣ن‬ ٕٝ‫ى‬ ‫ٛخ‬‫ٍى‬ ٍٝ‫ك٘لخ‬ ‫حُ٘ظخ٣خ‬ ‫طَحًذ‬ ٍ‫كخ‬ ٢‫ك‬ ‫أٓخ‬.
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 36 H-‫حُِؤش‬ ًٍٞٔ: : ٠ُ‫ا‬ ‫حُِؤش‬ ًٍٞٔ ‫ٓؼخُـش‬ ْٔ‫طو‬-‫ٓلخكع‬ -٢‫ؿَحك‬. ٝ ‫حُٞظ٤لش‬ ‫أىحء‬ ٢‫ك‬ ‫حُويٍس‬ ٞٛ ‫حُٔؼخُـش‬ ‫ٗـخف‬ ّ‫ٓو٤خ‬‫حُٔ٠ؾ‬ ‫ىٍٝس‬ ٢‫ك‬ ‫حُـخٗز٤ش‬ ‫حُلًَخص‬ ‫اؿَحء‬. a-‫حُظٜ٘٤ق‬: ‫أ‬-ُٔ‫ح‬ ٖٟٔ ًَٔ‫للظش‬(a):-‫حُـخٗذ‬ ١‫أكخى‬ -‫حُـخٗذ‬ ٢‫ػ٘خث‬. ‫د‬-‫حُٔللظ‬ ‫هخٍؽ‬ ًَٔ‫ش‬(b-c):-‫حُـخٗذ‬ ١‫أكخى‬ -‫حُـخٗذ‬ ٢‫ػ٘خث‬. ً‫ح‬‫ؿي‬ ‫ٛؼذ‬ ‫حُٔللظش‬ َ‫ىحه‬ ًٍٞٔ ٚ٤‫ط٘و‬ ٖٓ٢ِ٣‫ًٔخ‬ ٌٍُٞٔ‫ح‬ ‫ٛ٘لض‬ ‫حُٔؼخُـش‬ َ‫ٗظ‬ ‫ٝؿٜش‬: 1-‫أ‬ :ٍ‫ح٧١لخ‬-.‫رخ٩١زخم‬ ‫طوَد‬ ٕٝ‫ى‬ ‫د‬-‫رخ٩١زخم‬ ‫طوَد‬ ‫ٓغ‬. 2-‫أ‬ :ٖ٤‫حُزخُـ‬-.‫رخ٩١زخم‬ ‫طوَد‬ ٕٝ‫ى‬ ‫د‬-‫رخ٩١زخم‬ ‫طوَد‬ ‫ٓغ‬.
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 37 ‫طٜخٗ٤ق‬ ‫ػيس‬ ‫٣ٞؿي‬: ٢‫ك‬ ‫اهظِحُٜخ‬ ٌٖٔ٣ َٟ‫أه‬ ‫طٜ٘٤ق‬ **Spissel and Schroll 1972: ‫طٜ٘٤ق‬ **Lindahl1977: ‫٣ؼظٔي‬3: َ٤٣‫ٓؼخ‬ 1-٢‫حُظَ٘٣ل‬ ‫حُٔٞهغ‬ ‫كٔذ‬ 2-: ٢ِ‫حُٔل‬ ‫حُلي‬ ٢‫رخه‬ ‫ٓغ‬ ‫حُِؤش‬ ‫ػ٬هش‬ ‫كٔذ‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 38 3-: ‫حُـٔـٔش‬ ‫هخػيس‬ ‫ٓغ‬ ‫حُِؤش‬ ‫ػ٬هش‬ ‫كٔذ‬ ‫طٜ٘٤ق‬ **Neff & Rasse’s Modification2006: b-: ٚ٤‫حُظ٘و‬ 1-: ‫حَُٟٔ٤ش‬ ‫حُوٜش‬ ١ٞ‫طل‬ ‫ٓخ‬ ‫ؿخُزخ‬ ٢‫حُظ‬ ٝ‫حُِؤش‬ ٟٞ‫ٓٔظ‬ ٠ِ‫ػ‬ َٗ‫ٓزخ‬ ٍٝ ٝ‫أ‬ ٖ‫حٌُه‬ ٟٞ‫ٓٔظ‬ ٠ِ‫ػ‬ ٍٝ 2-: ‫حَُٔ٣َ٣ش‬ ‫حُؼ٬ٓخص‬ -َٛ‫حُظخ‬ ‫حُٔٔغ‬ ‫ه٘خس‬ ٖٓ ‫ِٗف‬ -ًٕ٧‫ح‬ ّ‫أٓخ‬ ‫ٝحٟق‬ ٍّٞ‫ط‬ ٝ ‫ًيٓش‬ -٢ٜ‫ٝؿ‬ َ‫ط٘خظ‬ ّ‫ػي‬ -‫حُـٜش‬ ٖٓ ‫حَُأى‬ ٍٞ١ ٢‫ك‬ َٜ‫ه‬‫حُٜٔخرش‬ -‫ٓلِٜ٤ش‬ ‫١وطوش‬ -‫حُلي‬ ‫طلَ٣ي‬ ‫ػ٘ي‬ ُْ‫أ‬ -‫ا١زخم‬ ‫ٓٞء‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 39 -٢ِ‫حُٔل‬ ‫حُلي‬ ‫ُؤش‬ ‫اٗلَحف‬ -‫حُٔخٟـش‬ ‫حُؼ٠٬ص‬ ‫ط٘٘ؾ‬ 3-: ٢‫حُ٘ؼخػ‬ ٚ‫حُلل‬ : َٔ٘٣ ٝ ‫ى‬ )*‫رخٍٗٞحٓ٤ش‬ ‫ٍٜٞس‬ )*‫رٟٞؼ٤ش‬ ‫أٗؼش‬ ‫ٍٛٞس‬Towne`s
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 40 )*‫هِل٤ش‬ ‫أٓخٓ٤ش‬ ‫ؿٔـٔش‬ ‫ٍٛٞس‬ )*‫ٓخثِش‬ ‫ؿخٗز٤ش‬ ‫ٍٛٞس‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 41 )*١ٍٞ‫ٓل‬ ٢‫١زو‬: ‫ح٧رؼخى‬ َ‫ػ٬ػ‬ َ٤ٌ٘‫ط‬ ‫ٓغ‬ )*٢ٔ٤١‫ٓـ٘خ‬ ٖ٤ٍٗ ‫ٍٛٞس‬ C-‫حُٔؼخُـش‬: 1-‫األطفاه‬: ‫أ‬-: ‫حُِؤش‬ ٖٟٔ ًٍٞٔ‫ط‬ ٍ‫ح٧١لخ‬ ٞ‫رؼ‬ ‫ػ٘ي‬ ًٍٞٔ ‫طليع‬ ‫هي‬ٝ ٢ٔ‫حُِو‬ ‫حُـ٠َٝف‬ ‫ٜ٤ذ‬ٝ ٢ِٜ‫حُٔل‬ ‫حُٔطق‬ً‫خ‬‫طوَر‬ ‫طٔزذ‬ ً‫خ‬٤ُ‫طخ‬ُٞٔ٘‫ح‬ ٢‫ك‬ٝ‫٣ليع‬ ‫حُلخ٫ص‬ ٞ‫رؼ‬ ٢‫ك‬‫ا‬٢ٌ‫حُل‬ َٜ‫ُِٔل‬ ٢‫ُ٤ل‬ ٝ‫أ‬ ٢ٔ‫ػظ‬ ‫ُظٜخم‬٢‫حُٜيؿ‬ٝ ،ٌٙٛ‫ا‬‫ٓٔخ‬ ‫اٟخك٤ش‬ ‫هظ٬١خص‬ ٝ . ً‫خ‬٠٣‫أ‬ ُٞٔ٘‫ح‬ ‫طؼ٤ن‬ ‫هي‬ ٢‫حُظ‬ ‫حُطز٤ؼ٤ش‬ ‫حُٞظ٤ل٤ش‬ ‫حُلًَخص‬ ٢‫ك‬ ‫اػخهش‬ ‫٣ٔزذ‬‫طؼخُؾ‬ ٍ‫ح٧١لخ‬ ‫ػ٘ي‬ ‫حُٔللظش‬ َ‫ىحه‬ ٌٍُٞٔ‫ح‬ ًَ ُ‫ح‬ ‫حُلًَخص‬ ‫رٞحٓطش‬٩‫ح‬ ‫كيٝع‬ ‫هطٍٞس‬ ٖٓ َِ‫طو‬ ٢ٌُ ‫لؼخُش‬‫ُظٜخم‬. ‫د‬-‫هخٍؽ‬ ًٍٞٔ‫حُٔللظش‬ٝ ‫ٓلخكع‬ ٌَ٘‫ر‬ ‫ٓؼخُـظٜخ‬ ‫٣ـذ‬ ٌٍُٞٔ‫ح‬ ٌٙٛ :٩‫ح‬ ‫هطٍٞس‬ ‫ٗٔزش‬ ٌٕٞ‫ط‬َ٤‫رٌؼ‬ َ‫أه‬ ٢ُ‫حُظخ‬ ‫ُظٜخم‬ ٝ . ‫حُٔللظش‬ َ‫ىحه‬ ٌٍُٞٔ‫ح‬ ٢‫ك‬ ‫كيٝػٜخ‬ ‫ٗٔزش‬ ٖٓٝ ‫هِ٤ِش‬ ‫ُٔيس‬ ‫حُظؼز٤ض‬ ْ‫٣ظ‬ ُْ‫أ‬ ‫كيٝع‬ ٍ‫كخ‬ ٢‫ك‬ ٌُٖ٢ٛ7ٝ ّ‫أ٣خ‬. ‫ًخك٤ش‬ ٌٕٞ‫ط‬ ٝ٠‫كظ‬ ١ٍٝ‫ى‬ ٚ‫كل‬ ٍ‫ح٧١لخ‬ ‫ػ٘ي‬ ‫حُ٘ي٣يس‬ ‫حُِؤش‬ ًٍٞٔ ٢ِ٣ُٞٔ٘‫ح‬ ٢ٜ‫٣٘ظ‬. 2-ٍِ‫اىثاىغ‬: ‫أ‬-ٝ ‫٣ظوَد‬ ٫ ‫ػخىس‬ ‫ح٩١زخم‬ : ‫حُـخٗذ‬ ‫أكخى٣ش‬ ‫حُٔللظش‬ ٖٟٔ ًٍٞٔ‫حُلي‬ ‫طؼز٤ض‬ ٕٝ‫ى‬ ‫ٓلخكع‬ ٌَ٘‫ر‬ ‫٣ؼخُؾ‬ ٕ‫أ‬ ‫٣ـذ‬ ٌَُٔ‫ح‬ ً‫خ‬ٗ‫أك٤خ‬ ٢ِ‫حُٔل‬. ‫ك٤٘ٔخ‬‫طؼز٤ض‬ ‫اؿَحء‬ ‫٣ـذ‬ ، ٢٤ٔ‫ر‬ ‫ا١زخم‬ ‫ٓٞء‬ ‫٣٬كع‬َٟ‫حُؼ‬ ‫رٞحٓطش‬ ٢٤ٔ‫ر‬ّ‫ح٧هٞح‬ ٝ‫أ‬ٝ .٩‫ح‬ َ‫هط‬ ‫ٛ٘خى‬‫ُظٜخم‬٠َُٟٔ‫ح‬ ‫ػ٘ي‬ ٝ ٖ٤‫حُزخُـ‬ٖ٤‫أٓزٞػ‬ ٖٓ َ‫أًؼ‬ ‫٣طزن‬ ٫‫أ‬ ‫٣ـذ‬ ‫حُظؼز٤ض‬.
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 42 ‫د‬-ٝ ‫ٓظوَد‬ َ٤‫ؿ‬ ‫ػخىس‬ ٌٕٞ٣ ٕ‫أ‬ ‫٣ـذ‬ ‫ح٩١زخم‬ ‫ٓظزيُش‬ َ٤‫حُـ‬ ٌٍُٞٔ‫ح‬ ٢‫ك‬ :‫حُـخٗذ‬ ‫أكخى٣ش‬ ‫حُٔللظش‬ ‫هخٍؽ‬ ًٍْٞٔ٤ُ َ٤‫حُٔظـ‬ ٌَُٔ‫ح‬ ‫أٓخ‬ ‫كؼخُش‬ ‫ٓؼخُـش‬ ١٧ ‫ٍَٟٝس‬ ‫ٛ٘خى‬ٚٗ‫كب‬ُ‫ا‬ ‫ػخىس‬ ١‫٣ئى‬‫طو‬ ٠َٜ‫ه‬ ٠ُ‫ا‬ ‫ػخثي‬ ‫ٝحٟق‬ ‫ا١زخم‬ ‫َد‬‫ا‬ٝ ‫حَُى‬ ‫ٍطلخع‬ّ‫طٔخ‬ ٝ ‫٣طزن‬ ٖ٤ٌ‫حُل‬ ‫طؼز٤ض‬ ‫حُلخُش‬ ٌٙٛ ٢‫ك‬ ٌَُٔ‫ح‬ ‫ؿخٗذ‬ ٢‫ك‬ ٌَ‫حُٔز‬ ٕ‫ح٧ٓ٘خ‬‫ٓيس‬ ٚ٤ِ‫ػ‬ ‫٣لخكع‬3-4‫أٓخر٤غ‬. ‫ؽ‬-‫ٓٞف‬ ‫حُٔللظش‬ ٖٟٔ ‫ػ٘خث٤ش‬ ٌٍٞٔ‫ر‬ ٖ٤‫حُٜٔخر‬ ٖ٤‫حُزخُـ‬ ٠َُٟٔ‫ح‬ ٖٓ ْٔ‫ه‬ :‫حُٔللظش‬ ٖٟٔ ‫حُـخٗذ‬ ‫حُؼ٘خث٤ش‬ ٌٍُٞٔ‫ح‬ َٕٟٞ‫٣ظؼ‬‫ُو‬ ً٬‫ٓٔظوز‬ٝ‫أ‬ ‫ٔخٝس‬‫ا‬‫اًح‬ َٜ‫حُٔل‬ ‫ُظٜخم‬‫ا‬ٖٓ َ‫أًؼ‬ ‫حُظؼز٤ض‬ َٔ‫ٓظ‬2-3‫أٓخر٤غ‬،‫كخُلًَخص‬ ‫ٓظوَد‬ َ٤‫ؿ‬ ‫ح٩١زخم‬ ٕ‫ًخ‬ ‫اًح‬ ٝ ٌٙٛ ‫حُظؼز٤ض‬ ‫ٓيس‬ ‫رؼي‬ ‫ططزن‬ ‫حُلؼخُش‬ٝ ‫ِٓلٞظ‬ ٌَ٘‫ر‬ ‫ح٩١زخم‬ ْٛ‫ػ٘ي‬ َ٤‫٣ظـ‬ ٠َُٟٔ‫ح‬ ٖٓ ‫ػيى‬ ٌُٖ‫ٓخ‬ ً‫خ‬٤‫طيٍ٣ـ‬ ‫ح٩١زخم‬ ‫٣ظوَد‬ ٝ ‫١ٞ٣ِش‬ ‫ُلظَس‬ ٢ٌ‫حُل‬ ‫حُظؼز٤ض‬ ‫ٗطزن‬ ًُُُْ ٠ِ‫ػ‬ َٜ‫ٗل‬ ٌٖ‫ر‬ ‫ي‬‫ب‬‫حُظؼز٤ض‬ ّٞ‫ه‬ ٝ‫أ‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ٠ِ‫ػ‬ ‫حُوزؼ٤ش‬ َ‫حُـزخث‬ ّ‫ٓظويح‬ ‫ُٔيس‬ ٖ٤ٌ‫حُل‬ ٖ٤‫ر‬2ْ‫ػ‬ ، ‫أٓخر٤غ‬ٗٝ ٖ٤ٌ‫حُل‬ ٖ٤‫ر‬ ‫ح٧ٓ٬ى‬ ‫رلي‬ ّٞ‫و‬ٝ ١‫حُٔطخ‬ ‫رٞحٓطش‬ َ٤ُِ‫ح‬ ‫أػ٘خء‬ ٢‫كو‬ ٖ٤ٌ‫حُل‬ ‫طؼز٤ض‬‫طٔٔق‬ ٝ ٍ‫حُٜ٘خ‬ ‫أػ٘خء‬ ‫حُلؼخُش‬ ‫رخُلًَخص‬ ّ‫رخُو٤خ‬ ٞ٣َُِٔ‫ُٔيس‬ ‫ًُي‬ َٔ‫٣ٔظ‬6‫أٓخر٤غ‬. ‫ى‬-ّ‫ُ٨ٓخ‬ ‫ًِ٤ٜٔخ‬ ٝ‫أ‬ ‫اكيحٛٔخ‬ ٕ‫ٌٓخ‬ َ٤‫٣ظـ‬ ‫هي‬ ‫حُٔللظش‬ َ‫أٓل‬ ٖ٤‫حُِؤظ‬ ٬ً ٌَٔ‫ط‬ ‫ػ٘يٓخ‬ : ‫حُٔللظش‬ ‫هخٍؽ‬ ‫حُؼ٘خث٤ش‬ ًٍٞٔ ٝ ٢ٔٗ٧‫ح‬‫ُٔيس‬ ٢ٌ‫حُل‬ ‫حُظؼز٤ض‬ ‫ٗطزن‬ ٕ‫أ‬ ‫٣ـذ‬ ‫ٌُح‬ ‫حُوِل٤ش‬ ٕ‫ح٧ٓ٘خ‬ ٠ِ‫ػ‬ ‫ا١زخم‬ ‫ُي٣٘خ‬ ‫٣ٜزق‬ ً‫خ‬‫ؿخُز‬4-6ٍٞ١ ٖٓ ْ‫رخَُؿ‬ ‫أٓخر٤غ‬ ‫اػخىس‬ ٕ‫كب‬ ‫حُظؼز٤ض‬ ‫ٓيس‬ٝ َ٘‫٣ل‬ ‫هي‬ ٢‫حُطز٤ؼ‬ ‫حُٔؼظخى‬ ١‫حُؼٔٞى‬ ‫ُِزؼي‬ َ٤ٌ٘‫حُظ‬‫أٓخٓ٤ش‬ ‫ٓلظٞكش‬ ‫ػ٠ش‬ ‫ُي٣٘خ‬ ‫٣٘ظؾ‬. ٖٝ٤‫حُظخُ٤ظ‬ ٖ٤‫رخُطَ٣وظ‬ ٖ٤‫حُطَك‬ ٬ً ٝ‫أ‬ ‫أكي‬ ‫ٍى‬ ٖ٤‫ؿَحك‬ ‫ػيس‬ ٍٝ‫٣لخ‬ ‫ح٧ٓزخد‬ ٌُٜٙ: 1-ٝ ‫حُوِل٤ش‬ ٕ‫ح٧ٓ٘خ‬ ٠ِ‫ػ‬ ً‫خ‬‫ٓلظٞك‬ ْ‫حُل‬ ‫اروخء‬ٝ ، ‫ٍهخثن‬ ‫رٞحٓطش‬ ‫ًُي‬‫٣ٔخػي‬ ٕ‫أ‬ ٌٖٔ٣ ‫ٌٛح‬‫حَُى‬ ٠ِ‫ػ‬ ً‫خ‬٣َ‫ٗظ‬ ٝ ٌَُِٔ ١ٞ‫حُؼل‬ٍ‫كؼخ‬ َ٤‫ؿ‬ ٞٛ ً‫خ‬٤ِٔ‫ػ‬ ٌُٖ. 2-ٝ ‫حُِؤش‬ ٠ُ‫ا‬ ٍُٞٛٞ‫رخ‬ ً‫خ‬٤‫ؿَحك‬ٝ ‫ٍىٛخ‬ٝ ‫طؼز٤ظٜخ‬‫هي‬‫ا‬‫هظَف‬Brown٢‫حُـَحك‬ ‫ُِظؼز٤ض‬ ‫رٔ٤طش‬ ‫طو٘٤ش‬. 3-: ً‫اىجشاح‬ ‫اىؼَو‬ a-‫٣ٞؿي‬ ّ‫ػخ‬ ٌَ٘‫ر‬4‫حُِؤش‬ ٠ِ‫ػ‬ ًٕ٧‫ح‬ ّ‫أٓخ‬ ٖٓ ‫حُـَحك٤ش‬ ‫ُِٔيحهِش‬ ‫١َم‬ 1-Blair’s Inverted Hockey Stick Incision 2-Thoma’s Angulated Incision
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 43 3-Dingman’s Incision 4-Popowich & Crane Incision 1 2 43 ‫الجلدي‬ ‫الشق‬ ‫العضالت‬ ‫صفاق‬ ‫تسلٌخ‬ ‫العضلٌة‬ ‫الطبقة‬ ‫شق‬ ‫المفصل‬ ‫كشف‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 44 b-ًٕ٧‫ح‬ ‫هِق‬ ٖٓ َ‫ٓيه‬ c-: ٢ِ‫حُٔل‬ ‫حُلي‬ ‫طلض‬ ٖٓ َ‫ٓيه‬ 1 43 2 ً‫الجراح‬ ‫الشق‬ ‫المبطحة‬ ‫العضلٌة‬ ‫للطبقة‬ ‫وصوال‬ ‫التسلٌخ‬ ً‫الوجه‬ ‫الشرٌان‬ ‫و‬ ‫الورٌد‬ ‫ربط‬ ‫العظمٌة‬ ‫للطبقة‬ ‫وصوال‬ ‫الماضغة‬ ‫العضالت‬ ‫شق‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 45 d-: ‫حٌُ٘ل٤ش‬ ‫حُـيس‬ َ‫ػز‬ َ‫ٓيه‬ e-: ١ٞٔ‫حُل‬ َ‫ىحه‬ َ‫حُٔيه‬ ‫ًز٤َس‬ ‫هزَس‬ ٠ُ‫ا‬ ‫٣لظخؽ‬ ٝ ‫ؿيح‬ ‫ٛؼذ‬ َ‫ٓيه‬ ٞٛ َٝٔ‫حُؼ‬ َ٤ٜٔ‫ُظ‬ ‫ُٝح٣خ‬ ‫ًحص‬ ‫هخٛش‬ ‫أىٝحص‬ ٝ 1 3 4 2 ‫الشق‬ً‫الوجه‬ ‫العصب‬ ‫لفرع‬ ‫موازي‬ ‫الجلدي‬ ‫التبعٌد‬ ‫و‬ ‫التسلٌخ‬ ‫العضلٌة‬ ‫الطبقة‬ ‫تسلٌخ‬ ‫و‬ ‫شق‬ ‫العظم‬ ‫كشف‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 46 4-: ‫اىرثثٍد‬ ‫ح٧ٓ٬ى‬ ّ‫ربٓظويح‬ ‫حُظؼز٤ض‬ ** : ‫حُٜلخثق‬ ّ‫ربٓظويح‬ ‫**حُظؼز٤ض‬ ‫الصفائح‬ ‫تثبٌت‬ ‫خال‬ ‫ٌحتاج‬ ‫الفموي‬ ‫داخل‬ ‫الشق‬‫خاصة‬ ‫مزواة‬ ‫أدواة‬ ‫إلى‬ ‫العمل‬ ‫لتسهٌل‬ ً‫براغ‬ ‫مفك‬ ‫و‬ ‫مثاقب‬ ‫من‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 47 ‫رٞحٓطش‬ ‫حُظؼز٤ض‬ **Lag screws ّ‫ربٓظويح‬ ‫حُظؼز٤ض‬ **Eckelt technique of lag screw osteosynthesis: I-ّ‫حُطؼخ‬َ‫ٝحُٔٞحث‬: ٝ ّ‫حُطؼخ‬ّ‫حُؼخ‬ َ٣‫حُظوي‬ ‫طلض‬ ٢‫ؿَحك‬ َٔ‫ػ‬ ٞ٣َُِٔ ١َ‫أؿ‬ ‫اًح‬ ‫اػطخءٛٔخ‬ ١ً‫٣ئ‬ ٫ ‫حَُ٘حد‬.‫حُلِ٤ذ‬ َ‫ٓؼ‬ َ‫حُٔٞحث‬ ‫اػطخء‬ ‫ٍرٔخ‬– ٝ ‫رؤٗزٞد‬ ِٜ‫ٓـ‬ ٕ‫ك٘ـخ‬ ٖ٤ٓ‫ٓٔظوي‬ ْٜ٤ٌ‫ك‬ ‫حُٔؼزض‬ ٠َُٟٔ‫ح‬ ‫ػ٘ي‬ ‫هخٛش‬ ... ‫حُلٔخء‬‫كخؿش‬ ‫حُٔخثِش‬ ‫حُٞؿزخص‬ ٌٙٛ ٖٓ‫طئ‬ ٕ‫أ‬ ‫٣ـذ‬ ‫ًخِٓش‬ ‫حُـٌحث٤ش‬ ٞ٣َُٔ‫ح‬.
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 48 ٍ‫ح٧١لخ‬ ‫ػ٘ي‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ًٞٔ ‫طٔظلن‬ًٍٞٔ ‫هخٛش‬ ٝ ٢ِ‫حُٔل‬ ‫حُلي‬ ٍٝ ‫ٗظخثـٜخ‬ ‫ُوطٍٞس‬ ‫ٓٔظل٤٠ش‬ ‫ىٍحٓش‬ ٍ‫ح٧١لخ‬ ‫ػ٘ي‬ ‫حُِؤش‬٠ِ‫ػ‬ ‫حُٔ٢ء‬ ‫اٌٗحٍٛخ‬ ٝ ‫حُوِو٤ش‬ ‫حُ٘خك٤ش‬ ٖٓ ٍ‫ح٧١لخ‬ٝ .‫حُ٘لٔ٤ش‬ُٞٔ٘‫ح‬ ًِ‫َٓح‬ ٢‫ك‬ َ‫٣ئػ‬ ‫هي‬ ًَٔ ١‫أ‬ ٕ‫كب‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ٞٔ٘‫ر‬ ‫حُٜخٓش‬ ‫ُؼ٬هظٜخ‬ ً‫ح‬َ‫ٗظ‬‫ك٤ٞهلٜخ‬ ٜٚ٣ٞ٘‫ط‬ ٝ‫أ‬ ‫حُلي‬ ‫طٞهق‬ ‫حُٜ٘خ٣ش‬ ٢‫ك‬ ‫٣ٔزذ‬ ‫ٓٔخ‬. 1-ٚ‫حُلل‬١َ٣َُٔ‫ح‬: ٝ ٚ‫كل‬ ‫ُٜٓٞش‬ ‫طؼظٔي‬ٝ َ‫حُطل‬ ٖ٤‫ر‬ ٕٝ‫حُظؼخ‬ ٠ِ‫ػ‬ ً‫ح‬َ٤‫ًؼ‬ ٍ‫ح٧١لخ‬ ‫ٓؼخُـش‬ٝ ‫ؿٜش‬ ٖٓ ِٚٛ‫أ‬ٖٓ ٍ‫ح٧١لخ‬ ‫ٓؼخِٓش‬ ٢‫ك‬ َ٤‫حُوز‬ ‫حُـَحف‬ ‫ؿ‬َٟ‫أه‬ ‫ٜش‬ٝ .‫ؿ٤زٞرش‬ ٚ‫ٗز‬ ‫كخُش‬ ٢‫ك‬ ٜٚ‫حُٔظو‬ ٠ُ‫ا‬ ‫رلخىع‬ ْٜ‫اٛخرظ‬ ‫رؼي‬ ٍ‫ح٧١لخ‬ ٢‫٣ؤط‬ ‫ٓخ‬ َ‫أًؼ‬(ّٝ‫ٜٓي‬ٝ ، )َ٤ٔ‫حُؼ‬ ٖٓ ٚٗ‫ا‬ ‫ٛؼٞرش‬ ١‫أ‬ ٕٝ‫ى‬ ‫حُ٬ُٓش‬ ٙٞ‫حُلل‬ ‫اؿَحء‬.٩‫ح‬ ‫حُلخُش‬ ٌٙٛ َ‫ٓؼ‬ ٢‫ك‬ َ٠‫٣ل‬ ‫ٌُُي‬١‫أ‬ ‫اؿَحء‬ َ‫هز‬ ٞ٣َُٔ‫ح‬ ‫كخُش‬ ٖٔ‫طظل‬ ٠‫كظ‬ ٍ‫ٗظظخ‬ ٚ‫ك٤خط‬ َٝ‫٣ؼ‬ ٝ‫أ‬ ٚ٤ُ‫ا‬ ‫٣ٔ٢ء‬ ٕ‫أ‬ ٚٗ‫ٗؤ‬ ٖٓ َٔ‫ػ‬َ‫ُِوط‬. 2-ٚ‫حُلل‬٢‫حُ٘ؼخػ‬: ٌَُٔ‫ح‬ ٢‫ه‬ ‫طلـذ‬ ٢‫حُظ‬ ْ‫حُزَحػ‬ ‫ُٞؿٞى‬ ٕ‫ح٧ك٤خ‬ ٞ‫رؼ‬ ‫ٛؼذ‬ ٍ‫ح٧١لخ‬ ‫ػ٘ي‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ْٔ‫ؿ‬ ٌٍُٞٔ ٢‫حُ٘ؼخػ‬ ٚ٤‫حُظ٘و‬ ٕ‫ا‬ ‫حُٔطِٞد‬ ٠ِ‫ػ‬ ٍٜٞ‫حُل‬ ٖٓ ‫طٔ٘غ‬ ‫حُٔٔظَٔس‬ َ‫حُطل‬ ‫كًَش‬ ٕ‫أ‬ ‫ًٔخ‬‫حُٜٔيثخص‬ ‫اػطخء‬ َ٠‫٣ل‬ ‫ٌُُي‬Sedatives.(‫حُٜٔيثخص‬ َ٠‫أك‬ ٕ‫ا‬ ٢ٛ ‫حُٔٔظؼِٔش‬Nembutalٝ‫أ‬Chloral Hydrateٝ‫أ‬Seconal٩‫ح‬ ‫١َ٣وش‬ ‫أٓخ‬ٝ ُٕٝ ٠ِ‫ػ‬ ‫كظؼظٔي‬ ٍ‫ٓظؼٔخ‬َ‫حُطل‬ َٔ‫ػ‬.) 3-‫حُٔؼخُـش‬: ٕ‫ا‬‫ا‬ٍ‫هظ٤خ‬ٝ َ‫حُطل‬ َٔ‫ػ‬ ٠ِ‫ػ‬ ‫طؼظٔي‬ ‫حُظؼز٤ض‬ ‫١َ٣وش‬ٝ .ٕ‫ح٧ٓ٘خ‬ ‫رِٝؽ‬ ٍٞ‫طط‬ ٠ِ‫ػ‬ ٢ُ‫رخُظخ‬ُٖٓ‫ح‬ ٍٞٓ٧‫ح‬ٌٙٛ ‫ٓؼخُـش‬ ٢‫ك‬ ‫ٜٔٔش‬ ٩‫ح‬ ٞٛ ٌٍُٞٔ‫ح‬‫حُ٠ٍَٝ٣ش‬ ٢‫رخُ٘ٞحك‬ ّ‫ٛظٔخ‬‫حُوخٛش‬ٝ ٌَُٔ‫ح‬ ‫ٓؼخُـش‬ َ‫هز‬‫حُ٠ٍَٝ٣ش‬ ٢‫حُ٘ٞحك‬ ٌٙٛ ٖٓ: *ٕ‫ح٧ٓ٘خ‬ ‫ٓؼخُـش‬. *٩‫ح‬ ‫ٓؼخُـش‬‫هظ٬١خص‬. *‫حُؼخٓش‬ ٞ٣َُٔ‫ح‬ ‫كخُش‬ ‫ٓؼخُـش‬. *‫رخُوخٛش‬ ٌَُٔ‫ح‬ ‫ٓؼخُـش‬. *‫حُـ‬ َٔ‫حُؼ‬ ‫رؼي‬ ‫حُؼ٘خ٣ش‬٢‫َحك‬. ‫أ‬-ٕ‫ح٧ٓ٘خ‬ ‫ٓؼخُـش‬: ٝ ّ‫حُطؼخ‬ ‫ك٠٬ص‬ ٍ‫طِح‬ ْ‫ػ‬ ،‫َٓحص‬ ‫ػيس‬ َُٜٔ‫رخ‬ ْ‫حُل‬ َٜ‫ٗط‬ ‫حُٜٔخرش‬ ٕ‫ح٧ٓ٘خ‬ ‫رٔؼخُـش‬ ‫حُزيء‬ َ‫هز‬ٝ ‫حُيٓٞ٣ش‬ ‫حُؼِوخص‬‫حُِٔٔهش‬ ‫ح٧ؿ٘٤ش‬ ٝ ‫ٟٝؼٜخ‬ ‫كٔذ‬ ٕ‫ح٧ٓ٘خ‬ ‫طؼخُؾ‬ ْ‫ػ‬ٝ ‫حُٜيٓش‬ َ‫أػ‬‫آٌخ‬‫حُلي‬ ٢‫ك‬ ‫روخثٜخ‬ ‫ٗ٤ش‬٩‫ح‬ َ٠‫٣ل‬ ‫ًٔخ‬ ،ٌٖٓ‫أ‬ ٕ‫ا‬ ‫حُِز٘٤ش‬ ٕ‫ح٧ٓ٘خ‬ ٠ِ‫ػ‬ ‫روخء‬ ‫ٓؼخُـظٜخ‬. ‫د‬-‫حُؼخٓش‬ ٞ٣َُٔ‫ح‬ ‫كخُش‬ ‫ٓؼخُـش‬: ٝ ٞ٣َُٔ‫ح‬ ‫كخُش‬ ‫َٓحهزش‬ ٖٓ ‫ري‬ ٫ٝ ُٚٗٞٝ ٚٔ‫ط٘ل‬ٝ ‫حُلٔٞ٣ش‬ ‫حُللَس‬ ٚ‫كل‬ٝ ّ‫ى‬ ٖٓ ‫حُٔلَُحص‬ ‫اُحُش‬ٌٖٔ٣ ‫أؿ٘ز٤ش‬ ّ‫أؿٔخ‬ ٝ‫أ‬ ١‫ٓوخ‬ ٝ ٢ٓٞ‫حُزِؼ‬ َٟ‫حُٔـ‬ ‫طٔي‬ ٕ‫أ‬ٝ ٚ‫ٟـط‬ ّ‫٣وخ‬ ‫ًٔخ‬ ٢ٔ‫حُظ٘ل‬ٚ٠‫ٗز‬.
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 49 ‫ؽ‬-‫ح٫هظ٬١خص‬ ‫ٓؼخُـش‬: *‫حُِ٘ف‬ ٠ِ‫ػ‬ ‫حُٔ٤طَس‬: ٝٝ ‫حُِ٘ف‬ ‫٣ٞهق‬ ‫رل٤غ‬ ‫ٗخُف‬ ٢ٜ‫ٝؿ‬ ‫ؿَف‬ ١‫أ‬ ٠ِ‫ػ‬ َٗ‫حُٔزخ‬ ٢‫رخُ٠ـ‬ ‫ًُي‬ ْ‫٣ظ‬‫ٓئهض‬ ٌَ٘‫ر‬ ُٞ٠‫كظ‬١ٞٓ‫حُي‬ ‫حُٞػخء‬ ٠ُ‫ا‬ ٍُٞٛٞ‫ح‬ ٝ ‫حُ٘خُف‬ٝ ٚ‫ٍرط‬ّ‫حُي‬ ‫اٍهخء‬‫حُؼخٓش‬ ‫حَُٔهجخص‬ ٞ٣َُٔ‫ح‬ ٠‫٣ؼط‬ ‫ًٔخ‬ .. *‫حُٜيٓش‬ ‫ٓؼخُـش‬: ‫حُِ٘ف‬ ٖ‫ػ‬ ‫حُٔٔززش‬ ‫حُٜيٓش‬ ‫ُؼ٬ؽ‬ ّ‫حُي‬ َ‫ر٘و‬ ‫حُ٘خهٜش‬ ّ‫حُي‬ ‫ًٔ٤ش‬ ‫طؼخُؾ‬‫أٓخ‬ ،ٝ ‫حُِٔل٤ش‬ َ٤ُ‫حُٔلخ‬ ‫ربػطخء‬ ‫ك٤ؼخُؾ‬ ‫ح٩ٓخٛش‬ ٚ‫ٗو‬ ‫حَُٔحهزش‬ ‫طلض‬ ٌٕٞ٤ُ ٠‫حُٔٔظ٘ل‬ ٢‫ك‬ ٞ٣َُٔ‫ح‬ ‫ٟٝغ‬ َ٠‫٣ل‬ ‫ًٔخ‬ ‫حٍُٞ٣ي‬ ‫١َ٣ن‬ ٖ‫ػ‬ ‫حٌَُٔ٣ش‬. *٩‫ح‬ ٠ِ‫ػ‬ ‫حُٔ٤طَس‬ٕ‫ٗظخ‬: ُٝ‫ٌُِِح‬ ‫حُٔ٠خى‬ َُٜٔ‫ح‬ ‫ربػطخء‬ ‫ًُي‬ ٌٕٞ٣Tetanus Antitoxin)‫ِٓٞػش‬ ٝ ‫ػٔ٤وش‬ ٝ ‫ٓلظٞكش‬ ‫ؿَٝف‬ ‫ٝؿٞى‬ ٍ‫كخ‬ ٢‫ك‬ (ٝ‫حُٜخىحص‬ ٤‫حُل‬‫ٞ٣ش‬‫ٍٝ٣ي٣خ‬ ٝ‫أ‬ ‫ػ٠ِ٤خ‬َ‫ٓؼ‬ ‫حُلخُش‬ َ‫حُؤخث‬ ‫ربػطخء‬ ‫حًُٞٓخص‬ ‫طؼخُؾ‬ ‫ًٔخ‬Ananase , Chymoral , Alpha Chymotrypsin ‫ى‬-‫رخُوخٛش‬ ٌَُٔ‫ح‬ ‫ٓؼخُـش‬‫(حُظؼز٤ض‬: ) )*‫١َ٣وش‬ ٢ٛ ٍ‫ح٧١لخ‬ ‫ػ٘ي‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ‫ُظؼز٤ض‬ ‫١َ٣وش‬ َ٠‫أك‬١‫حَُرخ‬٠ِ‫ػ‬ ‫حُٔؼظٔي‬ َ٤‫ؿ‬ ‫(حُظؼز٤ض‬ ‫حُلي‬ ٍٞ‫ك‬ َ‫حُيحث‬ ٕ‫ح٧ٓ٘خ‬: ) •‫ُِلي‬ ‫١زؼخص‬ ٌ‫طئه‬ٝ ١ِٞ‫حُؼ‬٢ِ‫حُٔل‬. •ٝ ٌَُٔ‫ح‬ ‫ٟٝؼ٤ش‬ ٍ‫طؼي‬ ‫حُـزٔ٤ش‬ ‫حُطزؼخص‬ ‫ٛذ‬ ‫رؼي‬ٝ ٚ٤‫ك‬ ٍ‫طزي‬ ‫ٝؿٞى‬ ٍ‫كخ‬ ٢‫ك‬ ‫هخٛش‬َ٘٘‫ر‬ ‫ًُي‬‫ح‬ ٢‫ه‬ ‫ٓ٘طوش‬ٍ‫حُٔؼخ‬ ٠ِ‫ػ‬ ٌَُٔ ٝ ٢ٔ‫حُـز‬٩‫ح‬ ‫ٗؼ٤ي‬٢‫حُطز٤ؼ‬ ٚ‫ٟٝؼ‬ ٠ُ‫ا‬ ‫١زخم‬. •‫ٓ٤ِحرش‬ ‫ٜٗ٘غ‬‫ا‬ٍ‫ُِٔؼخ‬ ‫ًَ٣ِ٤ش‬٨ُ ‫حُطخك٘ش‬ ‫حُٔطٞف‬ ‫ٓـط٤ش‬ ٢ِ‫حُٔل‬ٝ ‫حُٔلِ٤ش‬ ٕ‫ٓ٘خ‬‫حُٔط‬ ٖٓ ً‫خ‬ٔٔ‫ه‬ٝ ٢ٗ‫حُِٔخ‬ ٖ٤‫ل‬ ٩‫ح‬ ٖ٤٘ٓ‫ٓئ‬ ١ِ٤ِٛ‫حُي‬ٌ‫٧ه‬ ‫١زخم‬‫ا‬ٝ ‫حُٔ٤ِحرش‬ ٠ِ‫ػ‬ ‫حُؼِٞ٣ش‬ ٕ‫ح٧ٓ٘خ‬ ‫ٗطزخػخص‬ُِ‫ح‬ ٖٓ ‫طٌ٘د‬ ْ‫ػ‬ ٖٓٝ ‫ٝحثي‬ٝ ‫طِٔغ‬ْ‫٣ظ‬ ‫ًُي‬ ‫رؼي‬ ٝ ‫ٛلظٜخ‬ ٖٓ ‫ُِظؤًي‬ ٞ٣َُٔ‫ح‬ ْ‫ك‬ ٢‫ك‬ ‫طـَرظٜخ‬َ‫ك‬ ‫ُٔ٘غ‬‫٫ري‬ ‫ًظٜخ‬‫طؼز٤ظٜخ‬ ٖٓ١‫رخَُرخ‬‫حُلي‬ ٍٞ‫ك‬ َ‫حُيحث‬. •َٟ‫طـ‬( ‫حُٔوزَ٣ش‬ ٙٞ‫حُلل‬ ‫ٓوظِق‬ ‫اؿَحء‬ ‫رؼي‬ ّ‫حُؼخ‬ َ٣‫رخُظوي‬ ‫حُؼِٔ٤ش‬‫حُِ٘ف‬ َُٖٓٝ‫حُظوؼ‬ ٍُٖٓٝٞ‫حُز‬ ٚ‫كل‬. ) ٍَٝ‫رخُِك‬ ٢‫حُـَحك‬ َٔ‫حُؼ‬ ‫ٓ٘طوش‬ َ٤ٜ‫طط‬ ‫رؼي‬Zepherolٝ( ّ‫ه٤خ‬ ‫حُ٬ٛية‬ ً٫ٞ‫حُل‬ ٖٓ ٢ٗ‫ٓؼي‬ ‫ِٓي‬ َٔ‫٣ٔظؼ‬ ‫حُٔولق‬ ‫حُ٤ٞى‬0.5) َ٣‫ر‬ ٍٝ٧‫ح‬ ‫حُطَف‬ ٚ٤‫١َك‬ ٖٓ ًَ ٢‫ك‬ ٢‫ر‬‫ب‬ٝ ‫ٓٔظو٤ٔش‬ ‫رَس‬‫ر‬ ٢ٗ‫حُؼخ‬ ‫حُطَف‬‫ب‬ٝ ‫حُوخٍؽ‬ ٖٓ ‫حُٔؼٞؿش‬ ‫ح٫رَس‬ َ‫طيه‬ ،‫ٓؼٞؿش‬ ‫رَس‬٢‫ك‬ ٝ ، ‫حُِز٘٤ش‬ ‫حُؼخٗ٤ش‬ ٠‫حَُك‬ ‫ٓ٘طوش‬‫ح٫رَس‬ َ‫ٓيه‬ ْ‫ٗل‬ ٖٓ َ‫كظيه‬ ‫حُٔٔظو٤ٔش‬ ‫ح٫رَس‬ ‫أٓخ‬ ،ْ‫حُل‬ َ‫ىحه‬ ‫حُِٔخٗ٤ش‬ ‫حُ٘خك٤ش‬ ٖٓ ‫طوَؽ‬ ٝ ‫حُٔؼٞؿش‬‫حُيِٛ٤ِ٣ش‬ ‫حُ٘خك٤ش‬ ٖٓ ‫طوَؽ‬ ٌُٖٕ‫ٍ٣لَىح‬ ‫ارَس‬ ٍ‫آظؼٔخ‬ ٌٖٔ٣()ُِٔ‫ح‬ ‫٣لَى‬ ْ‫ػ‬ٍَ‫٣ظل‬ ٠‫كظ‬ َ‫ٝح٧ٓل‬ ٠ِ‫ح٧ػ‬ ٠ُ‫ا‬ ‫ي‬ ‫حُلي‬ ٖٓ َ‫ح٥ه‬ ‫حُطَف‬ ٖٓ ‫حُؼِٔ٤ش‬ ْ‫ٗل‬ َٟ‫طـ‬ .ٚ‫ر‬ ‫ػخُوش‬ ٌٕٞ‫ط‬ ٢‫حُظ‬ ‫حَُهٞس‬ ‫ح٧ٗٔـش‬ ٖٓ. •ٝ ْ‫حُل‬ ٢‫ك‬ ‫حُٔ٤ِحرش‬ ‫طٟٞغ‬‫ر‬ ‫طؼزض‬‫ب‬٧‫ح‬ ‫ٝط٘ي‬ ّ‫كٌخ‬٢‫حُظ‬ ‫ٓ٬ى‬‫أ‬ٝ ‫حُلي‬ ٍٞ‫ك‬ ‫ىهِض‬‫ًُي‬ٝ ُ‫حُـٜخ‬ ٍٞ‫ك‬ ً‫ح‬‫ؿ٤ي‬ ‫رلظِٜخ‬٩‫ح‬ ٠‫كظ‬ّ‫كٌخ‬ ٝ ُ‫حُـٜخ‬ ‫٣ٜزق‬ ‫رل٤غ‬ ّ‫حُظخ‬ّٞ‫حُو‬‫ٝحكيس‬ ‫هطؼش‬ ‫حُٔ٘٤ش‬. ٢‫ىحػ‬ ٫٩‫حُوخٍؽ‬ ٖٓ ‫ح٫رَس‬ ٍٞ‫ىه‬ ٕ‫ٌٓخ‬ ٢‫ك‬ ‫حُو٤خ١ش‬ ‫ؿَحء‬ٝ ‫حًُٞٓش‬ ‫كيٝع‬ ‫ُٔ٘غ‬ ٢‫ٟخؿ‬ ١‫ٍرخ‬ ‫ٟٝٝغ‬ ‫حُٔ٘طوش‬ َ٤ٜ‫طط‬ ٢‫٣ٌل‬ ‫اٗٔخ‬ ، ً‫ح‬َ٤‫ًؼ‬ ‫حُلي‬ ‫طلَ٣ي‬ ّ‫ػي‬ ٠ِ‫ػ‬ ‫حُٔٔخػيس‬. -٢ٓٞ‫ٓظ‬ ًَٔ‫اؿَحء‬ ‫٣ـذ‬ :‫ؿخٗذ‬ ًَ ٢‫ك‬ ٕ‫ٍرخ١خ‬. -٢‫ؿخٗز‬ ًَٔ‫اؿَحء‬ ‫٣ـذ‬ :‫ٓ٘طوش‬ ٍٞ‫ك‬ ٕ‫ٍرخ١خ‬ٝ ٌَُٔ‫ح‬‫آ‬َ‫ح٥ه‬ ‫حُطَف‬ ٢‫ك‬ ‫حٌُز٤َس‬ ‫حُٔ٘طوش‬ ٠ِ‫ػ‬ َ‫ه‬. ‫ٓظز‬ ٕ‫ًخ‬ ‫اًح‬ ‫أٓخ‬ٌٖٔ٣ ٢٤ٔ‫ر‬ ٌَ٘‫ر‬ ً٫‫ٓظزي‬ ٝ‫أ‬ ً٫‫ي‬‫ا‬ٝ ٢٘‫حٌُه‬ ‫حُٔو٬ع‬ ّ‫ٓظويح‬َٝ‫رؼ‬ ١‫حُؼخى‬ ٕ‫حُ٘خ‬ ٖٓ ٞٛ2-3َٔ٣ ‫ك٤غ‬ ْٓ ‫٣ظ‬ ْ‫ػ‬ ٖ‫حٌُه‬ ‫طلض‬ُ‫ح‬ ٍٞ‫ك‬ ‫٣ِق‬ ٝ‫أ‬ ّ‫حَُأ‬ ‫هٔش‬ ٢‫ك‬ ‫ٜخُذ‬‫ـ‬ٝ ‫ُِظؼز٤ض‬ ‫ُ٣خىس‬ ٖ٤‫ز‬‫١َكخ‬ ‫٣ؼزض‬ٙ‫أ‬ ٢‫ؿَحك‬ ّٞ‫ىر‬ ‫رٞحٓطش‬‫رٞحٓطش‬ ٝ ُ‫ح‬ ‫ٌٛح‬ ‫ٓٔخٝة‬ . ‫ُٜخم‬ ‫ٗٔ٤ؾ‬ٔ‫رُٜٔٞش‬ ‫٣ظلَى‬ ٚٗ‫أ‬ ٞٛ ‫و٬ع‬‫ػخرض‬ َ٤‫ؿ‬ ٝ
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 50 )*ٕ‫ح٧ٓ٘خ‬ ٠ِ‫ػ‬ ‫حُٔؼظٔي‬ ‫حُظؼز٤ض‬: ٌٖٔ٣‫ا‬‫ٓظو‬ٝ ٢‫أ٣ل‬ َٟ‫ػ‬ ّ‫يح‬٢‫ك‬ ‫ٛؼٞرش‬ ‫ٗـي‬ ‫ٛ٘خ‬‫ا‬‫ِٓي‬ ّ‫ٓظويح‬0.45ِ‫ػ‬ ِْٓ‫ِٓي‬ ّ‫ٗٔظوي‬ ‫ٌُُي‬ ‫حُٔئهظش‬ ٕ‫ح٧ٓ٘خ‬ ٠0.35 ّٞ‫ه‬ ّ‫ٗٔظوي‬ ٝ‫أ‬ ِْٓ‫ا٣َى‬ٝ ‫حُٔخرن‬ ّٞ‫حُو‬ ٖٓ ‫أٍم‬ ٌٕٞ٣ ‫ك٤غ‬ ٍ‫ُ٨١لخ‬ٝ ِ٤ٓ‫ٜٓخ‬ ٠ِ‫ػ‬ ١ٞ‫٣ل‬ ٫ٌٖٔ٣‫ا‬‫كخَٛحص‬ ّ‫ٓظويح‬ ١‫ٓطخ‬ ٝ‫أ‬ ‫أٓ٬ى‬ ‫رٞحٓطش‬ ٖ٤ٌ‫حُل‬ ‫طؼزض‬ ْ‫ػ‬ ‫ُٜن‬ ‫ًٔزُٞ٣ض‬ ‫رٞحٓطش‬ ‫حُيحثٔش‬ ٕ‫ح٧ٓ٘خ‬ ٠ِ‫ػ‬ ‫طؼز٤ض‬ ْ٣ٞ‫طو‬. -‫حُزخُؿش‬ َ٤‫ؿ‬ ٕ‫ح٧ٓ٘خ‬: ٖٓ َ‫أه‬ ٞ٣َُٔ‫ح‬ َٔ‫ػ‬ ٕ‫ًخ‬ ‫اًح‬9ٝ‫أ‬10١ٞ‫٣لظ‬ ٢ٌ‫حُل‬ ْٔ‫حُـ‬ ٕ‫كب‬ ‫ٓ٘ٞحص‬ٝ ، ْ‫حُؼظ‬ ٢‫ك‬ ٕ‫ح٧ٓ٘خ‬ ٠ِ‫ػ‬‫حُٔل٤ي‬ َ٤‫ؿ‬ ٖٓ ٌٕٞ٣ ٢‫ك‬ ‫ٛلخثق‬ ٝ‫أ‬ ‫ػظ٤ٔش‬ ْ٤‫ىرخر‬ ٝ‫أ‬ ‫ػظٔ٤ش‬ ‫ه٤خ١ش‬ ‫ططز٤ن‬ٝ ٍ‫ح٧كٞح‬ ٌٙٛ٩‫ح‬ ‫حُلخ٫ص‬ ٞ‫رؼ‬ ٢‫ك‬‫ٓظؼ٘خ‬‫ُٔ٘طوش‬ َ٤‫حٌُز‬ ٍ‫حُظزي‬ َ‫هز‬ ‫ث٤ش‬ ٩‫ح‬‫ٗي٣ي‬ ٌٍ‫رل‬ ‫حُٔلِ٤ش‬ ‫حُلخكش‬ ‫ه٤خ١ش‬ ٌٖٔ٣ ‫حُلي‬ ‫ُحٝ٣ش‬ ٝ‫أ‬ ٢٘‫حٌُه‬ ‫ٍطلخم‬. ٙ-٢‫حُـَحك‬ َٔ‫حُؼ‬ ‫رؼي‬ ‫حُؼ٘خ٣ش‬: •٫٩‫ح‬ ‫حُٔ٤ِحرش‬ ٠ِ‫ػ‬ ‫حُٔلخكظش‬ ٖٓ ‫ري‬ً‫َ٣ِ٤ش‬ٝ١‫حَُرخ‬َٔ‫حُؼ‬ ‫رؼي‬ ٢‫حُ٠خؿ‬٩‫ح‬ ‫ً٤ل٤ش‬ َٛ٧‫ح‬ ْ٤ِ‫طؼ‬ ‫ٓغ‬ ٢‫حُـَحك‬َ‫حُطل‬ ‫ػظ٘خء‬. •‫٣ـذ‬‫ا‬ٝ ‫حُظؼز٤ض‬ ‫كظَس‬ ‫١٤ِش‬ َ‫حُٔٞحث‬ ٠ِ‫ػ‬ َ‫حُطل‬ ‫روخء‬ٌ‫حُظـ‬ ‫َٓحػخس‬ٝ ‫رخُل٤ظخٓ٤٘خص‬ ‫حٌُخك٤ش‬ ‫٣ش‬‫حُٔوٞ٣خص‬. •ٍَٝٓ ‫رؼي‬20-30‫اُحُش‬ ٌٖٔ٣ ٢‫حُـَحك‬ َٔ‫حُؼ‬ ٖٓ ّٞ٣١‫حَُرخ‬َ‫حُيحث‬ٝ٩ ‫كخؿش‬ ٫ ‫ٛ٘خ‬ٝ َ٣‫حُظوي‬ ٍ‫ٓظؼٔخ‬‫حُلخ٫ص‬ ٞ‫رؼ‬ ٢‫ك‬ ٌُٖ َ‫ٗ٠ط‬ ‫هي‬ ‫حُوخٛش‬‫ٌُُي‬. َٝ‫حُطل‬ ‫َٗحهذ‬ َ‫ٗظ‬ ٕ‫أ‬ ‫٣ـذ‬٪ُ ‫١ٞ٣ِش‬ ‫ُلظَس‬ ٌَٔ‫ر‬ ‫حُٜٔخد‬ٝ ٚ٣‫ُي‬ ٢ِ‫حُٔل‬ ‫ُِلي‬ ُٞٔ٘‫ح‬ ‫اػخهش‬ ّ‫ػي‬ ٠ِ‫ػ‬ ٕ‫١ٔج٘خ‬ٝ‫أ‬ ‫اػخهش‬ ّ‫ػي‬ ‫حُزِٝؽ‬ ٠ِ‫ػ‬ َ٤‫حُظؤػ‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ ‫كساب‬ ‫جودت‬ ‫فراس‬ .‫د‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ ‫كساب‬ ‫جودت‬ ‫فراس‬ .‫د‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 51 ًٍٞٔ١ِٞ‫حُؼ‬ ‫حُلي‬ A–‫أٓزخد‬ًٍٞٔ‫حُلي‬١ِٞ‫حُؼ‬ٝٚ‫حُٞؿ‬: ٫‫ط‬‫وظِق‬‫أٓزخد‬ًٍٞٔ‫حُلي‬١ِٞ‫حُؼ‬ٖ‫ػ‬‫أٓزخد‬ًَٔ‫حُلي‬٢ِ‫حُٔل‬ٌَ٘‫ر‬ّ‫ػخ‬ٝ‫رٔزذ‬‫ٓٞهغ‬‫حُلي‬١ِٞ‫حُؼ‬٢‫ك‬‫حُؼِغ‬ ٢ٓٞ‫حُٔظ‬ٖٓٚ‫حُٞؿ‬ٚٗ‫كب‬٠ٔ‫٣ل‬ٖٓ‫حُٜيٓخص‬‫رخُلي‬٢ِ‫حُٔل‬َ‫ح٥ًؼ‬‫رَُٝح‬ٝ‫ًٌُي‬ْ‫رخُؼظ‬٠٘‫حُٞؿ‬،٢‫ح٥ٗل‬،٢ٜ‫حُـز‬.ٝ‫ٌُُي‬ ٢ٜ‫ك‬‫ؿٔ٤ؼخ‬َ‫أًؼ‬‫طؼَٟخ‬ٌَُِٖٔٓ‫حُلي‬١ِٞ‫حُؼ‬،ٌٝٙٛ‫حُ٘ٔزش‬( ٍ‫طوي‬1١ِٞ‫ػ‬ )‫ا‬( ٠ُ4ًٍٞٔ )٢‫ك‬‫حُلي‬‫كٔذ‬ ( ٢ِ‫حُٔل‬ Rowe،1900 .) ٝ‫ا‬ٕ‫ًخٗض‬ٌٙٛ‫حُ٘ٔزش‬َ‫٣و‬‫حُلَم‬‫ر٤ٜ٘خ‬٢‫ك‬‫ح٩كٜخث٤خص‬‫حُلي٣ؼش‬،‫ك٤غ‬‫ا‬‫ُىحىص‬ٌٍُٞٔ‫ح‬‫حُٞؿٜ٤ش‬‫ٓغ‬ٍٞ‫طط‬‫حُٔيٗ٤ش‬‫حُلي٣ؼش‬ٝ . َ‫طؼظز‬َُٟٝٞ‫ح‬ٌَ٘‫ر‬ّ‫ػخ‬ْٛ‫أ‬‫ح٥ٓزخد‬‫حُٔليػش‬ٌٍُٞٔ‫حُلي‬ٍٝ ( ١ِٞ‫حُؼ‬‫رٔزذ‬‫ٛيٓش‬‫رٞحٓطش‬َ‫ٗو‬،١ٞ‫ٓو‬،‫أُؼخد‬ ‫ٍ٣خٟ٤ش‬،٠ٓ‫َٓح‬) ‫ٗخٍ٣ش‬‫أٓخ‬‫أٓزخد‬‫حُؼ٘ق‬ٜ‫حُ٘و‬٢َ‫كظؼظز‬‫هِ٤ِش‬٢‫ك‬‫اكيحع‬ًٍٞٔ‫حُلي‬ٝ . ١ِٞ‫حُؼ‬َ‫طؼظز‬‫كٞحىع‬‫حُٔ٤خٍحص‬َ‫أًؼ‬ ‫ح٥ٓزخد‬‫طٞحطَح‬. ‫ا‬ٌٌََُٕٗٔ‫ح‬ٝٚ‫ٗيط‬ٕ‫٣ظؼِوخ‬‫رٟٔٞغ‬‫حُٜيٓش‬ٝ‫ٗيطٜخ‬،‫ًٔخ‬ٕ‫٣ظؼِوخ‬‫ر‬‫ب‬‫ػظزَحص‬‫ػي٣يس‬‫ٜٓ٘خ‬: *‫طَ٘٣ل٤ش‬ًٌَْ٘ٝ‫كـ‬ٝ‫ٟٝغ‬ٝ‫ًؼخكش‬ٝ‫ػ٬هش‬ْ‫حُؼظ‬‫رخ٥ػ٠خء‬‫حُٔـخٍٝس‬. َ‫طئػ‬ *‫حُ٘ٔؾ‬‫حَُهٞس‬‫حُٔـط٤ش‬ّ‫ُِؼظخ‬٠ُ‫ح‬‫كي‬‫ٓخ‬٢‫ك‬ٌٌٍَُٗٞٔ‫ح‬ٝ‫ىٍؿش‬ٍ‫حُظزي‬٢‫ك‬‫حُ٘ظخ٣خ‬. ْ‫*٣٘ـ‬ٍ‫حُظزي‬٢‫ك‬ٌٍُٞٔ‫ح‬‫حُٞؿٜ٤ش‬‫حُلٌ٤ش‬ٖ‫ػ‬‫ا‬ٙ‫طـخ‬ٝ‫ٗيس‬‫حُوٞس‬‫حَُحٟش‬ٝ‫ٟٗٞق‬: )+‫ػ٘يٓخ‬ٌٕٞ‫ط‬‫حُٜيٓش‬‫ٓ٘ول٠ش‬‫رخُ٘ٔزش‬‫ُِلي‬١ِٞ‫حُؼ‬‫طليع‬ًٍٞٔ‫حُ٘ظٞء‬٠‫حُٔ٘و‬.
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 52 )+‫أٓخ‬‫حُٜيٓخص‬٢‫حُظ‬ٌٕٞ‫ط‬٠ِ‫أػ‬ٖٓ‫ًُي‬‫كظليع‬‫ًٍٔٞح‬‫ٓظؼيىس‬ٝ‫أ‬‫َٛٓ٤ش‬٢‫ك‬‫حُلي‬١ِٞ‫حُؼ‬ٝ‫طٜزق‬‫ًٍٔٞح‬٢‫ك‬ ( ‫ٓلظظش‬ ‫حُٜيٓخص‬‫ح٥ٗي‬ٝ) ٠ِ‫ح٥ػ‬ ٌَٝ٘‫ر‬ّ‫ػخ‬: -‫حُوٞس‬‫حُـزٜ٤ش‬‫ًحص‬‫حُيٍؿش‬‫حُٔؼظيُش‬‫ًخُ٘خطـش‬ٖ‫ػ‬١ٞ‫حُٔو‬‫ٓٞف‬‫طٔزذ‬ًَٔ‫ٓ٘ن‬‫حُلي‬١ِٞ‫حُؼ‬ٝ‫أ‬ًَٔ‫ُٞكٍٞص‬ ‫ٛ٘ق‬ٍٝ‫أ‬. -‫أٓخ‬‫حُوٞس‬‫حُـزٜ٤ش‬‫ًحص‬‫حُيٍؿش‬ْ‫ح٥ػظ‬َ‫ٓؼ‬‫أً٣ش‬‫طول٤ق‬‫حَُٔػش‬٠‫حُلـخث‬(٠ِ‫ػ‬‫ٗخٍ٣ش‬ ‫ىٍحؿش‬‫٣ٔزذ‬ ) ٬‫ٓؼ‬‫ًُي‬ًَٔ ( ‫ُٞكٍٞص‬2–3ٝ )‫ًَٔح‬‫ٜٓٔ٤خ‬ٖٓ‫هٞس‬ٍ‫ٜٓي‬ ٖٓ ‫ؿزٜ٤ش‬‫ًخُ٘خطـش‬ ( ٠ُ‫ػخ‬ٖ‫ػ‬‫َٛحٝس‬ٝ‫أ‬( ‫ُٞكٍٞص‬ ًَٔ ‫طٔزذ‬ ) ‫ػٜخ‬3) ‫رخ٩ٟخكش‬ٌٍُٞٔ‫أٗل٤ش‬‫ؿَرخُ٤ش‬. -ْ‫ٓؼظ‬‫حُوٞس‬‫حُـزٜ٤ش‬‫طليع‬‫ا‬‫ِٗ٣خكخ‬‫هِل٤خ‬ٝ‫أ‬ِٓ‫ل‬‫٤خ‬ٝ‫أ‬( ‫َٛٓخ‬‫ا‬‫ُِلي‬ ) ‫ٗلٜخٍح‬١ِٞ‫حُؼ‬. -٣‫أ‬‫ش‬‫َٟرش‬ٝ‫أ‬‫ٛيٓش‬‫ُٔ٘ظٜق‬ٚ‫حُٞؿ‬ٖٓ‫حُـخٗذ‬‫ح‬٘‫ُٞك‬٢‫طٔزذ‬‫ًٍٔٞح‬‫ٝؿ٘٤ش‬ٝ‫ىٍٝحٗخ‬‫ُِلي‬١ِٞ‫حُؼ‬٠ُ‫ح‬‫حُـخٗذ‬ َ‫حُٔوخر‬. *‫٣ِؼذ‬َ‫حُـ‬ِ٠‫حُؼ‬٢‫ىٍٝح‬‫أ‬‫ٓخٓ٤خ‬ًٍٞٔ ‫اِٗ٣خف‬ ٢‫ك‬‫حُلي‬٢ِ‫حُٔل‬،‫أٓخ‬٢‫ك‬‫حُلي‬١ِٞ‫حُؼ‬‫كِٜخ‬ٍٝ‫ى‬ٟٞٗ‫ػخ‬٢‫ك‬ٌٍُٞٔ‫ح‬ . ‫ًُي‬َ‫ػز‬ ‫حُٜلخثق‬‫حُ٘خك٤ش‬‫حُلٌ٘٤ش‬‫ٓظٔٔق‬‫ُِؼ٠٬ص‬‫حُـ٘خك٤ش‬‫طلَ٣ن‬٪ُ‫ح‬٢‫ك‬ ٢ٔ‫حُؼظ‬ ٍ‫طٜخ‬‫حُلي‬١ِٞ‫حُؼ‬ٌٍُٞٔٔ‫ح‬ٝ‫ك٘٤خ‬‫أٗٔ٤خ‬ ٝ‫أ‬ ‫ٓٔززخ‬‫طٔخٓخ‬‫ٓزٌَح‬‫ُ٦ٍكخء‬ٝ‫ػ٠ش‬‫ٓلظٞكش‬ ٩‫ح‬‫ِٗ٣خف‬٢‫حُوِل‬‫ُِلي‬١ِٞ‫حُؼ‬َٜ‫٣ظ‬ً‫ب‬١‫ٗ٠ـخ‬٢‫ك‬ٚ‫ٝؿ‬ ( ٚ‫حُٞؿ‬‫ٓلِطق‬َ‫ًٔ٘ظ‬ٖ‫حُٜل‬). ٩‫ح‬‫ِٗ٣خف‬٢ِ‫حُٔل‬‫ُِلي‬١ِٞ‫حُؼ‬َٜ‫٣ظ‬١ِٝ‫ط‬٢‫حك‬ٚ‫ٝؿ‬ ( ٚ‫حُٞؿ‬‫ٓ٠ِغ‬ٚ‫ٗخه‬. ) ّ‫حُؼظخ‬ B-‫حُظٜ٘٤ق‬ ‫حُٜؼذ‬ ٖٓ‫ا‬. ‫حُلٌ٤ش‬ ‫حُٞؿٜ٤ش‬ ٌٍُٞٔ‫ح‬ ٢‫ك‬ ‫حُُٔ٘ٔٞش‬ ّ‫ُِؼظخ‬ ‫ىه٤ن‬ ٠‫ٗؼخػ‬ ٝ َٟ٣َٓ ْ٤٤‫طو‬ ‫١٬م‬‫ا‬ًًٍٞٔ َٔ٘‫ط‬ ‫ٓخ‬ ‫ؿخُزخ‬ ١ِٞ‫حُؼ‬ ‫حُلي‬، ‫حُٔـخٍٝس‬ ‫حُٞؿٜ٤ش‬ ّ‫حُؼظخ‬ ‫ٗؼظٔي‬١ِٞ‫حُؼ‬ ‫حُلي‬ ًٍٞٔ ْٔ‫٣و‬ ‫طٜ٘٤ق‬ ‫كخُ٤خ‬‫ا‬٠ُ: ‫ؿِث٤ش‬ ًٍٞٔ. ‫طخٓش‬ ًٍٞٔ. 1-‫اىقسٍَح‬ ( ‫اىنسىساىجضئٍح‬): ‫ا‬‫ػَٟش‬ ٕ‫ح٥ٓ٘خ‬ َ‫أًؼ‬ ‫٥ٜٗخ‬ ‫حُوٞح١غ‬ ‫أٓ٘خم‬ ‫هخٛش‬ ، ‫كيٝػخ‬ ‫حُـِث٤ش‬ ٌٍُٞٔ‫ح‬ َ‫أًؼ‬ ٢ٛ ‫ح٥ٓ٘خم‬ ًٍٞٔ ٕ. ‫حُٔزخَٗس‬ ‫حُٜيٓخص‬ ٠‫ُظِو‬ ٕ‫ح٥ٓ٘خ‬ ٠ِ‫ػ‬ ‫طليع‬ ٢‫حُظ‬ ‫حُزٔ٤طش‬ َُٟٝٞ‫ح‬ ‫رٔزذ‬ ٌٍُٞٔ‫ح‬ ٌٙٛ ‫طليع‬ ٝ. ‫ططز٤ن‬ ‫رٔزذ‬ ٠‫حُٔ٘و‬ ‫حُ٘ظٞء‬ ٌَٔ٘٣ ‫هي‬ ٝ٩‫ح‬ ‫ؿخٗز٤ش‬ ٝ‫أ‬ ‫أٓخٓ٤ش‬ ‫ٓزخَٗس‬ ‫هٞس‬٢ِ‫حُٔل‬ ‫حُلي‬ ٠ِ‫ػ‬ ‫١زوض‬ ‫ٛخػيس‬ ‫ر٠َرش‬ ٝ‫أ‬ . ٙ‫طـخ‬ ١ِٞ‫حُؼ‬ ٠‫حُٔ٘و‬ ‫حُ٘ظٞء‬ ًٍٞٔ ‫٣ٔزذ‬ ‫ٓٔخ‬. 2-‫اىراٍح‬ ‫اىنسىس‬: ‫ا‬ّٕ‫ُؼظخ‬ ٠‫حُـَحك‬ ٝ ٠‫حُظَ٘٣ل‬ َ‫حُظيحه‬ ‫رٔزذ‬ ، ‫ٛؼذ‬ َٓ‫أ‬ ١ِٞ‫حُؼ‬ ‫ُِلي‬ ‫حُظخٓش‬ ٌٍُٞٔ‫ح‬ ‫طٜ٘٤ق‬٫‫ا‬ ٚ‫حُٞؿ‬ ّ‫ػظخ‬ ‫ٓغ‬ ١ِٞ‫حُؼ‬ ‫حُلي‬ ‫أ‬‫ح‬ ّ‫هخ‬ ٢‫حُظ‬ ‫حُظـخٍد‬ ٕ( ‫ٓ٘ش‬ ‫ُٞكٍٞص‬ ُْ‫ُؼخ‬1901٠ِ‫ػ‬ )‫حُـؼغ‬ ْ‫ؿٔخؿ‬.ّ‫ػظخ‬ ٠ِ‫ػ‬ َُٝ‫ح‬ ‫ططز٤ن‬ ٝ ، ‫حَُهٞس‬ ‫حُ٘ٔؾ‬ ‫اُحُش‬ ‫رؼي‬ ٚ‫حُٞؿ‬) ٖ٤‫ٓؼ‬ ‫اٍطلخع‬ ٖٓ ْ‫ُِـٔخؿ‬ َ‫حُل‬ ١‫ح٩ٓوخ‬ َ‫ػز‬ (‫كٔذ‬ ( ‫حُظخٓش‬ ١ِٞ‫حُؼ‬ ‫حُلي‬ ًٍٞٔ ْ٤ٔ‫طو‬ ٖٓ ‫حُظـخٍد‬ ٌٙٛ ٚ‫ٌٓ٘ظ‬ ، ) ٌَُِٔ ٟٞ‫ٓٔظ‬ ٠ِ‫أػ‬‫ا‬٢ٛ ‫أٗٞحع‬ ٝ‫أ‬ ‫أٛ٘خف‬ ‫ػ٬ػش‬ ٠ُ:
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 53 ‫ىىفىسخ‬ *1: ٌ‫اىؼائ‬ ‫اىنسش‬ ‫أو‬ ٧‫ح‬ ٌٍُٞٔ‫ح‬ ( ‫أ٣٠خ‬ ‫ػِ٤ٜخ‬ ‫٣طِن‬ ‫ًٔخ‬ًٍٞٔ ْٓ‫رخ‬ ‫طؼَف‬ ٝ ) ‫كو٤ش‬( Guerin ). ٣ٕ‫ح٥ٓ٘خ‬ ًٍٟ ‫كٞم‬ َٝ‫ٓؼظ‬ ٌَ٘‫ر‬ ‫أكو٤خ‬ ‫٣ٔظي‬ ٝ ، ‫ُ٦ٗق‬ ‫حٌُٔؼَ٣ش‬ ‫حُٞك٘٤ش‬ ‫حُلخكش‬ ٢‫ك‬ ٌٍُٞٔ‫ح‬ ٖٓ ‫حُ٘ٞع‬ ‫ٌٛح‬ ‫زيأ‬٠ِ‫ػ‬‫أ‬ٍٝ ‫حُـ٤ذ‬٢ٌ‫حُل‬‫حُلٌ٘٤ش‬ ‫حُـ٘خك٤ش‬ ‫حُٜل٤لش‬ َ‫٣ؼز‬ ٠‫كظ‬ ٠٘‫حُٞؿ‬ ‫حُ٘ظٞء‬ َ‫أٓل‬ ‫٣ٔظي‬ ٝ(َ‫ىحه‬ ‫أٓخ‬ . ‫ؿخٗذ‬ ًَ ٢‫ك‬ ) ٠‫حُـ٘خك‬ ‫حُ٘خطت‬ ‫ٗٞى‬ ٖ‫ػ‬ ٢‫ح٥ٗل‬ ِ‫حُلخؿ‬ َٜ‫ك٤٘ل‬ ، ‫ح٥ٗق‬‫حُٔ٤ٌؼش‬ ْ‫ػظ‬ ‫هخػيس‬ َ‫ػز‬ ‫٣ٔظي‬ ٝ ، ‫حُل٘ي‬ ْ‫ػظ‬ ٝ ٠ٓ‫ح٥ٓخ‬ ‫ح٥ٗق‬. َٓ‫ًخ‬ ٌٕٞ٣ ٍٝٝ‫أ‬ ، ٠‫حُٔ٘و‬ ‫حُ٘ظٞء‬–‫هخع‬–‫حُِٜزش‬ ‫حُل٘ي‬ ‫هزش‬ ، ‫حُـ٤ذ‬،‫حُـٔـٔش‬ ٖ‫ػ‬ ‫ٓ٘لِٜش‬ًِٚٔ‫رؤ‬ ١ِٞ‫حُؼ‬ ‫حُلي‬ ٌٕٞ٣ ‫ًٔخ‬ ٌُٚٗٞ ، ‫ٓظلًَخ‬( ‫حَُهٞس‬ ‫رخُ٘ٔن‬ ٢‫كو‬ ‫ٓؼِوخ‬ ‫أٛزق‬‫حُـ٤ذ‬ ٝ ‫ح٥ٗق‬ ٝ ْ‫ُِل‬ ٠١‫حُٔوخ‬ ‫رخُـ٘خء‬)‫ٌُُي‬ ٝ‫ا‬‫رٔويٓش‬ ٚ‫حُلخك‬ ‫أٓٔي‬ ‫ًح‬ َٓ‫ًخ‬ ‫ك٤ـي‬ ، ًَٚ‫ك‬ ٝ ١ِٞ‫حُؼ‬ ‫حُلي‬‫ٌُُي‬ . ‫ُِلًَش‬ َ‫هخر‬ ١ِٞ‫حُؼ‬ ‫حُلي‬ٝ ، ‫رخُؼخثٔش‬ ٌٍُٞٔ‫ح‬ ٌٙٛ ‫ىػ٤ض‬‫ػ٘خث٤ش‬ ٝ‫أ‬ ‫أكخى٣ش‬ ٌٕٞ‫ط‬ ‫هي‬ ‫حُـخٗذ‬. ‫حَُٔ٣َ٣ش‬ ‫ٝحُؼ٬ٓخص‬ ٝ‫ح٧ػَح‬: *‫حُلي‬ ٌ‫٣ظو‬ ‫هي‬ ٖ٤‫حُـ٘خك٤ظ‬ ٖ٤‫حُؼ٠ِظ‬ ‫ٗي‬ ‫رٔزذ‬‫ٝحُوِق‬ َ‫ح٧ٓل‬ ٞ‫ٗل‬ ‫ٟٝؼ٤ش‬ ١ِٞ‫حُؼ‬،‫ػ٠ش‬ ‫ٓ٘خٛيس‬ ٌٖٔ٣ ‫ٌُُي‬ ٝ .‫أٓخٓ٤ش‬ ‫ٓلظٞكش‬‫حُلًَش‬ َ‫ك‬ ٝ‫أ‬ ‫ٓلٍ٘ٞس‬ ‫رٟٞؼ٤ش‬ ١ِٞ‫حُؼ‬ ‫حُلي‬ ‫٣ظٞحؿي‬ ‫هي‬. *‫رَٔػش‬ ٍٞ‫طظط‬ ٢‫حُظ‬ ‫حًُٞٓش‬ ‫رٔزذ‬ ‫حُلـخؽ‬ ‫طلض‬ ‫رخُؼٜذ‬ ّ‫ح٩كٔخ‬ ٚ‫ٗو‬ ‫٣ليع‬ ‫هي‬. *٢٘‫حُٞؿ‬ ‫حُ٘خطت‬ ‫طلض‬ ‫ىٓٞ٣ش‬ ‫ًيٓش‬ *٢ٌ٘‫حُل‬ ٍُ‫حُي‬ ٖٓ ‫هَ٣زخ‬ ٌَُٔ‫ح‬ ٢‫ه‬ َٔ٣ ‫ػ٘يٓخ‬ ‫حُـخٗذ‬ ١‫أكخى‬ ٌَُٔ‫ح‬ ٌٕٞ٣ ٕ‫أ‬ ٌٖٔ٣ٝ .‫هزش‬ ٢‫ك‬ ‫حٌُيٓش‬ ‫ط٬كع‬ ‫ٛ٘خ‬ ‫حُل٘ي‬ *ٌٍُٞٔٔ‫ح‬ ‫حُطزن‬ " ‫ٛٞص‬ ‫كيٝع‬cracked-potsouncٕ‫ح٧ٓ٘خ‬ ٠ِ‫ػ‬ ‫حُوَع‬ ‫ػ٘ي‬.
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 54 *‫ىىفىسخ‬2: ًٍ‫اىهش‬ ‫اىنسش‬ ‫أو‬ ‫ط‬َ‫ئػ‬ٌٍُٞٔ‫ح‬ ٌٙٛ٠ِ‫ػ‬ّ‫حُؼظخ‬: ‫حُلي‬١ِٞ‫حُؼ‬. ٢‫ح٥ٗل‬. ٠‫حُيٓؼ‬. ١‫حُٞطي‬. ٢ُ‫حُـَرخ‬. ‫ا‬‫ح٩ٛخرخص‬ ٢‫ك‬ ‫٣ليع‬ ٍ‫حُظزي‬ ‫ٌٛح‬ ٝ ‫ح٥ٗٔ٤ش‬ ٝ ‫حُٞك٘٤ش‬ ‫حُـ٘خك٤ش‬ ‫حُؼ٠٬ص‬ َٔ‫ػ‬ ‫رٔزذ‬ ‫ٛ٘خ‬ ‫ٓظٞهغ‬ ١ِٞ‫حُؼ‬ ‫حُلي‬ ٢‫ك‬ ٍ‫حُظزي‬ ٕ ٢‫ح٥ٗل‬ ٢ٜ‫حُـز‬ ٍُ‫حُي‬ َ‫أٓل‬ ‫ح٥ٗق‬ َٔ‫ؿ‬ ‫أؿِحء‬ ‫أٟؼق‬ ‫ػ٘ي‬ ٌَُٔ‫ح‬ ‫٣زيأ‬ ٠ٔ‫ػظ‬ ‫رظلظض‬ ‫حُٔظَحكوش‬ ‫حُ٘ي٣يس‬. ٣ ٝ٠‫حُيٓؼ‬ ْ‫حُؼظ‬ َ‫ػز‬ ٝ ٠ٌ‫ُِل‬ ٢ٜ‫حُـز‬ ‫حُ٘ظٞء‬ َ‫ػز‬ ٖ٤‫ُِـخٗز‬ ‫ٔظي‬‫ا‬ٌَُٔ‫ح‬ ٢‫ه‬ ٍِ٘٣ ْ‫ػ‬ . ‫ح٥ٗل٤ش‬ ‫حُيٓؼ٤ش‬ ‫ُِو٘خس‬ ‫ح٥ٓخٓ٤ش‬ ‫حُلخكش‬ ٠ُ ‫هَرٜخ‬ ٝ‫أ‬ ‫حُلـخؽ‬ ‫طلض‬ ‫حُؼوزش‬ ٝ ‫حُلـخؽ‬ ‫طلض‬ ‫رخُلخكش‬ َٔ٣ ٝ ، ٠ٓ‫ح٥ٓخ‬ ‫حُلـخؽ‬ ‫هخع‬ َٔ٘٤ُ ّ‫ح٥ٓخ‬ ٝ ٠٘‫حُٞك‬. ‫ح٥ٓخٓ٤ش‬ ٕ‫حُـيٍح‬ ٍٞ١ ٠ِ‫ػ‬ َ‫ُ٦ٓل‬ ْ‫ػ‬( ‫ُٞكٍٞص‬ ٢‫ك‬ ‫ًٔخ‬ . ‫ٝك٘٤خ‬ ٠٘‫حُٞؿ‬ ْ‫حُؼظ‬ ‫طلض‬ ‫٣ٔظي‬ ‫ٛ٘خ‬ ٖٓ ٝ ، ٠ٌ‫حُل‬ ‫ُِـ٤ذ‬1. ) ‫رٔٔظ‬ ٌُٖ ٝ ٟ‫ُِٞطي‬ ٠‫حُـ٘خك‬ ‫حُ٘خطت‬ َ‫٣ؼز‬ ٝ ٠ٌ‫حُل‬ ٠‫حُـ٘خك‬ ِْ‫حُؼ‬ َ‫ػز‬ ٝ ‫حُلٌ٤ش‬ ‫حُليرش‬ ٍٞ١ ٠ِ‫ػ‬ ‫٣ٔظي‬ ْ‫ػ‬ٞٛ ‫ٓٔخ‬ ٠ِ‫أػ‬ ٟٞ ( ‫ُٞكٍٞص‬ ًَٔ ٢‫ك‬1). ‫ُلخؿ‬ ١ِٞ‫حُؼ‬ ‫حُؼِغ‬ َ‫ػز‬ ٌَُٔ‫ح‬ ٢‫ه‬ ‫ك٤ٔظي‬ ‫ح٥ٗق‬ َ‫ىحه‬ ‫أٓخ‬ُ‫ح‬ ْ‫ػظ‬ ‫ٓ٘ظٜق‬ ٝ ‫حُـَرخُ٤ش‬ ‫حُٜل٤لش‬ َ‫ػز‬ ٝ ‫ح٥ٗق‬ ِٔ‫٤ٌؼش‬ٌٙٛ ‫طظٔزذ‬ ٝ ‫ُِلي‬ ٢ٜ‫حُـز‬ ‫حُ٘ظٞء‬ ٝ ٢‫ح٥ٗل‬ ْ‫حُؼظ‬ ًٍٞٔ ‫طٔزذ‬ ٢‫حُظ‬ ٝ ١ِٞ‫حُؼ‬ ‫حُلي‬ ٖٓ ‫حُؼِٞ٣ش‬ ‫ُِٔ٘طوش‬ ‫َٟرش‬ ٝ‫أ‬ ‫ٛيٓش‬ ٖ‫ػ‬ ٌٍُٞٔ‫ح‬. ٝ‫ح٧ػَح‬‫ٝحُؼ٬ٓخص‬‫حَُٔ٣َ٣ش‬: ‫طلَ٣ي‬ ‫ٓلخُٝش‬ ‫ػ٘ي‬ ٝ ١َ٣َُٔ‫ح‬ ٚ‫رخُلل‬ *، ٢ٜ‫حُـز‬ ٢‫ح٧ٗل‬ ٍُ‫حُي‬ ‫ػ٘ي‬ ‫رخُلًَش‬ ّ‫ح٧كٔخ‬ ٌٖٔ٣ ١ِٞ‫حُؼ‬ ‫حُلي‬ *ًٕٞ‫حَُح‬ ‫رؼ٬ٓش‬ ‫٣ؼَف‬ ‫ٓخ‬ ٝ‫أ‬ ٖ٤‫حُؼ‬ ٍٞ‫ك‬ ‫حٌُيٓش‬ ‫ٓغ‬ ‫طظَحكن‬ ‫حُلـخؽ‬ ٍٞ‫ك‬ ‫حًُٞٓش‬Racon sign. *‫حٌُيٓش‬ ٝ‫أ‬ َٗ‫حُٔزخ‬ َُٝ‫ح‬ ‫رٔزذ‬ ‫٣ليع‬ ‫ٌٝٛح‬ ‫ٗخثغ‬ ‫حُلـخؽ‬ ‫طلض‬ ‫حُؼٜذ‬ ّ‫اكٔخ‬ ٚ‫ٗو‬. *‫حُٔلظٞكش‬ ‫حُؼ٠ش‬ ‫ٓغ‬ ‫٣ظَحكن‬ ‫ٓخ‬ ‫ٝؿخُزخ‬ ‫ح٩١زخم‬ ‫ٓٞء‬. *ٌٖٔ٣ ( ٢ٜ‫حُـز‬ ٢‫ح٧ٗل‬ ٍُ‫حُي‬ ‫ػ٘ي‬ ‫ٓ٬كظظٜخ‬ ٌٖٔ٣ ‫ًٔخ‬ ْ‫رخُـ‬ ‫ُِلـخؽ‬ ‫حُٔلِ٤ش‬ ‫حُلخكش‬ ‫ػ٘ي‬ ‫ىٍؿش‬ ‫ٓ٬كظش‬ ٌٖٔ٣ ‫رخُظلَ٣ي‬ ‫ًُي‬ ‫ٓ٬كظش‬). *‫ٝحَُػخف‬ ‫ح٧ٗق‬ َ‫ػز‬ ٢ًُٞ٘‫ح‬ ٢‫حُيٓخؿ‬ َ‫حُٔخث‬ ‫ِٗف‬. *٢ٔٗ٫‫ح‬ ٢‫حُٔآه‬ ١‫حَُرخ‬ ‫طِٔم‬ ‫رٔزذ‬ ٖ٤٘٤‫حُؼ‬ ٖ٤‫ر‬ ‫حُٔٔخكش‬ ‫طزخػي‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 55 *‫ىىفىسخ‬3‫اىَؼرشضح‬ ‫اىنسىس‬ ‫أو‬: ٩‫ح‬ ‫طلَم‬ ٌٍُٞٔ‫ح‬ ٌٙٛ ‫طٔزذ‬ ٝ٩‫ح‬ ( ٍ‫طٜخ‬َٓ‫ًخ‬ ‫طلَم‬ ‫٩كيحع‬ ‫ًخك٤ش‬ ‫حُوٞس‬ ٌٕٞ‫ط‬ ‫ػ٘يٓخ‬ ‫طليع‬ ٢ٛ ٝ ، ٢‫حُولل‬ ٢ٜ‫حُٞؿ‬ ) ٍ‫ٗلٜخ‬ ٖٓ ‫حُٞؿٜ٤ش‬ ّ‫ُِؼظخ‬‫ا‬ٖٔ٠‫طظ‬ ٝ ‫حُولل٤ش‬ ‫ٍطزخ١خطٜخ‬٠٘‫حُٞؿ‬ ْ‫حُؼظ‬ ٝ ‫ح٥ٗق‬ ْ‫ػظ‬ ٌٍُٞٔ‫ح‬ ٌٙٛ. ‫ٓلِطلخ‬ ٬ٌٗ ٚ‫حُٞؿ‬ ‫ٓؼط٤خ‬ ‫ُِوِق‬ ‫ٓ٘يكؼش‬ ٚ‫حُٞؿ‬ ٖٓ ٢ٓٞ‫حُٔظ‬ ‫حُؼِغ‬ ٝ ١ِٞ‫حُؼ‬ ‫حُلي‬ ٌٕٞ٣.٢ٜ‫حُـز‬ ٍُ‫حُي‬ ‫ػ٘ي‬ ٌَُٔ‫ح‬ ‫٣زيأ‬ ٠‫حُيٓؼ‬ ٢‫ح٥ٗل‬ ‫حُٔ٤ِحد‬ ٖٓ ١ِٞ‫حُؼ‬ ْٔ‫حُو‬ َ‫ػز‬ ٖ٤‫ُِطَك‬ ٚ‫٣ظـ‬ ٝ ، ٠ٌ‫حُل‬ ٢ٜ‫حُـز‬ ٝ ٢‫ح٥ٗل‬. ٠ِ‫ػ‬ ٝ . ‫حُزَٜ٣ش‬ ‫حُؼوزش‬ ّ‫أٓخ‬ ‫طٔخٓخ‬ ‫ٗوطش‬ ٠ُ‫حُـَرخ‬ ْ‫حُؼظ‬ ٍٞ١ ٠ِ‫ػ‬ ‫هِل٤خ‬ ‫٣ٔظي‬ ٝ‫ا‬‫رخُؼوزش‬ ٠ٔ‫حُٔل‬ ٟ‫حُٞطي‬ ْ‫حُؼظ‬ ٕ‫أ‬ ٍ‫ػظزخ‬ ‫٣٠ؼق‬ ‫ٌُح‬ ‫ؿيح‬ ٖ٤‫ػو‬ ‫حُزَٜ٣ش‬‫ا‬‫ر‬ ٌَُٔ‫ح‬ ٢‫٣ٜز‬ ْ‫ػ‬ َٟٜ‫حُز‬ ‫حُ٘لن‬ ‫ٌٛح‬ ٢‫ك‬ ٌَُٔ‫ح‬ ٍ‫كظٔخ‬‫ب‬٠ُ‫ح‬ ٚ٘ٓ ٝ ‫حُلـخؽ‬ ‫طلض‬ ‫حُ٘لن‬ ‫ريح٣ش‬ ٙ‫طـخ‬ ٤ُ‫ػخ‬ ْ‫ػ‬ ‫حُلٌ٘٤ش‬ ‫حُٞطي٣ش‬ ‫حُللَس‬ٖ٤‫حُلٌ٘ظ‬ ٖ٤‫حُـ٘خك٤ظ‬ ٖ٤‫حُٜل٤لظ‬ َ‫ػز‬ ‫خ‬. ٔ٣‫ر‬ ٌَُِٔ ٕ‫ػخ‬ ٢‫ه‬ ‫حُلـخؽ‬ َ‫ىحه‬ ٖٓ َ‫ب‬ٍ‫حُـيح‬ ٍٞ١ ٠ِ‫ػ‬ ٠ِ‫ُ٦ػ‬ ‫ُ٤ٔظي‬ ٢ِ‫حُٔل‬ ‫حُلـخؽ‬ ‫طلض‬ ‫حُ٘ن‬ ٍٞ١ ٠ِ‫ػ‬ ٠ٓ‫أٓخ‬ ٙ‫طـخ‬ ‫ػ٘ي‬ ‫ُِلـخؽ‬ ٠٘‫حُٞك‬٩‫ح‬‫حُٞط‬ ٠‫حُـ٘خك‬ ٝ ٠٘‫حُٞؿ‬ ٍ‫طٜخ‬١‫ي‬‫٣ٔظي‬ ْ‫ػ‬‫ا‬. ٟ‫حُٞطي‬ ٢ٜ‫حُـز‬ ٍُ‫حُي‬ ٠ُ ‫ا‬ٖ٤‫حُٞؿ٘٤ظ‬ ٖ٤ٓٞ‫حُو‬ ًَٔ ٕ( ‫ٛ٘ق‬ ‫ُٞكٍٞص‬ ًَٔ َٟ‫ٓـ‬ ْٔ‫٣ظ‬3‫ح٥ٗق‬ ‫(هخٍؽ‬ ٠‫حُوخٍؿ‬ ).) ‫حُٜل٤لش‬ ٢‫ك‬ ‫طللض‬ ٝ ‫طِٔم‬ ‫ػخىس‬ ‫٣ٔزذ‬ ٝ . ٠ُ‫حُـَرخ‬ ْ‫ُِؼظ‬ ‫حُؼٔٞى٣ش‬ ‫حُٜل٤لش‬ ‫هخػيس‬ َ‫ػز‬ ٌَُٔ‫ح‬ ٢‫ه‬ َٔ٤‫ك‬ ‫ح٥ٗق‬ َ‫ىحه‬ ‫أٓخ‬ ٝ ، ‫حُٜٔلٞ٣ش‬َ‫ػز‬ ٠ِ‫حُيحه‬ ٌَُٔ‫ح‬ ٢‫ه‬ َٔ٣ ‫أه٤َح‬‫ا‬ٟ‫رخُٞطي‬ ‫حُٔ٤ٌؼش‬ ْ‫ػظ‬ ٍ‫طٜخ‬. ٩‫ح‬ َِ‫ه‬ َٔ‫٣ٌظ‬ ‫ٌٌٛح‬ ٍٝ‫طٜخ‬‫طظَحك‬ ، ٢‫حُولل‬ ٢ٜ‫حُٞؿ‬‫ٝؿٜ٤ش‬ ٌٍٞٔ‫ر‬ ‫ػخىس‬ ٌٍُٞٔ‫ح‬ ٌٙٛ ‫ن‬‫ح‬ ّ‫ػظخ‬ ٢‫ك‬ ‫ٓظؼيىس‬‫طظَحكن‬ ‫ًٔخ‬ ٚ‫ُٞؿ‬ ‫ؿخُزخ‬‫ح٥ٓخٓ٤ش‬ ‫حُولل٤ش‬ ‫حُللَس‬ ٢‫ك‬ ًَٔ ‫ٝؿٞى‬ ٠ِ‫ػ‬ ٬٤ُ‫ى‬ ‫ٌٛح‬ ٌٕٞ٣ ٝ ‫ح٥ٗق‬ ٖٓ ٠ًُٞ٘‫ح‬ ٠‫حُيٓخؿ‬ َ‫حُٔخث‬ ٕ٬٤ٔ‫ر‬. ٩‫ح‬ ‫٣ـذ‬ ‫ٛ٘خ‬ ٝٙ‫ٗظزخ‬‫ا‬ّ‫ػي‬ ٠ُ‫ا‬َ‫هز‬ ٟٝ‫٣ي‬ ٚ‫كل‬ ٝ‫أ‬ ‫ٓيحهِش‬ ٟ‫أ‬ ‫ؿَحء‬‫ا‬‫ٓظيػخء‬ٟ‫ٓي‬ ‫ُٔؼخ٣٘ش‬ ٠‫ػٜز‬ ‫ؿَحف‬ٝ ‫حُيٓخؿ٤ش‬ ‫ح٩ٛخرش‬ . ‫ٓؼخُـظٜخ‬ ٖ٤‫حُطَك‬ ٢‫ك‬ ٝ‫أ‬ ‫ٝحكي‬ ‫رطَف‬ ، ٞ٣َُٔ‫ح‬ ْ‫ٗل‬ ٢‫ك‬ ‫ٓؼخ‬ ٌٍُِٞٔ ‫ُٞكٍٞص‬ ‫طٜ٘٤ق‬ ٖٓ ‫حُؼ٬ػش‬ ‫ح٥ٗٞحع‬ ‫طليع‬ ‫هي‬. ‫كٞحىع‬ ٢‫ك‬ ٖ٤٤ٗ‫حُٔي‬ ‫ػ٘ي‬ ‫طليع‬ ‫هي‬ ‫أٜٗخ‬ ٫‫ا‬ ، ‫حُلَٝد‬ ٢‫ك‬ ‫طليع‬ ‫ٓخ‬ ‫ؿخُزخ‬ ٢ٜ‫ك‬ ‫حُٔلظظش‬ ٌٍُِٞٔ ‫رخُ٘ٔزش‬ ‫أٓخ‬ٝ‫أ‬ ‫حُ٘ي٣يس‬ ‫حُٔ٤خٍحص‬ ْ‫كـ‬ ‫كلٔذ‬ ‫ٓؼخُـظٜخ‬ ‫أٓخ‬ ٝ . ‫حُ٘ٔؾ‬ ٢‫ك‬ ‫ًز٤َح‬ ‫ٓخى٣خ‬ ‫ٍٟ٤خ‬ ‫ط٘ٞٛخ‬ ٝ ّ‫حُؼظخ‬ ٢‫ك‬ ‫ًز٤َح‬ ‫طلظظخ‬ ‫طليع‬ ٢‫حُظ‬ ‫حُ٘خٍ٣ش‬ ‫حُطِوخص‬ ٢‫ك‬ ‫ٌٓخٜٗخ‬ ٝ ‫ح٩ٛخرش‬. ٝ‫ح٧ػَح‬‫ٝحُؼ٬ٓخص‬‫حَُٔ٣َ٣ش‬: *ٖ‫حُٜل‬ ٚ‫ٝؿ‬Dish face.ٖٓ ٢ٓٞ‫حُٔظ‬ ‫ٝحُؼِغ‬ ١ِٞ‫حُؼ‬ ‫حُلي‬ ّ‫ػظخ‬ ٌٕٞ‫ط‬ ‫ك٤غ‬٬ٌٗ ‫ٓؼط٤ش‬ ‫ُِوِق‬ ‫ٓ٘يكؼش‬ ٚ‫حُٞؿ‬ ‫ٓلِطلخ‬ *٢٘‫حُٞؿ‬ ٢ٜ‫حُٞؿ‬ ‫حُٔؼوي‬ ‫كًَش‬. *٢ًُٞ٘‫ح‬ ٢‫حُيٓخؿ‬ َ‫حُٔخث‬ ٕ٬٤ٓ. *‫حُلـخؽ‬ ٍٞ‫ك‬ ‫ٝحٌُيٓش‬ ‫حًُٞٓش‬.
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 56 *٢َُٟ‫ح‬ ‫حُٔآم‬ ‫طزخػي‬ *ٖ٤‫حُؼ‬ )ٍ‫ٝهٞٙ(ؿئ‬ َٔ‫ٓلظ‬ ‫ٗلغ‬ ‫ٓغ‬ ‫حُؼ٤٘٤ش‬ ‫حُلًَخص‬ ٢‫ك‬ ‫طليى‬. *‫ح٫ٗٔ٤ش‬ ‫حُـ٘خك٤ش‬ ٖٓ َ‫أًز‬ ٍٝ‫ى‬ ‫حُٔخٟـش‬ ‫حُؼ٠ِش‬ ‫ٝطِؼذ‬ ‫ح٫ٓخٓ٤ش‬ ‫حُٔلظٞكش‬ ‫حُؼ٠ش‬ ّ‫ػخ‬ ٢‫ك‬1993: ٢‫حَُٔؿؼ‬ ‫ُِظٜ٘٤ق‬ ‫ح٧ٓخٓ٤ش‬ ‫رخُٔزخىة‬ ّ‫حُٔٔخ‬ ٕٝ‫ى‬ ٌُٖ ٝ ‫ُٞكٍٞص‬ ‫طٜ٘٤ق‬ ٠ِ‫ػ‬ ‫طؼي٣٬ص‬ ‫ػيس‬ ‫أىهِض‬ )*‫ُٞكٍٞص‬1ٞ‫ٓ٘ول‬ ١ِٞ‫ػ‬ ‫كي‬ ًَٔ : ‫ُٞكٍٞص‬1a‫ٓغ‬ ٞ‫ٓ٘ول‬ ١ِٞ‫ػ‬ ‫كي‬ ًَٔ :‫هطغ‬ ‫ػيس‬ ‫ٝؿٞى‬ )*‫ُٞكٍٞص‬2٢َٓٛ ًَٔ : ‫ُٞكٍٞص‬2a‫ح٧ٗق‬ ْ‫ػظ‬ ًَٔ ‫ٝؿٞى‬ ‫ٓغ‬ ٢َٓٛ ًَٔ : ‫ُٞكٍٞص‬2b٢ُ‫حُـَرخ‬ ٢‫ح٧ٗل‬ ‫حًَُٔذ‬ ٢‫ك‬ ًَٔ ‫ٓغ‬ ٢َٓٛ ًَٔ : )*‫ُٞكٍٞص‬3:َٝ‫ٓؼظ‬ ًَٔ ‫ُٞكٍٞص‬3a‫ح٧ٗق‬ ْ‫ػظ‬ ًَٔ ‫ٝؿٞى‬ ‫ٓغ‬ َٝ‫ٓؼظ‬ ًَٔ : ٍٞ‫ُٞك‬‫ص‬3b:ًَٔ٢َٓٛ‫ٓغ‬ًَٔ٢‫ك‬‫حًَُٔذ‬٢‫ح٧ٗل‬٢ُ‫حُـَرخ‬ )*‫ُٞكٍٞص‬4‫ُٞكٍٞص‬ ًَٔ ٞٛ :2ٝ‫أ‬3‫حُـٔـٔش‬ ‫هخػيس‬ ٢‫ك‬ ًَٔ ‫ٓغ‬ ‫ُٞكٍٞص‬4a‫ُِلـخؽ‬ ‫حُؼِٞ٣ش‬ ‫حُلخكش‬ ًَٔ ٚ٤ُ‫ا‬ ‫٣٠خف‬ : ‫ُٞكٍٞص‬4b‫ُِلـخؽ‬ ‫حُؼِٞ٣ش‬ ‫حُلخكش‬ ًَٔ ٝ ‫ح٧ٓخٓ٤ش‬ ‫حُولل٤ش‬ ‫حُللَس‬ ٢‫ك‬ ًَٔ ‫اُ٤ش‬ ‫٣٠خف‬ : ‫ُٞكٍٞص‬4c:٢‫ك‬ ًَٔ ٚ٤ُ‫ا‬ ‫٣٠خف‬‫حُلـخؽ‬ ٍ‫ؿيح‬ ًَٔ ‫ٓغ‬ ‫ح٧ٓخٓ٤ش‬ ‫حُولل٤ش‬ ‫حُللَس‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 57 C-ٝ‫ح٧ػَح‬ ٢ِ٣ ‫ٓخ‬ ‫ؿٔ٤غ‬ ٝ‫أ‬ ٞ‫رؼ‬ ‫حُلي‬ ٢‫ك‬ ًَٔ ‫كيٝع‬ ٖ‫ػ‬ ْ‫ط٘ـ‬ ‫هي‬ ٢‫حُظ‬ ٝ‫ح٧ػَح‬ ٖٔ٠‫طظ‬: ‫رٔزذ‬ *‫ٗي‬ٖ٤‫حُؼ٠ِظ‬ٖ٤‫حُـ٘خك٤ظ‬‫هي‬ٌ‫٣ظو‬‫حُلي‬١ِٞ‫حُؼ‬‫ٟٝؼ٤ش‬ٞ‫ٗل‬َ‫ح٧ٓل‬‫حُوِق‬ ٝ,‫ٌُُي‬ٌٖٔ٣‫ٓ٘خٛيس‬‫ػ٠ش‬‫ٓلظٞكش‬ ‫أٓخٓ٤ش‬،‫هي‬ ٝ‫٣ظٞحؿي‬‫حُلي‬١ِٞ‫حُؼ‬‫رٟٞؼ٤ش‬‫ٓلٍ٘ٞس‬ٝ‫أ‬َ‫ك‬‫حُلًَش‬. ‫هي‬ *‫٣ليع‬ٚ‫ٗو‬ّ‫ح٩كٔخ‬‫رخُؼٜذ‬‫طلض‬‫حُلـخؽ‬‫رٔزذ‬‫حًُٞٓش‬٢‫حُظ‬ٍٞ‫طظط‬‫رَٔػش‬. ‫ًيٓش‬ *‫ىٓٞ٣ش‬‫طلض‬‫حُ٘خطت‬٢٘‫حُٞؿ‬ ٌٖٔ٣ *ٕ‫أ‬ٌٕٞ٣ٌَُٔ‫ح‬١‫أكخى‬‫حُـخٗذ‬‫ػ٘يٓخ‬َٔ٣٢‫ه‬ٌَُٔ‫ح‬‫هَ٣زخ‬ٍُٖٓ‫حُي‬٢ٌ٘‫حُل‬.ٝ‫ٛ٘خ‬‫ط٬كع‬‫حٌُيٓش‬٢‫ك‬‫هزش‬‫حُل٘ي‬ ‫كيٝع‬ *‫ٛٞص‬"‫حُطزن‬ٌٍُٞٔٔ‫ح‬cracked-potsounc‫ػ٘ي‬‫حُوَع‬٠ِ‫ػ‬ٕ‫ح٧ٓ٘خ‬. ‫ا‬ *‫حُؼ٠ش‬ ‫ُظٞحء‬. *ٝ ،‫حُِؼخد‬ ٕ٬٤ْٓ‫حُل‬ ‫اؿ٬م‬ ٠ِ‫ػ‬ ‫حُويٍس‬ ّ‫ػي‬ ٝ‫أ‬ ‫ٛؼٞرش‬ ٖٓ ‫حُظِكِف‬ ‫ًُي‬ ٚ‫٣ٔزز‬ ‫ٓخ‬ ‫ٗظ٤ـش‬ ‫ًُي‬. *‫حُوخٍؽ‬ ٠ُ‫ا‬ ‫حُلي‬ َُٝ‫ر‬. *ّ‫ػي‬‫ا‬‫ٓؼخ‬ ٕ‫ح٧ٓ٘خ‬ ٢‫ٛل‬ ّ‫ٗظظخ‬. *‫حُلي‬ ٢‫ك‬ ّ٫‫آ‬. *‫حُظِكِف‬ ‫ك٤ٜخ‬ ‫كيع‬ ٢‫حُظ‬ ‫حُـٜش‬ ٖٓ ًٕ٧‫ح‬ ‫هِق‬ ‫ًَِٓٛخ‬ ٌٕٞ٣ ٚ‫حُٞؿ‬ ٢‫ك‬ ّ٫‫آ‬. ‫حُلًَش‬ ‫ٓغ‬ ‫ٓٞءح‬ ‫طِىحى‬ ّ٫٥‫ح‬ ٌٙٛ ٕ‫أ‬ ًٌَ٣ٝ٢‫حُ٠ـ‬ ‫ٓغ‬ ٝ‫أ‬. D-‫حُٔ٠خػلخص‬ ٢ِ٣ ‫ٓخ‬ ٖ٤‫حُلخُظ‬ ٢‫ًِظ‬ ٖ‫ػ‬ ْ‫ط٘ـ‬ ‫هي‬ ٢‫حُظ‬ ‫حُٔ٠خػلخص‬ ٖٔ٠‫طظ‬: ْ‫حُظ٘ل‬ َٟ‫ٓـ‬ ‫اٗٔيحى‬. ‫حُِ٘٣ق‬. ٝ‫أ‬ ّ‫حُي‬ ٍٖٞٛٝ٤‫حَُثظ‬ ٠ُ‫ا‬ َ‫حُٔٞحث‬ ٝ‫أ‬ ّ‫حُطؼخ‬ ‫كظخص‬. ٝ ٌِْ‫حُظ‬ ٢‫ك‬ ‫حُٔئهظش‬ ‫حُٜؼٞرش‬ّ‫حُطؼخ‬ ٍٝ‫ط٘خ‬. ‫كيٝع‬‫ا‬‫ُظٜخ‬‫٣ظطِذ‬ ‫ٓخ‬ ،‫حُلي‬ ٝ‫أ‬ ٚ‫حُٞؿ‬ ٢‫ك‬ ‫رخص‬‫ا‬‫حُل٤ٞ٣ش‬ ‫حُٔ٠خىحص‬ ّ‫ٓظويح‬. ّ‫ػي‬‫ا‬٧‫ح‬ ‫ؿ٬م‬‫ؿ٤ي‬ ٌَ٘‫ر‬ ٕ‫ٓ٘خ‬. E-١ِٞ‫حُؼ‬ ‫حُلي‬ ٌٍُٞٔ ١َ٣َُٔ‫ح‬ ٚ٤‫حُظ٘و‬ 1-ٚ٤‫حُظ٘و‬: ٩‫ح‬ ‫حُلخ٫ص‬ ٢‫ك‬٫ٝ‫أ‬ ‫٣ـذ‬ ‫ٓؼخك٤ش‬ٝ ‫حُِ٘٣ق‬ ٠ِ‫ػ‬ ‫حُٔ٤طَس‬ ْ‫ػ‬ ٢ٔ‫حُظ٘ل‬ َٟ‫حُٔـ‬ َ٤‫طير‬‫ُظلي٣ي‬ ‫ٓٞؿِس‬ ‫َٟٓ٤ش‬ ‫هٜش‬ ٌ‫ٗؤه‬ ‫ًُي‬ ‫رؼي‬ ٝ ‫ٓزذ‬٧‫ح‬ ‫كيٝع‬ ُٖٓٝ ‫ًٔخ‬ ‫ً٣ش‬َ٣ٜٞ‫ط‬ ْ‫٣ظ‬ٝ ٢‫آؼخك‬٨ُ ‫ىه٤ن‬َٛ‫ظخ‬ َ٤‫ؿ‬ ‫ُِل٤خس‬ ‫ٜٓيى‬ َٜ‫ٓظ‬ ١‫أ‬ ٝ‫أ‬ ‫حَُٔحكوش‬ ‫ً٣خص‬ْ‫ػ‬ ٖٓ ٝ ‫َٟٓ٤ش‬ ‫هٜش‬ ٌ‫أه‬ ٌٖٔ٣ 2-‫حَُٟٔ٤ش‬ ‫حُوٜش‬ ٝ ‫ٓٞؿِس‬ ٌٕٞ‫ط‬ ٕ‫أ‬ ‫٣ـذ‬‫ٛخىكش‬ٝٝ َُٝ‫ح‬ ‫ر٘ٞع‬ ‫حُٔظؼِوش‬ ‫حُٔؼِٞٓخص‬ َٔ٘‫ط‬‫ا‬ٝ ٚٛ‫طـخ‬ٚ٤‫حُظ٘و‬ ٞ‫ٗل‬ ٚ‫حُظٞؿ‬ ٢‫ك‬ ‫ُظٔخػي‬ ٚ‫ٗيط‬ ْ٤ُِٔ‫ح‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 58 3-١َ٣َُٔ‫ح‬ ٚ‫حُلل‬ ‫ح‬: ٢ٌ‫ك‬ ٢ٜ‫ٝؿ‬ َٝ‫ر‬ ‫ٜٓخد‬ ٞ٣َُٔ ‫حُٞؿٜ٤ش‬ ‫ُٔ٬ٓق‬ *ٝ ‫رخًُٞٓش‬ ٠‫ٓـط‬ ٚ‫حُٞؿ‬ ٌٕٞ٣ٝ ٍّٞ‫ٓظ‬ ٚ‫ٝؿ‬ ‫ٓغ‬ ‫حٌُيٓش‬ٝ ٠ٓ‫حُٔي‬ ‫حُِؼخد‬ ٍَٝٔ‫ر‬ ‫طٔٔق‬ ‫ٓلظٞكش‬ ٙ‫ٗلخ‬٧‫ح‬ ‫٣ليع‬‫ػ٘ي‬ ُْ‫كًَش‬ ٝ ‫ًٔخ‬ ٢ِ‫حُٔل‬ ‫حُلي‬ٝ ‫حُزِغ‬ ‫٣ٜؼذ‬ٝ ‫حُظٜٞ٣ض‬‫ػظٔ٤ش‬ ‫ر٘ٞحطت‬ ‫حُـِي‬ ْ‫ؿ‬ ‫ػ٘ي‬ ‫أك٤خٗخ‬ َ‫ٗ٘ؼ‬ ‫ًٔخ‬ ‫حُٔ٠ؾ‬ َ٤‫٣ٔظل‬ *ٙٞ٘‫حُظ‬:ٝ ٍّٞ‫حُظ‬ ٠ُ‫ا‬ ٙٞ٘‫حُظ‬ ‫ٌٛح‬ ‫٣ؼٞى‬٩‫ح‬ٝ ‫حُلخىع‬ ‫ٗظزخؽ‬ٝ ‫حُظٜظي‬ ٠ُ‫ا‬ٝ ‫حَُهٞس‬ ‫حُ٘ٔؾ‬ ٢‫ك‬ َٛ‫حُلخ‬ ١ً‫حُظؤ‬ٕ‫كب‬ ‫حُٞحهغ‬ ٢‫ك‬ ٚ‫طلظ‬ ‫حُٞحهؼش‬ ٌٍُٞٔ‫ح‬ ‫ُ٘يس‬ ٢‫حُٔزيث‬ ٖ٤ٔ‫حُظو‬ ٢‫ك‬ ‫٣ٔخػي‬ ٙٞ٘‫حُظ‬ ‫ٌٛح‬ *ٝ ‫ٓ٘ظٔخ‬ ١َ٣َُٔ‫ح‬ ٚ‫حُلل‬ ٌٕٞ٣ ٕ‫أ‬ ‫٣ـذ‬٫ ‫رل٤غ‬ ٬ٜ‫ٓل‬‫ٓ٘طوش‬ ١‫أ‬ َٜٔٗ,ٝ‫حُٔ٬كظش‬ ٢ٛ ٚ‫ُِلل‬ ‫حُظوِ٤ي٣ش‬ ‫حُطَ٣وش‬ ُ‫ح‬‫ٔظزٞػش‬‫ٓغ‬ ْ‫رخُـ‬‫ٓ٬كظش‬ٝ ٢‫حُـخٗز‬ َ‫حُظ٘خظ‬ ّ‫ػي‬٧‫ح‬ٝ ٢ٓ‫ٓخ‬٢ُٜٔٔ‫ح‬ *‫اؿَحء‬ ‫٣ـذ‬٨ُ ِ‫ٓٞؿ‬ ٚ‫كل‬٢‫أٗل‬ ٕ٬٤ٓ ‫ٝؿٞى‬ ٖ٤‫ٓ٬كظ‬ ‫ٗق‬(٧‫ح‬ ‫رخُِ٘ف‬ ٠‫٣ـط‬ ‫هي‬ ١ٌُ‫ح‬٢‫ٗل‬)‫هي‬ ٝ‫أ‬ٕ٬٤ُٔ‫ح‬ ٚ‫٣ظـ‬ّٞ‫حُزِؼ‬ ٠ُ‫ا‬ ٧‫ح‬‫ػ٘ي‬ ٢‫ٗل‬ٝ ٞ٣َُٔ‫ح‬ ٚ‫٣لل‬٢‫ٓٔظِو‬ ‫رٟٞغ‬ ٞٛ *ٝ ّ‫حَُأ‬ ‫ُلَٝس‬ ٚ‫كل‬ ‫اؿَحء‬ ‫٣ـذ‬ٝ ‫حُٔؼخ٣٘ش‬ ْ‫طظ‬ ٕ‫أ‬ ٠ِ‫ػ‬ ‫حُـٔـٔش‬‫ٓؼخ‬ ١‫أ‬ ‫اؿَحء‬ َ‫هز‬ ْ‫حُـ‬ٓ‫ٝؿٞى‬ ‫ٗ٬كع‬ ‫كوي‬ ‫٣يٝ٣ش‬ ‫ِش‬ ‫ط٘ط٤زخص‬ٝٝ ٕ‫رخُ٘خ‬ ٢‫حُ٠ـ‬ ‫طلض‬ ٠‫كظ‬ ‫ٗخُكش‬ ‫ؿَٝف‬٠ُ‫ا‬ َ٤٘‫ط‬ ‫حُٔٞؿٞىحص‬ ٌٙٛ‫ا‬‫(كًَش‬ ٕ‫أ‬ ‫ًٔخ‬ ٢‫هلل‬ ًَٔ ‫ٝؿٞى‬ ‫ٌٓخٗ٤ش‬ ‫حُلو‬ ‫حُؼٔٞى‬ ‫اٛخرش‬ ٠ُ‫ا‬ َ٤٘‫ط‬ ‫هي‬ ‫حُِط٤ق‬ ْ‫حُـ‬ ٝ‫أ‬ ‫رخُلًَش‬ ‫حُظَٜ٣ش‬ ٚٓ٫‫آ‬ ٞ٣َُٔ‫ح‬)١َ *ٝ ‫حَُٔكِش‬ ٌٙٛ ٢‫ك‬ ٖ٤‫ُِؼ‬ ٢‫١ز‬ ٚ‫كل‬ ‫اؿَحء‬ ‫٣ـذ‬ ‫ًٔخ‬٨ُ ‫ُط٤ق‬ ‫ٗي‬ ٖٔ٠‫ط‬ ٖ٤‫ُِؼ‬ ٢٤ٔ‫حُز‬ ٚ‫حُلل‬‫ؿل‬ٝ ‫ًٔخ‬ ٕ‫خ‬َٔ‫ؿ‬ ٌٖٔ٣ ٝ‫أ‬ ْ‫ٓؼو‬ ‫رٔخء‬ ٖ٤‫حُؼ‬ٝ ٚ‫حُلل‬ ّ‫اطٔخ‬ ‫حُِ٘ف‬ ‫اػخهش‬ ٍ‫كخ‬ ٢‫ك‬ ‫َٓ١ذ‬ ٖ‫هط‬ٝ ٖ٤‫حُؼ‬ ‫ٝظ٤لش‬ ٚ‫كل‬ ‫رٜيف‬ ‫ًُي‬‫حُلًَش‬ ‫ٝؿٞى‬ ٚ٤‫ط٘و‬ ٖ٤‫ُِؼ‬ ‫حٌُحط٤ش‬ *٧‫ح‬ٝ ‫ح٫ؿِٜس‬ ًَ ٌٍ‫رل‬ ‫ِٗ٘ع‬ ٕ‫أ‬ ‫٣ـذ‬ ْ‫حُٔ٘ظ‬ ١ٞٔ‫حُل‬ َ‫ىحه‬ ٚ‫حُلل‬ ٢ٛ ‫حُظخُ٤ش‬ ‫ُٝٞ٣ش‬ٝ ٍٞٔ‫حُـ‬‫حُٔ٘لِٜش‬ ٝ‫أ‬ ‫حٌٍُٔٔٞس‬ ٕ‫حُظ٤ـخ‬ ٝ٧‫ح‬٧‫ح‬ ّ‫ؿٔخ‬٩‫ح‬ ٖٓ ٢ٔ‫حُظ٘ل‬ َُٔٔ‫ح‬ ‫ُلٔخ٣ش‬ ‫ؿ٘ز٤ش‬ٝ ٕ‫حُِٔخ‬ ‫هخػيس‬ ٚ‫ٗلل‬ ْ‫ػ‬ ‫ٗٔيحى‬ٝ ٢ٓٞ‫حُزِؼ‬ ‫حُـ٘خء‬ ٍٞ‫ك‬ ‫ٓخ‬ٝ ‫حُِٜخس‬ ٖ٤‫حُُِٞط‬.٧‫ح‬ ‫حُِؼخر٤ش‬ ‫حُـيى‬ ‫أه٘٤ش‬ ٢‫ك‬ ‫ؿَٝف‬ ٝ‫أ‬ ‫ط٘ط٤زخص‬ َٜ‫٣ظ‬ ‫هي‬ ْ‫حُل‬ ‫ُوخع‬ ‫ىه٤وخ‬ ‫كلٜخ‬ ٕ‫أ‬ ‫ًٔخ‬٤ٓ‫ٓخ‬‫ش‬ ‫ا‬ *ٓ ٚ‫كل‬ ‫ؿَحء‬ٜ‫ل‬١ِ٤ٛ‫ى‬ ٢‫ٓ٘و‬ ًَٔ ٠ُ‫ا‬ ٖٓ ١‫أ‬ ‫كًَش‬ َ٤٘‫ط‬ ٕ‫أ‬ ٌٖٔ٤‫ك‬ ‫كيس‬ ٠ِ‫ػ‬ ٖٓ ًَ ٚ‫رلل‬ ّٞ‫ٗو‬ : ١ِٞ‫حُؼ‬ ‫ُِلي‬ َ ٢ٌ٘‫ك‬ ٝ‫أ‬ *٩‫ح‬ ‫ٓٞء‬ٝ ‫حُٔٔ٤ِس‬ ‫حُؼ٬ٓخص‬ ْٛ‫أ‬ ٖٓ َ‫:٣ؼظز‬ ‫١زخم‬ٝ ‫حُٞحٟلش‬ٝ‫أ‬ ‫حُٜيٓش‬ َ٤‫كزظؤػ‬ ْ٤ُِٔ‫ح‬ ٚ٤‫حُظ٘و‬ ‫ٟٝغ‬ ٢‫ك‬ ‫٣ٔخػي‬ ٚ٣َ‫طل‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 59 ٝ ٌَُٔ‫ح‬ ‫هطغ‬ ٢‫ك‬ ٍ‫طزي‬ ‫٣ليع‬ ‫حُؼ٠٬ص‬ ‫ط٘٘ؾ‬‫ا١زخ‬ ‫ٓٞء‬ ٢ُ‫رخُظخ‬‫م‬ ٝ ‫ٝحٟق‬ َ٤ُ‫ى‬ ُٜٞ ٢ِ‫حُٔل‬ ‫حُلي‬ ‫ٓ٬ٓش‬ ‫ٓغ‬ ‫ا١زخم‬ ‫ٓٞء‬ ‫ٝؿٞى‬ ٕ‫ا‬ٝ ١ِٞ‫حُؼ‬ ‫حُلي‬ ٢‫ك‬ ًَٔ ‫ٝؿٞى‬ ٠ِ‫ػ‬ ‫أً٤ي‬ٖٓ ْ٤ُ ٌُٖ ١َٝ٠ُ‫ح‬‫ا‬١ِٞ‫حُؼ‬ ‫حُلي‬ ًٍٞٔ ًَ ٢‫ك‬ ‫ٝحؿزش‬ ‫ػ٬ٓش‬ ٍٙ‫ػظزخ‬(٧‫ح‬ ٌٍُٞٔ‫ح‬‫ح٫١زخم‬ ٢‫ك‬ ٍ‫طزي‬ ‫٫٣ليع‬ ‫هي‬ ‫حُظخٓش‬ ‫كو٤ش‬) 4-ْ‫حُـ‬ ٗ *٩‫ح‬ ٚ‫رخُلل‬ َ‫٘ظو‬٧‫ح‬ ‫حُليٝى‬ ٠ِ‫ػ‬ ٢‫ٛزؼ‬ٝ ‫ٓخٓ٤ش‬ٝ ٢ٌ‫حُل‬ ‫حُـ٤ذ‬ ٕ‫ُـيٍح‬ ‫حُـخٗز٤ش‬٩‫ح‬ ‫ُ٘ليى‬ ‫حُلـخؽ‬ ‫كٞحف‬٩‫ح‬ ٝ‫أ‬ ٍ‫ٓظَٔح‬‫ٗوطخع‬ ٩‫ح‬ ‫طلَم‬ ٝ‫أ‬ ‫حُيٍؿش‬ ْ‫طـ‬ ‫ك٤غ‬ ْ‫حُؼظ‬ ‫ٓطق‬ ٢‫ك‬‫رٟٞٞف‬ ٍ‫طٜخ‬ *َ٤٘‫ط‬ ٢٘‫حُٞؿ‬ ٢ٌ‫حُل‬ ٢٘‫حُٞؿ‬ ٍُ‫حُي‬ ‫ٓ٘طوش‬ ٢‫ك‬ ‫حُيٍؿش‬‫ا‬‫حُلـخؽ‬ ‫طلض‬ ‫حُلخكش‬ ٢‫ك‬ ًَٔ ٠ُ‫أ‬‫حُلي‬ ٢‫ك‬ ٢َٓٛ ًَٔ ٠ُ‫ا‬ ٝ ١ِٞ‫حُؼ‬ *‫ح‬ ‫ٓ٘طوش‬ ٢‫ك‬ ‫حُيٍؿش‬‫ُٞكٍٞص‬ ٠ُ‫ا‬ َ٤٘‫ط‬ ٢ٜ‫حُـز‬ ٢٘‫حُٞؿ‬ ٍُ‫ُي‬3 *٧‫ح‬ ‫كًَش‬‫ح٫ٗق‬ ْ‫ػظ‬ ٢‫ك‬ ًَٔ ‫كيٝع‬ ٠ُ‫ا‬ َ٤٘‫ط‬ ْ‫رخُـ‬ ‫ٗق‬ **ٝ‫أ‬ ‫حُ٘ظخ٣خ‬ ٢‫ك‬ ‫حُِحثي‬ ٍ‫حُظزي‬ ‫ه٘٤ش‬ ْ‫حُـ‬ ‫كًَخص‬ ‫اؿَحء‬ ‫ػ٘ي‬ ‫حُ٘ي٣ي‬ ٌٍ‫حُل‬ ‫٣ـذ‬ : ‫ٓ٬كظش‬ٗ‫ا‬٧‫ح‬ ‫أكي‬ ‫وطخع‬‫حُيٓٞ٣ش‬ ‫ٝػ٤ش‬‫أ‬ٝ ٧‫ح‬ ‫أكي‬‫ػٜخد‬ *ٝ ‫ر٤ي‬ ّ‫حَُأ‬ ‫رظؼز٤ض‬ ّٞ‫ٗو‬ُ‫ح‬ ‫طلَ٣ي‬‫لي‬٧‫ح‬ ‫رخُ٤ي‬ ١ِٞ‫حُؼ‬َٟ‫ه‬ ·‫ُٞكٍٞص‬ ًٍٞٔ ٢‫ك‬1َٜ‫ٓ٘ل‬ ٌَ٘‫ر‬ ٢‫حُٔ٘و‬ ْ‫حُؼظ‬ ‫٣ظلَى‬ ·ٝ ‫حُل٘ي‬ ‫هزش‬ ًٍٞٔ ٢‫ك‬ٜ‫ؿ‬ ٖٓ ٬ً ‫طظلَى‬ ‫هي‬ ‫حُٜٔٔ٤ش‬ ‫حُٔ٘ن‬٥‫ح‬ ٖ‫ػ‬ َٜ‫ٓ٘ل‬ ٌَ٘‫ر‬ ١ِٞ‫حُؼ‬ ‫حُلي‬ ٢‫ظ‬َ‫ه‬ ·٧‫ح‬ ‫حُ٘ظٞء‬ ‫ٓويٓش‬ ٢‫ك‬ ‫كًَش‬ ‫٫كظ٘خ‬ ‫اًح‬ ‫أٓخ‬‫ُٞكَص‬ ٠ُ‫ا‬ َ٤٘٣ ‫كٌٜح‬ ٢‫ٗل‬2‫أ‬َٓ‫ًخ‬ ‫كًَش‬ ‫ٓخ‬‫حُؼِغ‬ٚ‫حُٞؿ‬ ٖٓ ٢ٓٞ‫حُٔظ‬ َ٤٘٣ ‫كٌٜح‬‫ا‬‫ُٞكٍٞص‬ ٠ُ3 ‫ٓ٬كظش‬‫ٓخ‬ ‫اًح‬ :‫ُٞكٍٞص‬ ًَٔ ‫طلي٣ي‬ ْ‫ط‬3١ِٞ‫حُؼ‬ ‫ُِلي‬ ‫ُحثي‬ َ٣‫طزي‬ ٝ‫أ‬ ‫طلَ٣ي‬ ١‫أ‬ ‫طـ٘ذ‬ ‫ك٤ـذ‬ ·٩‫ح‬ ‫حُؼ٬ٓخص‬ ٖٓ َ‫طؼظز‬ :‫حُلَهؼش‬ٝ ‫٣ـخر٤ش‬‫ك٤غ‬ ٚ٤‫حُظ٘و‬ ٢‫ك‬ ‫حُٔٔخػيس‬‫أ‬ٕ‫ا‬‫ٛٞص‬ ٢‫طؼط‬ ْ‫حُؼظ‬ ٢‫ٜٗخ٣ظ‬ ‫كظٌخى‬ ‫ٝحٟلش‬ ‫كَهؼش‬ ·٧‫ح‬‫حُٔ٠ؾ‬ ٝ‫أ‬ ْ‫حُـ‬ ‫أػ٘خء‬ ٚ٤‫ُِظ٘و‬ ‫َٓٗيح‬ َ‫٣ؼظز‬ :ُْ ·‫حُؼٜز٤ش‬ ‫حُؼ٬ٓخص‬ٝ :٩‫ح‬ ‫٣ـذ‬ ٢‫حُظ‬ ‫حُٜخٓش‬ ‫حُؼ٬ٓخص‬ ٖٓ ٢ٛٙ‫ٗظزخ‬‫ا‬ٜ٤ُ‫خ‬‫ٓخ‬ ‫ؿخُزخ‬ ْ‫حُظٞحث‬ ‫ٓؼِغ‬ ‫كؼٜذ‬ٌٍٞٔ‫ر‬ َ‫٣ظؤػ‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 60 ُ٘ٔ‫ح‬ ٢‫ك‬ ٍ‫هي‬ ‫ٓليػخ‬ ١ِٞ‫حُؼ‬ ‫حُلي‬‫٣ؼٜزٜخ‬ ٢‫حُظ‬ ‫خ١ن‬ ·ٝ٩‫ح‬ ٢‫ك‬‫حَُه‬ ‫حُ٘ٔؾ‬ ‫طِٔم‬ ‫ٓغ‬ ‫حُٔظَحكوش‬ ‫ٛخرخص‬ُٞ‫ح‬ ‫حُؼٜذ‬ ‫ُلَٝع‬ ١ً‫طؤ‬ ‫٣ليع‬ ‫هي‬ ‫ٞس‬‫ؿ‬‫ٓليػ‬ ٢ٜ‫خ‬ٞ‫رؼ‬ ٢‫ك‬ َِٗ ‫٣ؼٜزٜخ‬ ٢‫حُظ‬ ‫حُؼ٠٬ص‬ ·ٝ‫ح٧ػَح‬ ‫ًخٗض‬ ‫اًح‬ ‫ٓئهض‬ ١ً‫حُظؤ‬ ‫ٌٛح‬ ٌٕٞ٣ ‫هي‬‫ٗخطـش‬ٖ‫ػ‬‫ا‬ٝ ١ٞٓ‫ى‬ ٍّٞ‫ر‬ ٝ‫أ‬ ْ‫حُؼظ‬ ‫ر٘ظخ٣خ‬ ‫حُؼٜذ‬ ١‫ٗ٠ـخ‬ٍ‫رِٝح‬ ٍِٝ‫ط‬ ‫ُِؼٜذ‬ ‫حُ٘ي٣ي‬ ١ً‫حُظؤ‬ ‫ػ٘ي‬ ْ‫ىحث‬ َُِ٘‫ح‬ ٌٕٞ٣ ٝ‫أ‬ ‫حُٔزذ‬. ·٩‫ح‬ ٢‫ك‬ ‫طليع‬ : ‫حُٔ٠خػلش‬ ‫حَُإ٣ش‬ٝ ‫حُ٘ي٣يس‬ ‫ٛخرخص‬‫هخٛش‬٢‫ك‬ٝ‫أ‬ ‫ُِلـخؽ‬ ‫حُٔلِ٤ش‬ ‫حُلخكش‬ ًًٍٍٞٔٞٔ ٢‫ك‬‫هخع‬ ٝ ‫طلُٜٞخ‬ ٝ‫أ‬ ٖ٤‫حُؼ‬ ١ٞ‫ُٜز‬ ١‫٣ئى‬ ‫ٓٔخ‬ ‫حُلـخؽ‬‫ا‬ٝ‫كي‬ ٠ُ‫ا‬ ١‫٣ئى‬ ‫ٓٔخ‬ ٢‫حُطز٤ؼ‬ ‫ٌٓخٜٗخ‬ ٖٓ ‫ٗـَحٍٛخ‬ٝ ‫حُٔ٠خػلش‬ ‫حَُإ٣ش‬ ‫ع‬‫طؼٞى‬ ٢‫حُظ‬ ٌَُٔ‫ح‬ ‫ٍى‬ ‫رؼي‬ ‫ُطز٤ؼظٜخ‬ F-: ‫حُؼ٬ؽ‬ ٩‫ح‬ ‫ٗيس‬ ٠ِ‫ػ‬ ‫حُؼ٬ؽ‬ ‫٣ؼظٔي‬ٝ ‫ٛخرش‬٧‫ح‬ ٖٓٝ َ٠‫ك‬٩‫ح‬ ‫حُ٘ظ٤ـش‬ ٕ‫ُ٠ٔخ‬٩‫ح‬ ‫٣ـذ‬ ‫ُِؼ٬ؽ‬ ٚ٤‫٣ـخر‬‫َٓحع‬( ٍ٬‫ه‬ ‫حُٔؼخُـش‬ ‫ريء‬ ٢‫ك‬30 ‫ىه٤وش‬٠‫كظ‬2‫ًلي‬ ٚ‫ٓخػ‬‫أ‬)٠ِ‫ػ‬‫طير٤َٛخ‬ ‫٣ـذ‬ ٢‫حُظ‬ ٝ ‫حُؼٜز٤ش‬ ‫أٜٛٔخ‬ ٝ ( َٟ‫أه‬ ‫ؿخٗز٤ش‬ ‫اٛخرخص‬ ١‫أ‬ ‫ٝؿٞى‬ ّ‫ػي‬ ٍ‫كخ‬ ٢‫ك‬ ‫ًُي‬ ٝ ) ٢ٌ‫حُل‬ ٢ٜ‫حُٞؿ‬ ‫رخُؼ٬ؽ‬ ‫حُزية‬ َ‫هز‬. ٝ‫ُِٔؼخُـ‬ ُٚٓ٬ُ‫ح‬ ‫ح٫ؿَحءحص‬ ٖٓ‫ش‬: -‫ا‬‫رؼخى‬‫أ‬َ‫ٓؼ‬ ٚ‫حُٞؿ‬ ٢‫ك‬ ‫ٓؼ٤وخص‬ ١ٝ‫أ‬ ‫حُوًٞس‬٧‫ح‬ٝ ٚ‫ه٘ؼ‬‫ؿ٤َٛخ‬ -‫حُظ‬‫ؤ‬ٖٓ ‫ًي‬ّ‫ػي‬‫ٗي٣ي‬ ‫ِٗف‬ ‫ٝؿٞى‬‫أ‬ٍّٝٞ‫ط‬ٝ ْ‫حُظ٘ل‬ ‫٣ٔ٘غ‬ ‫هي‬‫ا‬ْ‫حُظ٘ل‬ ‫حُٜٔخد‬ ‫٣ٔظط٤غ‬ ‫رل٤غ‬ ‫ٓلظٞكخ‬ ‫حُٜٞحء‬ َٟ‫ٓـ‬ ‫روخء‬ ٌٖٔ٣ ( ُٜٚٞٔ‫ر‬‫أ‬٩‫ح‬ ‫٣ليع‬ ٕ٧‫رخ‬ ‫ٗٔيحى‬ٚ‫ٗٔـ‬‫أ‬٧‫ح‬ ٝٝ )ٚ‫حُـَ٣ز‬ ّ‫ؿٔخ‬ٝ ٙ‫حُ٘ي٣ي‬ ‫حُلخ٫ص‬ ٢‫ك‬‫ػ٘ي‬‫ا‬ٞ‫هل‬ ٌٖٔ٣ ْ‫حُظ٘ل‬ ‫ػخهش‬ ٩‫ح‬ٚ‫ٛخر‬ٝ( ١ٞٔ‫ك‬ ٢‫ٛٞحث‬ ‫ِٓٔي‬ ‫ٟٝغ‬‫أ‬) ْ‫حُظ٘ل‬ ٠ِ‫ػ‬ ٙ‫ُِٔٔخػي‬ ٢‫ٛٞحث‬ ‫ٗزٞد‬. -‫ط٘ظق‬‫حُـَٝف‬ ٝ ‫حُظٔلـخص‬ ٝ ٕٝ‫حُوي‬‫حُلخؿش‬ ‫كخُش‬ ٢‫ك‬ ١‫طوخ‬ ٝ ‫حُٜٔخرش‬ ٚ‫حُٔ٘طو‬ ٢‫ك‬ -ٝ ٍّٞ‫حُظ‬ َ٤ِ‫ُظو‬ ٚ‫حُٞؿ‬ ٠ِ‫ػ‬ ‫ػِؾ‬ ‫ًٔخىحص‬ ‫ٟٝغ‬ُْ٧‫ح‬ -ٚ‫حُٞؿ‬ ٟٞ‫ٓٔظ‬ َ‫ؿؼ‬‫أ‬ٝ َ‫حُٔٞحث‬ ‫ٍؿٞع‬ ٢‫ك‬ ٙ‫ُِٔٔخػي‬ ‫حُوِذ‬ ٟٞ‫ٓٔظ‬ ٖٓ ٠ِ‫ػ‬ٝ ‫طـٔؼٜخ‬ ‫ٓ٘غ‬َ٤ِ‫طو‬ ٠ِ‫ػ‬ ‫٣ٔخػي‬ ‫ٌٛح‬ ٍّٞ‫حُظ‬ -‫ح‬ ْٔ‫ؿ‬ ‫طيكجش‬َ٤ِ‫ُظو‬ ‫ُٜٔخد‬‫ا‬‫ٛيٓش‬ ‫كيٝع‬ ٍ‫كظٔخ‬ ً ٕ‫ح٩ٗظخ‬ ‫ؿ٤خد‬ ٢‫ك‬‫ب‬‫ُٞكٍٞص‬ ( ١ِٞ‫حُؼ‬ ‫حُلي‬ ًٍٞٔ ٕ‫كب‬ ، ١٬‫هظ‬1٢ٌ‫ك‬ ٖ٤‫ر‬ ‫طؼز٤ض‬ . ) ‫ٓلظٞف‬ َ٤‫ؿ‬ ًَٔ ( ‫رَٔػش‬ ٢‫ط٘ل‬ ) ‫ر‬‫ب‬ّ‫ه٤خ‬ ِْٗ‫ٓظخ‬ ‫أٓ٬ى‬ ّ‫ٓظويح‬26Gauge‫حٌُِٔ٤ش‬ ّ‫ح٧هٞح‬ ٠ُ‫ا‬ ٢‫طَر‬ ،(Erich arch bar fixation)٠ِ‫ػ‬ ‫ٓٔزوخ‬ ‫طؼزض‬ ٢‫حُظ‬ ١ِٞ‫حُؼ‬ ‫حُلي‬ٝ‫ٌِٓ٤ش‬ َٟ‫ػ‬ ٠ُ‫ا‬ ٝ‫أ‬ ٠ِ‫حُٔل‬. ٕ‫أ‬ ٌٖٔ٣ ‫حُِٔحف‬ ١ِٞ‫حُؼ‬ ‫حُلي‬‫٣ؼخى‬ٝ‫٣ي‬ ‫رَى‬ ‫حُٜل٤ق‬ ٚ‫ٟٓٞؼ‬ ٠ُ‫ا‬١٢٤ٔ‫ر‬‫أ‬ٝ‫ٗٔظط٤غ‬‫ًُي‬‫ر‬‫ب‬٢‫حُو‬ ‫هَد‬ ‫٣ٟٞغ‬ ‫ِٓي‬ ّ‫ٓظويح‬ ، ‫اٍ٣ي‬ ّٞ‫ه‬ ٍٞ‫ك‬ ٢ٓٞ‫حُٔظ‬‫ر‬ ‫٣ٔٔق‬ ١ٌُ‫ح‬ َٜٝ‫حُٔ٘ل‬ ١ِٞ‫حُؼ‬ ‫حُلي‬ ًَٔ ‫ٔلذ‬( Impact )ٝ ّ‫ح٧ٓخ‬ ٠ُ‫ا‬‫ر‬ َ‫ح٧ٓل‬‫ب‬ٙ‫طـخ‬ ، ‫ح٩١زخم‬ٝ‫أ‬‫ر‬‫ب‬‫كٌ٤ش‬ ٖ٤‫ر‬ ١‫ٓطخ‬ ‫كِوخص‬ ّ‫ٓظويح‬. ٝ ، ‫حُٔزٌَس‬ ‫حُلخ٫ص‬ ٢‫ك‬ ‫رُٜٔٞش‬ ‫ُٞكٍٞص‬ ًٍٞٔ ‫ٍى‬ ْ‫٣ظ‬ٌٌُُٖٔ‫ح‬ ‫كخ٫ص‬ ٢‫ك‬ٍٞٝ ‫حُٔ٘لَٜس‬ٌُٔ‫ح‬ٍٞ‫حُوي٣ٔش‬ُ‫ح‬ ٖٓ‫ٜؼذ‬‫ًُي‬ ‫ٝ٣لظخؽ‬َٓ٧‫ح‬ٝ ‫هٞس‬ ٠ُ‫ا‬‫ر٘يس‬ ‫ٍى‬. ٠ٓ‫أٓخ‬ َ‫ؿ‬ ٠ُ‫ا‬ ٝ‫أ‬ ٝ ٢‫حُٞظ٤ل‬ ‫ح٩١زخم‬ ٖ٤ٓ‫طؤ‬ ‫اػخىس‬ ٞٛ ٌٍُٞٔ‫ح‬ ٌٙٛ ٢‫ك‬ ‫حُٔؼخُـش‬ ‫ٓلظخف‬‫ًُي‬١ِٞ‫حُؼ‬ ‫حُلي‬ ‫طؼز٤ض‬ َ‫هز‬. ٝ ، ‫ٓخروخ‬ ‫ٝٛق‬ ‫ًٔخ‬ ‫رخُ٘ي‬ ‫حَُى‬ ‫ٛ٘خ‬ ‫ٗطزن‬ٝ ‫ػِ٤ٜخ‬ ٍٞ‫ٓؼ‬ َ٤‫ؿ‬ ‫حَُى‬ ‫رؼي‬ ‫ُِظؼز٤ض‬ ّ‫حَُأ‬ ‫أكِٓش‬ ٕ‫كب‬ ّ‫ػخ‬ ٌَ٘‫ر‬ٝ ‫َٓ٣لش‬ َ٤‫ؿ‬٠ِ‫ػ‬ ٝ ، ٢‫ًٝخك‬ ‫ؿ٤ي‬ ٢ٌ‫حُل‬ ٖ٤‫ر‬ ‫حُظؼز٤ض‬ ٕ‫كب‬ ٍ‫كخ‬ ًَ‫ٌُٔخٜٗخ‬ ‫ك٤َىٛخ‬ ‫حُؼِٞ٣ش‬ ٌَُٔ‫ح‬ ‫هطؼش‬ ٠ِ‫ػ‬ ٢‫رخُ٠ـ‬ ّٞ‫ك٤و‬ ٠ِ‫حُٔل‬ ‫حُلي‬ ٍٝ‫ى‬ ‫أٓخ‬ ٠ُ‫ا‬‫حُ٘لخء‬ ْ‫٣ظ‬ ٕ‫أ‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 61 ٌَُٔ‫ح‬ ‫ٓٞهغ‬ ‫كٞم‬ ‫ِٛزش‬ ‫ٗوطش‬ ٍٝ‫أ‬ ٠ُ‫ا‬ ١ِٞ‫حُؼ‬ ‫حُلي‬ ‫رظؼِ٤ن‬ ‫حُظؼز٤ض‬ ٠ِ‫ػ‬ َٜ‫ُ٘ل‬ ‫طَ٘٣ل٤ش‬ ‫ٗوطخ‬ ‫ُٞكٍٞص‬ ًٍٞٔ ٢‫ك‬ َٔ‫ٗٔظؼ‬ ، ) ٢٘‫حُٞؿ‬ ‫حُ٘ظٞء‬ ، ‫حُٔلِ٤ش‬ ‫حُلـخؽ‬ ‫كخؿش‬ ، ‫حٌُٔؼَ٣ش‬ ‫حُلخكش‬ ( َ‫ٓؼ‬ *ٝ٢‫ك‬( ‫ىىفىسخ‬ ‫مسىس‬1)‫ك‬‫ب‬‫حُلـخؽ‬ ‫طلض‬ ‫حُلخكش‬ ٠ِ‫ػ‬ ْ‫٣ظ‬ ‫رخ٧ٓ٬ى‬ ‫حُظؼز٤ض‬ ٕ٩‫ح‬ ‫ٓغ‬ٓ‫ظلخ‬ٝ ْ٤ُِٔ‫ح‬ ٠ِ‫حُٔل‬ ‫حُلي‬ ٖٓ ‫ىس‬ ١ِٞ‫حُؼ‬ ‫حُلي‬ ‫ُٔٞهغ‬ َ٤ُ‫ًي‬ ٠ُ٘ٔ‫ح‬ ‫ح٩١زخم‬. ًْ‫طؼخ‬ ٌَ٘‫ر‬ ‫حَُٔٗش‬ ‫ح٧ُ٤خف‬ ‫طظٟٞغ‬ ٕ‫أ‬ ٌُٖٔٔ‫ح‬ ٖٓ ٚٗ‫كب‬ ، ‫حُزيح٣ش‬ ٖٓ ٌَُٔ‫ح‬ ‫ٍى‬ ْ‫ط‬ ‫اًح‬‫ا‬ٝ ، ‫ح٩ُحكش‬ ٝ‫أ‬ ‫حَُى‬ ٙ‫طـخ‬‫حُلي‬ ‫ؿِذ‬ ‫٣ـذ‬ ٝ ، ‫حَُى‬ ‫ططز٤ن‬ ‫ريء‬ ٖٓ ‫ٓخػخص‬ ‫ر٠غ‬ ٍ٬‫ه‬ ‫حُٜل٤ق‬ ‫ٓٞهغ‬ ٠ُ‫ا‬ ١ِٞ‫حُؼ‬ً ‫اًح‬‫خ‬‫ح‬ ُٕ‫ٜٓخرخ‬ ١ِٞ‫حُؼ‬ ‫لي‬(٫ ٚٗ‫أ‬ ‫ُيٍؿش‬ ‫ر٘يس‬ ) ‫ٓ٘لَٜح‬ ‫ػ٘ي‬ ‫ك٤ـذ‬ ، ‫حُٔخروش‬ ‫رخُطَم‬ ٙ‫ٍى‬ ٌٖٔ٣ٛ‫خ‬‫ا‬ٍٝ ٢‫ِٓو‬ َ‫ٓؼ‬ ‫حَُى‬ ٢‫ٓ٬ه‬ ٍ‫ٓظؼٔخ‬. ‫رؼي‬ ‫حُٔ٘خٛيس‬ ٌٍُٞٔ‫ح‬ ٕ‫كب‬ ‫ًًَٗخ‬ ‫ًٝٔخ‬2-3٩‫ح‬ ‫ٓٞء‬ ‫كخ٫ص‬ ‫ًٌُي‬ ، ٢ٌ‫حُل‬ ٖ٤‫ر‬ ‫رخُ٘ي‬ ٝ‫أ‬ ‫٣يٝ٣خ‬ ‫طَى‬ ٫ ‫ح٩ٛخرش‬ ٖٓ ‫أٓخر٤غ‬ّ‫ُظلخ‬ ٌَ‫حُٔز‬( Early Malunion )ٝ‫حُٔ٘ل٠َس‬ ٌٍُٞٔ‫ح‬Impacted ))ٝ ‫ؿَحك٤خ‬ ٝ‫أ‬ ٠ٌِ٤ُٜ‫ح‬ ‫حَُى‬ َ‫رٞٓخث‬ ‫َُِى‬ ‫أك٤خٗخ‬ ‫طٔظـ٤ذ‬ ٢ٜ‫ك‬ ‫حُلخ٫ص‬ ٌٙٛ ٢‫ك‬ ٫‫ا‬ ٢‫هخٍؿ‬ َ‫ؿ‬ ‫طلو٤ن‬ ٢‫ك‬ ‫ٓو٘غ‬ َ٤‫ؿ‬ ٚٗ‫أ‬ ‫ػِٔخ‬ ( ّ‫حَُأ‬ ّ‫ُلِح‬ ‫أك٤خٗخ‬). *‫أٓخ‬( ‫ىىفىسخ‬ ‫مسىس‬2)ٝ ، ٚ‫ٓ٘خر‬ ‫رؤِٓٞد‬ َ‫كظير‬ٕ‫أ‬ ‫حُـَحف‬ ٠ِ‫ػ‬ ‫٣ـذ‬ٌَُٔ‫ح‬ ٕ‫أ‬ ‫ٓظًٌَح‬ ‫رخُـش‬ ‫رؼ٘خ٣ش‬ ‫٣يٝ٣خ‬ ٌٍُٞٔ‫ح‬ ٌٙٛ ‫٣َى‬ ٝ ، ٠‫حُلـخؿ‬ ٠ٔٗ٧‫ح‬ ٍ‫حُـيح‬ َٔ٘٣ٝ ، ‫ح٧ٓخٓ٤ش‬ ‫حُلـخؽ‬ ‫أٍٟ٤ش‬‫أ‬ ٕ‫ا‬١٢‫ك‬ ًٟ‫طؤ‬ ‫٣ٔزذ‬ ‫هي‬ ‫ُحثي‬ ‫طلَ٣ي‬ُ‫ح‬ٝ ‫حُيٓؼ٤ش‬ ‫ح٧ٗل٤ش‬ ‫و٘خس‬ ٝ ‫حُلـخؽ‬ ‫طلض‬ ‫حُؼٜذ‬‫ر‬ ‫حُظؼز٤ض‬ ‫ططز٤ن‬ ‫رؼي‬٤ٝ ٢‫ح٧ٗل‬ ٢ٜ‫حُـز‬ ٍُ‫حُي‬ ْ‫رـ‬ ّٞ‫ٗو‬ ‫كبٗ٘خ‬ ٢ٌ‫حُل‬ ٖ‫حُلخكش‬ٖٔ٠ُ٘ ‫ُِلـخؽ‬ ‫حُٔلِ٤ش‬ ٌَُِٔ ّ‫طخ‬ ‫ٍى‬. *ٝ‫أٓخ‬( ‫ىىفىسخ‬ ‫مسىس‬3)‫ُٞكٍٞص‬ ٢‫ك‬ ‫ًٔخ‬1،2( ‫ُٞكٍٞص‬ ًٍٞٔ ٕ‫كب‬3ٝ ١ِٞ‫حُؼ‬ ‫حُلي‬ ‫رٟٞغ‬ ‫طَى‬ )١‫رب‬ ٫ٝ‫أ‬ ٠ِ‫حُٔل‬‫زخ‬‫م‬ ٘ٓ٢٢ٌ‫ك‬ ٖ٤‫ر‬ ‫طؼز٤ض‬ ‫ٗطزن‬ ْ‫ػ‬ ، ًَِٟٓ. : ‫اىشد‬ ** ‫ً٬رش‬ ‫ػ٘طَ٣ن‬ ٝ‫أ‬ َُٕٔ‫ح‬ ‫حُ٘ي‬ ‫١َ٣ن‬ ٖ‫ػ‬ ‫آخ‬Rowe`s
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 62 ‫ً٬رش‬ ّ‫آظويح‬ ٌٖٔ٣ ٝ‫أ‬Hayton Williams : ‫اىرثثٍد‬ ** A)‫طؼز٤ض‬٢ِ‫حُيحه‬: َ‫هز‬ ٖٓ ‫َٓس‬ ٍٝ٧ ‫أٓظؼِٔض‬MICHELETّ‫ػخ‬1972( ‫ًٜلخثق‬Miniplate٢‫ػ٬ػ‬ ‫ػزخص‬ َ‫طٞك‬ ٢‫حُظ‬ ٝ ‫حُوَ٘س‬ ‫أكخى٣ش‬ ) ‫ح٧رؼخى‬‫ُِٞظ٤لش‬ ‫حَُٔ٣ؼش‬ ‫حُؼٞىس‬ ٝ ‫ح٩ٓظ٘لخء‬ ‫ٓيس‬ ٖٓ ٞ‫طول‬ ٢‫حُظ‬ ٝ ٍ‫ح٩ٗلظخ‬ ‫كًَخص‬ ‫رٌُي‬ ‫طٔ٘غ‬ ٝ
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 63 ‫أ‬-‫ُظؼز٤ض‬٢‫١َك‬ْ‫حُؼظ‬َٗ‫حُٔزخ‬: ‫حُٜٔلَس‬ ‫حُٜلخثق‬ +Miniplates: ) ‫ػ٘ن‬ ٕٝ‫ى‬ ٝ‫أ‬ ‫ػ٘ن‬ ‫ٓغ‬ ( ‫ٓٔظو٤ٔش‬ : ٍ‫ح٧ٌٗخ‬ ‫ٓوظِلش‬X،H،L،TٝY : ‫ٓوظِلش‬ ‫ٓٞحى‬ ٖٓ ‫طٜ٘غ‬-ً٫ٞ‫حُل‬ّٝ‫حُٔوخ‬‫ُِٜيأ‬ -ّٞ٤ٗ‫حُظ٤ظخ‬ٖ٤‫ر‬ ‫طظَحٝف‬ ‫ػوخٗش‬ ‫ًحص‬ ٫‫آظؼٔخ‬ َ‫ح٧ًؼ‬ :0.6ٝ1.5‫هخٍؿ٤ش‬ ٍ‫أهطخ‬ ‫ًحص‬ ٢‫رزَحؿ‬ ‫طؼزض‬ ٝ ْٓ ٖ٤‫ر‬ ‫طظَحٝف‬0.7ٝ2‫ٓظلَهش‬ ٍ‫أ١ٞح‬ ‫ٓغ‬ ْٓ -ّٞ٤ُ‫حُل٤ظخ‬‫حٌُٞرخُض‬ٌَُّٝ‫ٝح‬ٝmolydenum)) -‫ٓٔظٜش‬Resorbable(Polylactide،‫حُزُٞ٤َٔحص‬polyglycolic) +‫ح٧ٓ٬ى‬َ‫ػز‬‫ػظٔ٤ش‬.:-ٟٞ‫ٓٔظ‬ٍ‫ػخ‬(٢ٜ‫حُـز‬٢٘‫حُٞؿ‬٢ٜ‫ٝحُـز‬٢‫ح٧ٗل‬) -ٟٞ‫حُٔٔظ‬٢ٓٞ‫حُٔظ‬(١ٍ‫حُٔيح‬‫كخكش‬/‫حُٞؿ٘ش‬‫ىػخٓش‬) -ٟٞ‫ٓٔظ‬ٞ‫ٓ٘ول‬(‫حُٔ٘و٤ش‬/‫ٓ٘ظٜق‬‫حُل٘ي‬.)
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 64 ‫د‬-‫ح٧ٓ٬ى‬‫طؼِ٤ن‬(‫طؼز٤ض‬ٌَ٤ُٜ‫ح‬٢ٔ‫حُؼظ‬) +: ٢ٜ‫ؿز‬-: ٢ٓٝ‫أ‬(٤ُ‫لٍٞص‬٢ٗ‫حُؼخ‬‫ٝحُؼخُغ؛‬‫كي‬َ٤‫ؿ‬َ‫ٓٔظو‬)‫رظؼِ٤ن‬ ٠‫طيػ‬ ٝKufner‫حُلي‬ ‫طؼِ٤ن‬ ْ‫٣ظ‬ ٝ ٢ٜ‫حُـز‬ ٢ٓٝ٧‫ح‬ ٢‫حُو‬ ٠ِ‫ػ‬ ‫ٍُ٣ؼش‬ ‫رٞحٓطش‬ -٢٘‫حُٞك‬(٤ُ‫لٍٞص‬٢ٗ‫حُؼخ‬‫ٝحُؼخُغ؛‬‫كي‬َ‫ٓٔظو‬)‫رظؼِ٤ن‬ ٠‫طيػ‬ :Thoma ١ِٞ‫حُؼ‬ ‫حُٔ٤ِحد‬ ‫هخع‬ ٠ُ‫ا‬ ٫ٞٛٝ ‫حُٞؿ٘٤ش‬ ّٞ‫حُو‬ ‫هِق‬ ‫ٓخ‬ ٠ُ‫ا‬ ٢ِ٠‫ػ‬ ‫طِٔ٤ن‬ ‫اؿَحء‬ ْ‫٣ظ‬ ‫حُلخؿذ‬ ‫كٞم‬ ٢‫ؿَحك‬ ‫ٗن‬ ‫اؿَحء‬ ‫رؼي‬ ٕ‫ٍ٣لَىح‬ ‫ارَس‬ ٍ‫اىهخ‬ ْ‫٣ظ‬‫ِٓي‬ ٍ‫اىهخ‬ ْ‫٣ظ‬ ْ‫ػ‬ ٢ٗ‫حُؼخ‬ ‫حُ٠خكي‬ ٢٘‫ٝك‬ ١ِٞ‫حُؼ‬ ‫حُٔ٤ِحد‬ ‫هخع‬ ‫ٗؼوذ‬ ٝ ٙ‫اؿَحء‬ ْ‫ط‬ ١ٌُ‫ح‬ ‫حُ٘لن‬ َ‫ػز‬ 0،45‫كٞم‬ ‫حُلخكش‬ ٢‫ك‬ ‫ػوزش‬ ٖٟٔ ‫حُِٔي‬ ‫طؼز٤ض‬ ‫رؼي‬ ٝ ‫حُلخؿذ‬ ‫كٞم‬ ٢‫حُـَحك‬ ‫حُ٘ن‬ ‫هخٍؽ‬ ٠ُ‫ا‬ ٚ‫ٓلز‬ ْ‫٣ظ‬ ٝ ‫ح٩رَس‬ ٖ٤‫ػ‬ ٖٟٔ ‫حُِٔي‬ ‫اػخىس‬ ْ‫٣ظ‬ ٝ ) ‫ٌِٓ٤ش‬ ‫ه٤خ١ش‬ ٝ‫أ‬ ‫طؼز٤ض‬ ‫ٛل٤لش‬ ٖٟٔ ٝ‫أ‬ ( ‫حُلـخؽ‬‫ا٣َ٣ي‬ ّٞ‫رو‬ ‫حُِٔي‬ ٢‫ٜٗخ٣ظ‬ ٢‫ٍر‬ ْ‫٣ظ‬ ٝ َُٔٔ‫ح‬ ْ‫ٗل‬ َ‫ػز‬ . ‫رخُؼوخٓش‬ ٢‫ٌٗظل‬ ٝ ْ‫حُل‬ َ‫ىحه‬ ٢‫حُـَحك‬ ‫حُؼوذ‬ ‫ُو٤خ١ش‬ ٢‫ىحػ‬ ٫ ٝ ‫حُ٘ن‬ ‫ه٤خ١ش‬ ْ‫٣ظ‬ ْ‫ػ‬ ) ‫ٓزخَٗس‬ ٕ‫ح٧ٓ٘خ‬ ٠ِ‫ػ‬ ٝ‫أ‬ (
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 65 +٢٘‫حُٞؿ‬ ٍٞ‫ك‬ َ‫حُيحث‬ ١‫حَُرخ‬: ‫ٓ٘ظٜق‬ ٢‫ك‬ ‫حُِٔي‬ ٍ‫اىهخ‬ ْ‫٣ظ‬ ٌُٖ ٝ ‫حُظو٘٤ش‬ ْ‫ر٘ل‬‫حُلخكش‬ ٖٓ ٢ٜ‫حُـز‬ ٢٘‫حُٞؿ‬ ٝ ٢‫حُٜيؿ‬ ٢٘‫حُٞؿ‬ ٍُ‫حُي‬ ٖ٤‫ر‬ ٖٓ ‫حُٔٔخكش‬ . ٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ‫طلض‬ ٝ ‫حُٜيؿ٤ش‬ ‫حُؼ٠ِش‬ ‫ٛلخم‬ ‫كٞم‬ ٌٕٞ٣ ‫حُظِٔ٤ن‬ ٝ ‫حُؼِٞ٣ش‬ +٢٘‫حُٞؿ‬-٢ٜ‫حُـز‬: ‫حُؼِٞ٣ش‬ ‫حُؼخٗ٤ش‬ ٝ ٠ُٝ٧‫ح‬ ‫ح٧ٍكخء‬ ‫كٞم‬ ‫ٗن‬ ‫اؿَحء‬ ْ‫٣ظ‬ ْ‫حُل‬ َ‫ىحه‬ ٖٓ ٍٞ‫رط‬1٧‫ح‬ ٠ِ‫ػ‬ ْٓ٠ُ‫ا‬ ٍُٞٛٞ‫ح‬ ٠‫كظ‬ ‫حُ٘ٔؾ‬ ‫طِٔ٤ن‬ ْ‫٣ظ‬ ٝ َ‫ه‬ ‫حَُإ٣ش‬ ‫رٞحٓطش‬ ٝ ) ٢٘‫حُٞؿ‬ ٢ًَٓ ( ١ِٞ‫حُؼ‬ ٢ٌ‫ُِل‬ ٢٘‫حُٞؿ‬ ‫حُ٘خطت‬ ٍ‫اىهخ‬ ٝ ‫ػِ٤ٜخ‬ ‫حُظؼِ٤ن‬ ‫حَُٔحى‬ ‫حُ٘وطش‬ ٢‫ك‬ ْ‫حُؼظ‬ ‫ػوذ‬ ْ‫٣ظ‬ ‫حُٔزخَٗس‬ ‫رخُـز٤َس‬ ٝ‫أ‬ ‫ا٣َ٣ي‬ ّٞ‫رو‬ ٚ‫ٍرط‬ ٝ ٢‫ؿَحك‬ ‫ِٓي‬ ٫ٞٛ‫أ‬ ‫حُ٘ن‬ ‫ه٤خ١ش‬ ْ‫٣ظ‬ ْ‫ػ‬ +‫حُلـخؽ‬ ‫طلض‬ ‫حُلخكش‬: ‫حُِٔي‬ َ٣َٔ‫ط‬ ٝ ْ‫حُؼظ‬ ‫ُؼوذ‬ ‫حُلـخؽ‬ ‫طلض‬ ‫ٗن‬ ‫اؿَحء‬ ‫ٛ٘خ‬ ‫٣ـذ‬ ٫ٝ‫أ‬ ‫حُطَ٣وش‬ ْ‫ر٘ل‬ ٕ‫ٍ٣لَىح‬ ‫ارَس‬ ‫رٞحٓطش‬ ٢‫حُـَحك‬ ‫حُلـخؽ‬ ‫طلض‬ ‫حُؼٜذ‬ ‫أً٣ش‬ ‫ُظـ٘ذ‬ ٙ‫ح٩ٗظزخ‬ ‫٣ـذ‬ ٌُٖ ٝ َ‫ىحه‬ ‫ٗن‬ ‫ٛ٘خى‬ ٕ‫ًخ‬ ٍ‫كخ‬ ٢‫ك‬ ٕ‫ٍ٣لَىح‬ ‫ارَس‬ ٖ‫ػ‬ ‫ح٩ٓظـ٘خء‬ ٌٖٔ٣ ‫حُؼِٞ٣ش‬ ‫ح٧ٍكخء‬ ٟٞ‫ٓٔظ‬ ٠ِ‫ػ‬ ١ٞٔ‫ك‬ ٘ٛٝ ‫حُلـخؽ‬ ‫طلض‬ ‫ٗن‬ ‫اؿَحء‬ ٠ُ‫ا‬ ‫حُلخؿش‬ ٕٝ‫ى‬ ‫ٓظزؼش‬ ‫١َ٣وش‬ ‫خى‬ ‫ح٩ًظلخء‬ ْ‫٣ظ‬ ٝ ‫آظؼٔخُٜخ‬ ‫ؿيح‬ ٍ‫حُ٘خى‬ ٖٓ ٝ ‫طو٘٤خ‬ ‫ٓؼويس‬ ‫١َ٣وش‬ ‫ٌُٜ٘خ‬ ٢ُ‫ػخ‬ ‫طِٔ٤ن‬ ٝ ٞ٣َ‫ػ‬ ١ٞٔ‫ك‬ َ‫ىحه‬ ‫ر٘ن‬ ‫ك٤ٜخ‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 66 +‫حٌُٔؼَ٣ش‬ ‫حُلظلش‬: ‫ِٜٓش‬ ‫١َ٣وش‬ ٢ٛ ٝ ‫ٓزخَٗس‬ ‫ٍإ٣ش‬ ٝ ١ٞٔ‫ك‬ َ‫ىحه‬ ‫ر٘ن‬ ‫ٛ٘خ‬ ٢‫ٌٗظل‬ +،‫حُيػخٓش‬َ‫ػز‬‫ح٧ٗق‬ +ٍٞ‫ك‬‫حُٔ٘ن‬ B)‫طؼز٤ض‬:٢‫حُوخٍؿ‬ ‫أ‬-: ٢ِ‫ٓل‬ ٢ٌ‫ك‬ ٢‫هلل‬ ٢‫حُولل‬ ٢ٜ‫حُٞؿ‬ ٍ‫ح٩١خ‬ +: ‫حُطَ٣وش‬ٍ ٝ ‫هي٣ٔش‬‫ٌُٜ٘خ‬‫اؿظٔخػ٤خ‬ ‫ٓظوزِش‬ َ٤‫ؿ‬ ٝ ‫ػِٔ٤خ‬ ‫ٓؼويس‬ ‫ٌُٜ٘خ‬ ٝ ‫طو٘٤خ‬ ‫ِٜٓش‬ ‫أٝطخى‬ ‫طؼز٤ض‬ ْ‫٣ظ‬ ‫ك٤غ‬) ٚ‫حُٞؿ‬ ًَِٓ ‫طٜ٤ذ‬ ٢‫حُظ‬ ٝ ‫حُٔظلظظش‬ ٌٍُِٞٔ ‫٣ٔظطذ‬ ًٚٗٞ ( ‫حُؼ٬ع‬ ‫حُٞؿٜ٤ش‬ ‫حُٔٔظٞ٣خص‬ ٠ِ‫ػ‬ ‫كٔذ‬ ‫حُٞطي‬ ‫طؼز٤ض‬ ٕ‫ٌٓخ‬ َ٤٤‫طـ‬ ٌٖٔ٣ ( ‫حٌُه٘٤ش‬ ‫حُؼوزش‬ ٟٞ‫ٓٔظ‬ ‫طلض‬ ٢‫حُٔل‬ ‫حُلي‬ ٠ِ‫ػ‬ ‫ح٧ٝطخى‬ ٖٓ ٖ٤‫ُٝؿ‬ ‫حُزيح٣ش‬ ٢‫ك‬ ‫٣ؼزض‬ ٤‫حُلـخؿ‬ ‫حُلخكش‬ ٠ِ‫ػ‬ ‫ح٧ٝطخى‬ ٖٓ ٖ٣َ‫آه‬ ٖ٤‫ُٝؿ‬ ‫٣ؼزض‬ ، ‫حُٔٞؿٞىس‬ ٌٍُٞٔ‫ح‬ٖٓ ٖ٤‫ُٝؿ‬ ‫طؼز٤ض‬ ‫حُلخؿش‬ ٍ‫كخ‬ ٢‫ك‬ ٝ ٌٖٔ٣ ، ‫حُؼِٞ٣ش‬ ‫ش‬ ٢ٗ‫ٓؼي‬ ٍ‫ا١خ‬ ‫رٞحٓطش‬ ‫أكو٤خ‬ ٝ ‫هخٛش‬ ‫أٝطخى‬ ‫رٞحٓطش‬ ‫ػٔٞى٣خ‬ ‫ح٧ٝطخى‬ َٛٝ ْ‫٣ظ‬ ٝ ٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ْٔ‫ؿ‬ ٠ِ‫ػ‬ ‫ح٧ٝطخى‬ ٢‫حُولل‬ ٢ٜ‫حُٞؿ‬ ٍ‫ح٩١خ‬ ‫ٓغ‬ َٓ‫حُظؼخ‬ ‫ُُٜٔٞش‬ ‫ٓؼيٗ٤ش‬ َٛ‫ٓلخ‬ ٖ‫ػ‬ ‫ػزخٍس‬ ‫حُٞٛ٬ص‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 67 +ٍ‫ا١خ‬Halo: ‫ُٓ٘٤خ‬ ّ‫أهي‬ ٌُٚ٘ ٝ ٢‫حُولل‬ ٢ٜ‫حُٞؿ‬ ٍ‫ح٩١خ‬ َ٤‫ًز‬ ‫كي‬ ٠ُ‫ا‬ ٚ‫٣٘ز‬ ٍ‫ح٩١خ‬ ‫ٌٛح‬ ‫ؿٔ٤غ‬ ‫طؼزض‬ ‫ػِٞ٣ش‬ ‫ٓؼيٗ٤ش‬ ‫هخػيس‬ ٫‫ا‬ ١ٞ‫٣ل‬ ٫ ٌُٚ٘ ٝ ‫حُظو٘٤ش‬ ْ‫ٗل‬ ُٞ‫ٛخ‬ ٍ‫ا١خ‬ ‫٣ؼظٔي‬ ‫طوَ٣زخ‬ ‫ح٧ٝطخى‬ ‫٣ؼ٤ن‬ ‫ٓخ‬ ٞٛ ٝ ‫ٜٓ٘ق‬ ٢ٗ‫ٓؼي‬ ‫ٝطي‬ ٠ِ‫ػ‬ ١ٞ‫٣ل‬ ًٚٗٞ ‫ح٧ٓخٓ٤ش‬ ُٞ‫ٛخ‬ ٍ‫ا١خ‬ ‫ٌِٓ٘ش‬ ٓ‫حُظؼخ‬ ‫ٛؼذ‬ ٚٗ‫أ‬ ٝ ‫حُظـٌ٣ش‬ ‫ػِٔ٤ش‬َ٣ٞ‫طط‬ ْ‫ط‬ ‫أٓخٓخ‬ ‫ح٧ٓزخد‬ ‫ٌُٜح‬ ٝ َ٣‫حُؼي‬ ٝ َ ٢‫حُولل‬ ٢ٜ‫حُٞؿ‬ ٍ‫ح٩١خ‬ ‫حُـزٔ٤ش‬ ْ٣ٍ‫رخ‬ ‫هزؼش‬ +: ‫كبٜٗخ‬ ‫حُٔؼيٗ٤ش‬ ‫حُيػخٓخص‬ ٝ ‫حُوٞحػي‬ ٖ‫ػ‬ ‫ػٟٞخ‬ ٝ ‫حُظؼز٤ض‬ ٢‫ك‬ ّ‫ح٧هي‬ ‫حُطَ٣وش‬ ٢ٛ ٞ٣َُٔ‫ح‬ ٠ِ‫ػ‬ ‫كٍٞ٣خ‬ ‫طٜ٘غ‬ ٢ٛ ٝ ْ‫حُـز‬ ٖٓ ‫حُولل٤ش‬ ‫حُوزؼش‬ ٚ‫٣٘ز‬ ‫ٓخ‬ ٠ِ‫ػ‬ ١ٞ‫طل‬ ٖٓ ٝ‫طٜٔ٤ٜٔخ‬ ‫رؼي‬ ‫ػِ٤ٜخ‬ َ٣‫حُظؼي‬ َ٤‫حُٔٔظل‬ ‫د‬-٢‫هلل‬٢ٌ‫ك‬١ِٞ‫ػ‬: ‫كخ٫ص‬ ٢‫ك‬ ‫طٔظطذ‬ ‫ًخٗض‬‫ٝؿٞى‬ّ‫ػي‬٩‫ح‬ٍ‫ٓظوَح‬٢ٓ‫ح٧ٓخ‬٢‫حُوِل‬ٌَٖٓ٤ُٜ‫ح‬٢ٔ‫حُؼظ‬ٚ‫حُٞؿ‬. ‫آظط‬ ‫ٓ٠خى‬ َ‫طؼظز‬ ٝ ٠‫حُٔ٘ل‬ ٢‫ك‬ ‫١ٞ٣ِش‬ ‫ٗوخٛش‬ ‫ُلظَس‬ ‫طلظخؽ‬ ٝ ‫َٓٛوش‬ ‫أؿِٜس‬ َ‫طؼظز‬ ‫أٜٗخ‬ ٫‫ا‬ٝ ‫حُولل٤ش‬ ‫ح٩ٛخرخص‬ ‫كخ٫ص‬ ٢‫ك‬ ‫زخد‬ّ‫ػي‬ ... ‫حَُٜع‬ ٝ ٕ‫ح٩ىٓخ‬ ‫كخ٫ص‬ ٝ ٢ٌُ٘ٛ‫ح‬ ٍ‫ح٩ٓظوَح‬ +ْ٤‫ىرخر‬‫كٞم‬‫حُلـخؿ٤ش‬. +ْ٤‫ىرخر‬‫ٝؿ٘٤ش‬. +‫ا١خٍحص‬Halo. +‫ا١خٍحص‬LEVANT.
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 68 G-٧‫ح‬ٝ ‫حَُٔحكوش‬ ‫ً٣خص‬٩‫ح‬‫هظ٬١خص‬: ٩ ‫ٗظَح‬‫ٍطزخ١خص‬ٝ ‫حُؼ٠ِ٤ش‬ ١ِٞ‫حُؼ‬ ‫حُلي‬ٝ ‫ٝػخث٤ش‬ ‫كِٓخ‬ ٟٞ‫٣ل‬ ًٚٗٞٝ ، ‫حُٔـخٍٝس‬ ‫حُؼظٔ٤ش‬‫حُـَحف‬ ٠ِ‫ػ‬ ‫ٌُح‬ ‫ٛخٓش‬ ‫ػٜز٤ش‬‫أ‬ٌٕٞ٣ ٕ ‫ر‬ ‫طخٓش‬ ‫ىٍح٣ش‬ ٠ِ‫ػ‬‫ؤ‬‫ر‬ ‫حُٜٔخد‬ ٞ٣َُٔ‫ح‬ ٕ‫ؤ‬‫ً٣خص‬‫ٝؿٜ٤ش‬‫ر‬ ‫ػخىس‬ ‫٣ٜخد‬‫ب‬ٝ ‫هظ٬١خص‬‫أ‬‫ٓ٘خ١ن‬ ٢‫ك‬ ‫َٓحكوش‬ ‫ً٣خص‬‫أ‬ٝ ‫ًخُـٔـٔش‬ َٟ‫ه‬‫حُؼٔٞى‬ ٝ َٟ‫حُلو‬ٝ ٍ‫حُٜي‬‫حُظ٘لٔ٤ش‬ ‫حُطَم‬ٝ‫حُلـخ‬ ‫ؿٞف‬٩‫ح‬ ‫ٓزذ‬ ‫كٔذ‬ ‫ؽ‬ٝ ‫ٛخرش‬‫٣ـذ‬‫أ‬ٝ ‫طليى‬ ٕ‫حُٜ٘خث‬ ‫حُؼ٬ؽ‬ َ‫هز‬ ‫رَٔػش‬ َ‫طير‬٢ ٚ‫حُٞؿ‬ ٌٍُٞٔ. ٝٝ ‫ًحطٜخ‬ ‫رلي‬ ‫ُِل٤خس‬ ‫ٜٓيى‬ َ٤‫ؿ‬ ٚ‫حُٞؿ‬ ‫ٓ٘ظٜق‬ ًٍٞٔ ًٕٞ ٖٓ ْ‫رخَُؿ‬‫كخى‬ ْ‫ط٘ل‬ ‫طٞهق‬ ‫طٔزذ‬ ‫هي‬ ‫ٌُٜ٘خ‬‫أ‬ٝ ، َ٣ِ‫ؿ‬ ‫ِٗف‬ ٝ٠ُ‫رخُظخ‬ ٝ ، َ٤‫حُظير‬ ‫كَٔػش‬ُ‫ح‬ ‫حُٔؼخُـش‬‫ٔٞؿٜش‬‫أ‬‫ٓخٓ٤ش‬‫ُٔ٘غ‬٧‫ح‬‫ً٣خص‬‫حُل٤خس‬ ‫طٜي٣ي‬ ٝ‫أ‬ ْ‫حُظلخه‬ ٖٓ ‫حَُٔحكوش‬، ‫ط‬ ٌٖٔ٣‫ؤ‬ٞ٣َُِٔ َٓ‫حٌُخ‬ ‫حُٟٞغ‬ َ‫٣ٔظو‬ ٠‫كظ‬ ٌٍُِٞٔ ‫حُلخٓٔش‬ ‫حُٔؼخُـش‬ َ٤‫ؿ‬ ٧‫ح‬ ٍ‫طٌَح‬ ‫رٔزذ‬ٝ ‫ُٔؼخُـش‬ َٛ‫ٓئ‬ ٠‫١ز‬ ‫كَ٣ن‬ ‫ٓ٬كظش‬ ‫طلض‬ ‫حُزيح٣ش‬ ٌ٘ٓ ٞ٣َُٔ‫ح‬ ‫ٟٝغ‬ ‫٣ـذ‬ ‫حَُٔحكوش‬ ‫ً٣خص‬ٝ ، َُٟٝٞ‫ح‬ ٚ٤‫ط٘و‬ ٩ ‫ًُي‬٩‫ح‬ ‫حُٔؼخُـش‬ ‫ؿَحء‬٨ُ ‫ٓؼخك٤ش‬ُ‫ح‬ ‫ً٣خص‬ٔ‫َحكوش‬. ٧‫ح‬ ٖٓ‫حَُٔحكوش‬ ‫ً٣خص‬‫حُ٘خثؼش‬: ‫ط٬كع‬ ‫ك٤غ‬ ، ‫ٝحُؼ٤٘٤ش‬ ‫حُلـخؿ٤ش‬ ‫ح٫ً٣خص‬٢‫ك‬20٧‫ح‬ ٖٓ %ٝ ، ‫حُٞؿٜ٤ش‬ ‫ً٣خص‬َٗ‫ٓزخ‬ ٌَ٘‫ر‬ ‫طليع‬ ٢ٛ‫ٗظ٤ـش‬ُ‫حُلـخؽ‬ َٝ‫أ‬ٝ ٝ ١ِٞ‫حُؼ‬ ‫حُلي‬ ًٍٞٔ ‫ٗظ٤ـش‬ َٗ‫ٓزخ‬ َ٤‫ؿ‬ ٌَ٘‫ر‬ٝ ، ٠٘‫حُٞؿ‬ ْ‫حُؼظ‬‫هي‬ ‫ٜٓ٘خ‬ َ٤ِ‫حُو‬‫٣ليع‬‫أ‬‫حُٔؼخُـش‬ ‫ػ٘خء‬‫أ‬ٟٝ‫حُ٤ي‬ ‫حَُى‬ ٝ. ‫أ‬‫األ‬ ٌ‫ه‬‫ػ‬‫و‬ ‫شاض‬‫اىحجاج‬ ‫ىنسش‬ ‫اىؼالٍاخ‬: ‫طلض‬ ‫ِٗف‬ ، ‫حُِٔظلٔش‬ ‫ًٝٓش‬ ، ‫حُلـخؽ‬ ‫طلض‬ ‫ًٝٓش‬، ‫حُِٔظلٔش‬‫ا‬٧‫ح‬ ‫ٓظَهخء‬ٝ ، ٕ‫ؿلخ‬‫حُ٘لغ‬‫ا‬‫ؿئ‬ ، ‫حَُإ٣ش‬ ‫ُىٝحؿ٤ش‬ٖٝ٤‫حُؼ‬ ٍ‫أ‬ٝ ‫ؿلٞظٜخ‬ٝ ٌَُٔ‫ح‬ ْ‫كـ‬ ‫كٔذ‬‫ا‬‫حُلـخؽ‬ َ‫ُيحه‬ ٚٛ‫طـخ‬‫أ‬، ٖ٤‫ُِؼ‬ ‫ًحط٤ش‬ ‫كًَش‬ ، ٚ‫ُوخٍؿ‬ ٝ‫ا‬‫ػ٤٘٤ش‬ ‫هظ٬١خص‬‫أ‬ٍُِ‫ًخ‬ َٟ‫ه‬‫حُٔخء‬ ‫م‬ ٧‫ح‬ ‫حُٔخء‬ ‫ٝحُٔخى‬ ‫حُٔٞىحء‬‫ٍُم‬. ً ‫َُِإ٣ش‬ ٕ‫كويح‬ ‫٣ليع‬‫ب‬١٬‫هظ‬،٧‫ح‬ُ‫حُظخ‬ ٠ٔ‫حُؼ‬ ٞٛ ‫ٗ٤ٞػخ‬ َ‫ًؼ‬٢٩َٜ‫حُز‬ ‫حُؼٜذ‬ ١‫ٗ٠ـخ‬١‫ك٤غ‬‫ا‬َُٞٓ ُْ‫حُؼخ‬ ‫هظَف‬‫أ‬‫٣ليع‬ ‫ػ٘يٓخ‬ ٚٗ ‫ك‬ ، ‫ٝحكي‬ ‫ؿخٗذ‬ ٢‫ك‬ ‫َُِإ٣ش‬ ٕ‫كويح‬‫ب‬‫٣ظٞهغ‬ ٚٗ‫ٝؿٞى‬ٝ ‫حُلـخؽ‬ ‫ؿٞف‬ ‫هٔش‬ َ‫ػز‬ ًَٔٚ‫حُٞؿ‬ ‫ٓ٘ظٜق‬ ًٍٞٔ ‫ٍى‬ ّ‫ػي‬ ‫٣ـذ‬ ‫ػ٘يٛخ‬. ‫حُٜ٘ق‬ ‫ُٞكَٝص‬ ًٍٞٔ ٕ‫كخ‬ ّ‫ػخ‬ ٌَ٘‫ٝر‬3ًٝ٧‫ح‬ ْ‫ػظ‬ ًٍٞٔ ‫ٌُي‬ٝ ‫حُلـخؽ‬ ‫ؿٞف‬ ٢‫ك‬ ًٍٞٔ ‫طٔزذ‬ ‫ٗق‬ٝ ، ٍٚٗ‫ؿيح‬َٜ‫ط‬ ‫هي‬‫ا‬٠ُ ٝ ، ‫حُلـخؽ‬ ‫ًٍٝس‬ٝ ، ٚٗ‫ؿيٍح‬، ‫حُلـخؽ‬ ‫ًٍٝس‬ ٠ُ‫ح‬ َٜ‫ط‬ ‫هي‬‫ف‬15ٝ ٠َُٟٔ‫ح‬ ٖٓ %ٖ٣ٌُ‫ح‬٧‫ح‬ ‫كيٝع‬ ‫ػ٘ي‬ ٠‫ُِٞػ‬ ‫كوي‬ ٖٓ ‫ػخٗٞح‬، ًٟ ‫هي‬‫أ‬‫ٓظ‬ ٌَ٘‫ر‬ ‫ٛ٤زٞح‬‫ؤ‬‫ر‬ َ‫ه‬‫ب‬‫ىٓخ‬ ‫ٟطَحد‬ً ‫ٓخ‬ ٠‫ؿ‬‫خَُٜحع‬‫أ‬، ‫ٗلٔ٤ش‬ ‫طزي٫ص‬ ٝ ٝ‫أ‬٩‫ح‬ ‫ٓخ‬‫حُلي‬ ٢‫ك‬ ‫طليع‬ ٢‫حُظ‬ ‫هظ٬١خص‬‫ك‬ ١ِٞ‫حُؼ‬‫ب‬‫طوغ‬ ‫هِٔخ‬ ‫ٜٗخ‬‫ا‬ِ‫ط‬ ‫ًح‬‫و‬ٝ ‫ٓزٌَس‬ ‫ٓؼخُـش‬ ٚ‫حُٞؿ‬ ‫ٓ٘ظٜق‬ ًٍٞٔ ‫ض‬ٝ ، ‫ًخك٤ش‬‫ط٘ظؾ‬ ٩‫ح‬٩‫ح‬ ٖ‫ػ‬ ‫هظ٬١خص‬ٝ ‫ٗلٜٔخ‬ ‫ٛخرش‬‫هي‬ٌٕٞ‫ط‬‫حُٔظخهَس‬ ‫ُِٔؼخُـش‬ ‫طخُ٤ش‬‫أ‬ٝ ، ‫حُوخ١جش‬ ٝ‫٣ـذ‬‫أ‬ٛ‫ُِٔظخ‬ ‫ٝحػ٤خ‬ ‫حُطز٤ذ‬ ٌٕٞ‫ط‬ ٕ‫حُٔظ‬ َ‫ؤ‬‫هَس‬ ٪ُٛ‫خ‬‫حُيٓخؿ٤ش‬ ‫رخص‬. ‫مسش‬‫قاع‬‫اىحجاج‬‫أ‬‫و‬‫اىنسش‬‫اإل‬‫ّفجاسي‬ : Orbital Blow-out Fracture ‫حُلـخؽ‬ٞٛ‫حُظـَ٣ق‬٢ٔ‫حُؼظ‬٢٤‫حُٔل‬ٖ٤‫رخُؼ‬‫ٝ٣٘ظؾ‬ٖ‫ػ‬ٍٝ٢ٓ‫أٓخ‬‫ٌَُس‬ ٖ٤‫حُؼ‬‫أ‬ٝ‫كخىع‬َ٤ٓ‫أ‬ٝ١‫ح‬‫كخىع‬‫ٗخطؾ‬ٖ‫ػ‬‫ا‬ّ‫ٍططخ‬ٚ‫حُٞؿ‬‫ر٘٠ء‬‫ِٛذ‬ (ٗ‫ٓزخ‬ ّ‫اٍططخ‬ َ‫اػ‬ ‫٣٘خٛي‬ ‫ٓخ‬ ‫ؿخُزخ‬ْ‫رؼظ‬ ‫ٗخرٜٜخ‬ ‫ٓخ‬ ٝ‫أ‬ ْ٘‫حُظ‬ ‫ٌَُس‬ َ ) َٗ‫ٓزخ‬ ٌَ٘‫ر‬ ٝ ‫حُلـخؽ‬ َ‫٣٘ظو‬َُٝ‫ح‬ٌَ٘‫ر‬١ٍ‫اؿزخ‬‫ُوخػيس‬‫حُلـخؽ‬٢ٔ‫حُؼظ‬‫حُ٠ؼ٤لش‬ٌَٔ٘‫كظ‬،
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 69 ‫حَُٔ٣َ٣ش‬ ‫حُؼ٬ٓخص‬: -‫حُِٔظلٔش‬ ‫طلض‬ ‫ًيٓش‬ -‫حُٜ٘٤ن‬ ‫ػ٘ي‬ ‫١وطوش‬ ‫ٓٔخع‬ -‫حُليهخص‬ ٟٞ‫ٓٔظ‬ َ‫ط٘خظ‬ ّ‫ػي‬ -‫ٗلغ‬ -ٙٞ‫ه‬ -٢ِ‫حُٔل‬ ٖ‫حُـل‬ ٙٞ٘‫ط‬ -‫ٓظ٬ُٓش‬( ١ِٞ‫حُؼ‬ ٢‫حُلـخؿ‬ ‫حُ٘ن‬‫ِٓ٣ؾ‬َِٖٖٓٗ٤‫حُؼ‬ّ‫حُظخ‬‫ٓغ‬َ٣‫طوي‬،‫حُوَٗ٤ش‬ٖ‫حُـل‬١ِٞ‫حُؼ‬ٝ‫حُٜ٘ق‬ْ‫ر٘ل‬‫حُـخٗذ‬ٖٓ ‫حُـزٜش‬) ‫طؤً٤ي‬ ْ‫٣ظ‬ٚ٤‫ط٘و‬ًٍّٞٔ‫ػظخ‬‫حُلـخؽ‬‫ر‬‫بؿَحء‬‫أ‬‫ٗؼش‬ ‫ٓوطؼ٤ش‬ٝ‫أ‬ٖ٤ٍٗ٢ٔ٤١‫ٓـ٘خ‬٠ِ‫ػ‬‫حُلـخؽ‬‫أ‬ٝ٠‫كظ‬ٍُٜٙٞ‫ح‬ ُ‫ح‬ٚ٤‫٘ؼخػ‬ٚ‫حُزٔ٤ط‬‫ًُي‬٠‫كظ‬‫ٌٗظ٘ق‬ٕ‫ٌٓخ‬‫حَُ٘م‬ٝ‫أ‬ ٌَُٔ‫ح‬٢ٔ‫حُؼظ‬‫ًٌُٝي‬ُ‫ٔؼَكش‬‫ػ٠٬ص‬ٖ٤‫حُؼ‬‫حُٔلٍ٘ٞس‬ َ‫ىحه‬‫ٌٛح‬ٌَُٔ‫ح‬، ٝ١‫طئى‬ٞ‫رؼ‬‫ا‬‫ٛخرخص‬‫حُلـخؽ‬٠ُ‫ا‬‫َٗم‬ٝ‫أ‬ًَٔ٢‫ك‬ٌٙٛ ّ‫حُؼظخ‬َ٘‫كظ٘ل‬‫ػ٠٬ص‬ٖ٤‫حُؼ‬َ‫ىحه‬‫ٌٛح‬‫حَُ٘م‬ٝ‫أ‬ٌَُٔ‫ح‬ ٝ‫طٜزق‬‫ػخؿِس‬ٖ‫ػ‬‫طلَ٣ي‬ٖ٤‫حُؼ‬ٝ‫أ‬َ‫ًؼ‬‫حُؼ٠٬ص‬ً‫ح‬َ‫طؤػ‬ٖٓ ‫ا‬‫ٛخرخص‬ّ‫ػظخ‬‫حُلـخؽ‬٢ٛ‫حُؼ٠٬ص‬‫حُٔلِ٤ش‬ٝ١‫٣ئى‬ ‫ا‬ّ‫كظزخ‬‫حُؼ٠٬ص‬‫حُٔلِ٤ش‬َ‫ىحه‬ٌٍُٞٔ‫ح‬‫حُؼظٔ٤ش‬٠ُ‫ا‬ ّ‫ػي‬‫هيٍس‬ٖ٤‫حُؼ‬٠ُ‫ا‬‫حُلًَش‬٠ُ‫ا‬٠ِ‫أػ‬‫ػِٔ٤ش‬ ٍ٬‫ه‬ ١َٜ‫ه‬ ٌَ٘‫ر‬ ٠ِ‫ُ٨ػ‬ ٖ٤‫حُؼ‬ ‫ًَس‬ َ‫كظ‬ ‫ٓلخُٝش‬ ٟ‫ُي‬ ‫ؿِ٤خ‬ ‫٣٬كع‬ ‫ٓخ‬ ٞٛ ٝ ٚ‫حُلل‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 70 ‫٣٬كع‬٠ِ‫ػ‬‫ٛئ٫ء‬٠َُٟٔ‫ح‬ْٜٗ‫أ‬‫ػ٘يٓخ‬َٕٝ‫٣٘ظ‬٠ُ‫ا‬٠ِ‫أػ‬ٕ‫كب‬ٖ٤‫حُؼ‬‫حُِٔ٤ٔش‬‫طظلَى‬٠ُ‫ا‬٠ِ‫أػ‬‫ر٤٘ٔخ‬ٖ٤‫حُؼ‬‫حُٜٔخرش‬٬‫ك‬،‫طَطلغ‬ ٝ‫هي‬٢‫٣ٜز‬ٞ‫رؼ‬‫ٌٓٞٗخص‬َ‫حُٔلـ‬ْٝ‫حُ٘ل‬ٝ‫أ‬‫حُؼ٠ِش‬‫حُٔٔظو٤ٔش‬‫حُٔلِ٤ش‬٠ُ‫ا‬‫ؿٞف‬‫حُـ٤ذ‬٢ٌ‫حُل‬ ١‫٣ئى‬ٌَُٔ‫ح‬ٍٝ‫ُـئ‬ٖ٤‫حُؼ‬ٝ‫طليى‬‫كًَخطٜخ‬ٝ‫هي‬‫٣ليع‬‫ٗلغ‬ٍ‫رخ٫رٜخ‬. ‫حُٔؼخُـش‬: ‫اؿَحء‬‫ؿَحكش‬َ٣َ‫ُظل‬‫حُ٘ٔؾ‬‫حُؼخُوش‬ٞ٣ٞ‫ٝطؼ‬‫حُـِء‬٢ٔ‫حُؼظ‬‫حُٔلوٞى‬. ‫هي‬‫٣ليع‬ٍٞ‫حُل‬١ٞٗ‫حُؼخ‬‫أ٣٠خ‬‫رؼي‬‫ػِٔ٤خص‬‫كـخؽ‬ٖ٤‫حُؼ‬،‫حُٔوظِلش‬ٖٓٝ‫أٜٛٔخ‬‫ػِٔ٤ش‬‫طول٤ق‬٢‫حُ٠ـ‬،‫رخُلـخؽ‬ٝ‫ػِٔ٤خص‬‫اٛ٬ف‬ ًٍٞٔ،‫حُلـخؽ‬ٌٕٝٞ٣‫ًُي‬‫ٗظ٤ـش‬١ٞ‫ُٜز‬‫حُؼ٠٬ص‬ٝ‫ح٧ٗٔـش‬‫حَُهٞس‬َ‫ىحه‬‫حُـ٤ٞد‬‫ح٧ٗل٤ش‬‫رطَ٣وش‬َ٤‫ؿ‬،‫ٓ٘ظظٔش‬ٝ‫أ‬‫حُظٜخم‬ ‫حُؼ٠ِش‬‫حُٔٔظو٤ٔش‬‫حُٔلِ٤ش‬‫رخُ٘ٔ٤ؾ‬،‫حٍُِٔٝع‬‫ٝ٣ؼظٔي‬‫كيٝع‬َ‫ٓؼ‬‫ٌٛح‬‫حُ٘ٞع‬ٍٖٓٞ‫حُل‬٠ِ‫ػ‬‫ػيس‬َٓ‫ػٞح‬،‫ٜٓ٘خ‬َٔ‫ػ‬،ٞ٣َُٔ‫ح‬ ‫ٝٝهض‬‫اؿَحء‬‫حُـَحكش‬‫رخُ٘ٔزش‬‫ُليٝع‬،ٌَُٔ‫ح‬‫ٝٗٞع‬‫حُؼِٔ٤ش‬،‫حُٔٔظويٓش‬ٝ‫ٗٞع‬‫حُ٘ٔ٤ؾ‬ّ‫حُٔٔظوي‬٠‫ك‬‫اٛ٬ف‬ٌَُٔ‫ح‬,ٝ٠‫ك‬ ‫أؿِذ‬ٕ‫ح٧ك٤خ‬ْ‫٣ظ‬‫حُ٘لخء‬ٍٖٓٞ‫حُل‬‫طِوخث٤خ‬٠‫ك‬ٕٞ٠‫ؿ‬‫ٓظش‬َٜٗ‫أ‬‫رؼي‬‫حُـَحكش‬.‫ٝػ٬ؽ‬‫ٌٛح‬ٍٞ‫حُل‬ٌٕٞ٣ً‫خ‬٤‫ؿَحك‬‫رٟٞغ‬‫َٗ٣لش‬ ‫ر٬ٓظ٤ٌ٤ش‬َٜ‫طل‬‫حُؼ٠٬ص‬‫حُٔلٍ٘ٞس‬ٖ‫ػ‬ّ‫حُؼظخ‬‫حٌٍُٔٔٞس‬٠‫كظ‬‫طٔظط٤غ‬‫حُظلَى‬‫رلَ٣ش‬.
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 71 **‫حُـَحك٤ش‬ َ‫حُٔيحه‬ -‫حُِٔظلٔش‬ َ‫ػز‬Transconjunctival:‫ػوذ‬ ‫ُظـ٘ذ‬ ‫ػخُ٤ش‬ ‫ٜٓخٍس‬ ‫طظطِذ‬ ٝ ‫ىه٤وش‬ ‫ِٓ٤ش‬ ٢ٛ ٝ ٖ‫حُـل‬ َ‫ٗط‬ ‫رؼِٔ٤ش‬ ‫أ٣٠خ‬ ٠‫طيػ‬ ‫حُِٔظلٔش‬ ٝ‫أ‬ ٖ‫حُـل‬ ‫ؿِي‬ -٢ِ‫حُٔل‬ ٖ‫حُـل‬ َ‫ػز‬Subciliary:ٖ‫حُـل‬ ٢ُ‫طي‬ ‫حُؼِٔ٤ش‬ ٌٙٛ ‫اهظ٬١خص‬ ٖٓ -‫حُلـخؽ‬ ‫طلض‬Subtarsal:‫اٗظ٘خٍح‬ َ‫ح٧ًؼ‬ ٝ ‫أٓخٗخ‬ َ‫ح٧ًؼ‬ ‫حُؼِٔ٤ش‬ ٢ٛ ٝ -: ٢ٌ‫حُل‬ ‫حُـ٤ذ‬ َ‫ػز‬ٝ ١‫ؿِي‬ ‫ٗن‬ ٠ُ‫ا‬ ‫حُؼِٔ٤ش‬ ٌٙٛ ‫طلظخؽ‬ ٫ ٝ َ‫ح٧ٓل‬ ّ ‫حُلـخؽ‬ ‫هخع‬ ‫ٗظخ٣خ‬ ْ‫ىػ‬ ٠ُ‫ا‬ ‫حُؼِٔ٤ش‬ ٌٙٛ ‫طٜيف‬ ١ٞٔ‫ك‬ َ‫ىحه‬ ‫ر٘ن‬ ٢‫ٌٗظل‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 72 : ‫حُلـخؽ‬ ‫هخع‬ ْ٤َٓ‫ط‬ ** ‫طَٓ٤ٔ٤ش‬ ‫ٓٞحى‬ ‫ػيس‬ َٔ‫ٗٔظؼ‬ ‫ٌُُي‬ ٝ ْ٤َٓ‫ط‬ ٠ُ‫ا‬ ‫حُلـخؽ‬ ‫هخع‬ ‫٣لظخؽ‬ 1-ْ‫حُطؼ‬٢‫ًحط‬:-ّ‫حُؼظخ‬(،‫حُـٔـٔش‬،‫ح٧ٟ٬ع‬٢‫حُلَهل‬) -‫ؿ٠َٝف‬ 2-ُ‫ح‬ّٞ‫طؼ‬‫حُٜ٘ؼ٤ش‬:-‫حُـخك٤ش‬‫حُٔـللش‬‫رخُظزَ٣ي‬ 3-: ‫حُٔـخ٣َس‬ ّٞ‫حُطؼ‬-‫٣ٍِع‬SiliasticٝPROPLAST -ِٕٞ‫طل‬ -٢ًٍٔٝ‫ٛ٤ي‬‫أ‬‫رخط٤ض‬ -‫ٗزٌش‬ّٞ٤ٗ‫حُظ٤ظخ‬) ٫‫آظؼٔخ‬ َ‫ح٧ًؼ‬ ٢ٛ ٝ () ‫حٍُٜٞس‬ ( H-َ٤ٛ‫حُظؤ‬: .‫حُٔ٘ظًَش‬ ‫ح٩كظ٤خ١خص‬ ٞ‫رؼ‬ ‫طٔظٞؿذ‬ َ٤ٛ‫طؤ‬ ‫ُلظَس‬ ٚ‫حُٞؿ‬ ًٍٞٔ ‫ؿٔ٤غ‬ ‫طلظخؽ‬ ّ‫ػخ‬ ٌَ٘‫ر‬ ٫ٌٖٔ٣‫ا‬ُ‫ح‬ ِٚ‫حَُٔك‬ ٢‫ك‬ ‫ريٗ٤ش‬ ٖ٣ٍ‫طٔخ‬ ١‫أ‬ ‫ؿَحء‬٩‫ح‬ ٖٓ ٌَٙ‫ٔز‬‫ٝؿٞى‬ ‫ػ٘ي‬ ٚٛ‫هخ‬ ٚ‫ٛخر‬‫ا‬ٝ ْ‫حُظ٘ل‬ ‫ػخهش‬‫ٓخ‬ ‫ؿخُزخ‬ ١ٌُ‫ح‬َٙ‫ُلظ‬ َٔ‫٣ٔظ‬ ‫ٓؼ٤٘ش‬ٚ‫ح٫ٛخر‬ ‫ُ٘يس‬ ‫طزؼخ‬ -ٖ٤ٓٞ٣ ‫ُٔيس‬ ‫ٍحكش‬ ‫رؼي‬ ‫طيٍ٣ـ٤خ‬ ١‫حُ٘٘خ‬ ‫٣زيأ‬ ٩‫ح‬‫أٓخر٤غ‬ ‫ٓظش‬ ‫٣ٔظـَم‬ ً‫خ‬‫ؿخُز‬ ‫ٓظ٘لخء‬,ٝ٩‫ح‬ َ‫٣ؼظز‬٫ ‫ػ٘يٓخ‬ ً٬ٓ‫ًخ‬ ّ‫ُظجخ‬ٝ ٌَُٔ‫ح‬ ٕ‫ٌٓخ‬ ٢‫ك‬ ُْ‫أ‬ ‫ٛ٘خى‬ ٌٕٞ٣‫ح٧ٗؼش‬ َٜ‫طظ‬ ‫ػ٘يٓخ‬ ٩‫ح‬ّ‫ُِؼظخ‬ َٓ‫حٌُخ‬ ّ‫ُظلخ‬. ٝ٩‫ح‬ َ‫هز‬ َٙ‫حُلظ‬ ٍ٬‫ه‬ ‫٣ٜ٘ق‬٢‫٣ؤط‬ ‫رٔخ‬ ّ‫ُظجخ‬: -٢‫حُ٠ـ‬ ٖٓ ٚ‫حُٞؿ‬ ‫ُلٔخ٣ش‬ َٜ‫حُظ‬ ٠ِ‫ػ‬ ُّٞ٘‫ح‬ -ٍٝ‫ط٘خ‬‫أ‬‫حُٔ٠ؾ‬ ‫ِٜٓش‬ ‫ؿٌ٣ش‬‫ط‬ٝ ٖ٤‫حُزَٝط‬ ٖٓ ‫ًز٤َس‬ ‫ًٔ٤خص‬ ٠ِ‫ػ‬ ١ٞ‫لظ‬‫حُلي‬ ‫طؼز٤ض‬ ‫أػ٘خء‬ ّ‫أ٣خ‬ ‫ُؼيس‬ َ‫حُٔٞحث‬ ( ٖٓ َ‫أًؼ‬ ‫ُٔيس‬ ‫ٍَٟٝ٣ش‬ ٌٕٞ‫ٓظ‬ َ‫رخُٔٞحث‬ ‫حُظـٌ٣ش‬8. ‫)أٓخر٤غ‬ -‫أ‬ٚ‫ٝحٌُل‬ ّ‫حُؼطخ‬ َ‫ٓؼ‬ ‫رَكن‬ ٚ‫حُٞؿ‬ ‫كًَخص‬ ‫ىحء‬‫ٝحُظو٤ئ‬.…‫حُن‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ ‫كساب‬ ‫جودت‬ ‫فراس‬ .‫د‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ ‫كساب‬ ‫جودت‬ ‫فراس‬ .‫د‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 73 ‫ح٧ٗق‬ ْ‫ػظ‬ ًٍٞٔ٢ُ‫حُـَرخ‬ ٢‫ح٧ٗل‬ ‫حًَُٔذ‬ ٝ A-: ‫ٓويٓش‬ ‫ح٧ٗق‬ ّ‫ػظخ‬ ٟ‫اكي‬ ًَٔ ٞٛ ٌٍُٞٔٔ‫ح‬ ‫ح٧ٗق‬‫ًُي‬ ٝٝ ٚ‫حُٞؿ‬ ٖٓ ‫ح٧ٗق‬ َُٝ‫ر‬ ‫رٔزذ‬ٗ‫ٛ٘خ‬ٚ‫ظ‬ ٝ ً‫خ‬‫ٗ٤ٞػ‬ ‫ح٩ٛخرخص‬ َ‫أًؼ‬ ٖٓ ‫ٝحكي‬ ٌٍُٞٔٔ‫ح‬ ‫ح٧ٗق‬ ٖٝٓ ‫٣وَد‬ ‫ٓخ‬ ْ٠‫ط‬ ٢‫حُظ‬ ٢ٛ40ٚ‫حُٞؿ‬ ٢‫ك‬ ‫ح٩ٛخرخص‬ ‫ؿٔ٤غ‬ ٖٓ ٪. ٚ‫حُٞؿ‬ ٖٓ ٢ٓٝ٨ُ‫ح‬ ‫حُؼِغ‬ ٢‫ك‬ ‫حُٜ٘ش‬ ّ‫حُؼظخ‬ ٖٓ ٢ُ‫حُـَرخ‬ ٢‫ح٧ٗل‬ ‫حًَُٔذ‬ َ‫٣ؼظز‬ ٝ
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 74 B-٧‫ح‬: ‫ٓزخد‬ )+ٝ ‫حُؼِٞ٣ش‬ ‫حُظ٘لٔ٤ش‬ ‫ُِطَم‬ ٠ِ‫ح٧ػ‬ ْٔ‫حُو‬ ٢‫ك‬ ‫ح٧ٗق‬ ‫٣وغ‬ٞٛٝ ٍٝ٧‫ح‬ َُٔٔ‫ح‬ٝ ٕ‫ح٩ٗٔخ‬ ‫ػ٘ي‬ ْ‫ُِظ٘ل‬ ٢ٓ‫ح٧ٓخ‬ٞ٠‫حُؼ‬ ٞٛ ٍُ‫حُزخ‬ٝ ‫رخُـش‬ ‫ربٛخرخص‬ َُِٟٝٞ َٝ‫ٓؼ‬ ٞٛ ‫ٌُُي‬ ٚ‫ُِٞؿ‬‫ريٍؿخص‬ٝ ‫ٓوظِلش‬ٝ ‫ح٧ٗق‬ ْ‫ػظ‬ ًَٔ ٠ُ‫ا‬ ١‫طئى‬ ‫ٓظ٘ٞػش‬ ‫١َم‬‫ٗٔزش‬ ‫طزِؾ‬ ٢ُ‫كٞح‬ ٍ‫ٝح٧١لخ‬ ٖ٤‫حُزخُـ‬ ٖ٤‫ر‬ ‫ح٩ٛخرش‬٣٣ٝ ٚ‫حُٞؿ‬ ٍٟٝٞ ٖٓ ٪‫ر٘ٔزش‬ ‫ح٩ٗخع‬ ٖٓ ًٌٍُٞ‫ح‬ ‫ػ٘ي‬ "‫ٗ٤ٞػخ‬ َ‫ح٧ًؼ‬ ٢ٛ٢‫׃‬١ٖٓ ٖ٤‫ر‬ ١١‫ـ‬٢١ًٝ‫خ‬ٜٛٞ‫ه‬ٖ٤٤ٟ‫حَُ٣خ‬ ‫ػ٘ي‬. )+٢‫ك‬ ٚ‫ًٍٝط‬ ‫٣زِؾ‬ ‫ح٧ٗق‬ ًَٔ ٕ‫كب‬ ‫ح٩ٗخع‬ ٠ُ‫ا‬ ‫رخُ٘ٔزش‬ ‫أٓخ‬ٝ ٚ‫حُٞؿ‬ ٠ِ‫ػ‬ ١ٞ‫ُِٔو‬ ‫ٗظ٤ـش‬ ‫ٓ٘ش‬ ٖ٤‫حُٔظ‬ َٔ‫ػ‬‫ح٧ٗق‬ ًٍٞٔ ‫أؿِذ‬ ‫ػ٘ي‬ٝ ٖ٤‫حُٔلظَك‬ ٖٓ ‫حَُ٣خٟش‬ ٍٕٞٓ‫٣ٔخ‬ ٖ٣ٌُِ ٌٕٞ‫ط‬ ‫حُ٘زخد‬ٝ ‫حُٜٞحس‬ً‫خ‬ٜٛٞ‫ه‬‫حُٔ٬ًٔش‬ َ‫ٓؼ‬ ‫حُؼ٘٤لش‬ ‫حَُ٣خٟش‬ ٍٕٞٓ‫٣ٔخ‬ ٖ٣ٌُ‫ح‬ ‫اُن‬ ...‫ٝحُٜٔخٍػش‬ٝ ,ٝ ّ‫حُوي‬ ‫ًَس‬ َ‫ٓؼ‬ ‫حٌَُٝ٣ش‬ ‫حَُ٣خٟش‬ ٠‫كظ‬‫ًَس‬‫حُِٔش....اُن‬‫رخُ٘ٔزش‬ ‫أٓخ‬ ,‫ك٘ٔزش‬ ٍ‫ح٧١لخ‬ ‫ػ٘ي‬ ‫ح٧ٗق‬ ٌٍُٞٔ ٜ‫كيٝػ‬‫خ‬ٜٜ٤‫ط٘و‬ ‫٣ٜؼذ‬ ٚٗ‫أ‬ ‫ك٤غ‬ ٖ٤‫حُزخُـ‬ ٖٓ َ‫أه‬‫خ‬ٝ‫ط‬ٛٞ٘‫ط‬ َ‫أه‬ ٌٕٞ‫خ‬ٖٓ ‫رَُٝح‬ َ‫أه‬ ٌٕٞ٣ ٍ‫ح٧١لخ‬ ‫ػ٘ي‬ ‫ح٧ٗق‬ ٕ٧ ٖ٤‫حُزخُـ‬ ٖٓ ٖ٤‫حُزخُـ‬. )+‫ح٧ٗق‬ ٠ِ‫ػ‬ ١ٞ‫حُٔو‬ ٝ‫أ‬ ‫حٌُِٔش‬ ٖٓ ‫أٗي‬ ‫ح٧ٗق‬ ٠ِ‫ػ‬ ٍٟٝٞ ‫حُٔ٤خٍحص‬ ‫كٞحىع‬ ‫طٔزذ‬ ‫ٓخ‬ ‫ؿخُزخ‬ )+‫٣ِىحى‬ًَٔ َ‫هط‬ْ‫ػظ‬‫ح٧ٗق‬َٓ‫ػٞح‬ ‫ػيس‬ ‫رٔزذ‬ٝٔ٘‫ط‬: َ ٍ‫ح٧ػٔخ‬ *‫ٓظويٓش‬ *‫َٛع‬ *‫ح٧ٗق‬ ‫اٛخرش‬ ٝ‫أ‬ ‫حُٔخرن‬ ‫أٗق‬ ًَٔ *٧‫ح‬‫حَُ٣خٟخص‬ ‫(ٝهخٛش‬ ‫حَُ٣خٟ٤ش‬ ‫ُؼخد‬) ‫حُؼ٘٤لش‬ *ّ‫ػي‬ٍ‫ا‬‫حُٔ٤خٍس‬ ٢‫ك‬ ٕ‫ح٧ٓخ‬ ّ‫كِح‬ ‫طيحء‬ٕ‫ح٧ك٤خ‬ ٞ‫رؼ‬ ٢‫ك‬ ‫أ٣٠خ‬ ٌٖٔ٣ ‫حُٜٞحء‬ ّ‫(أً٤خ‬ٕ‫أ‬‫اٛخرخص‬ ‫طٔزذ‬. ) C-:‫طٜ٘٤ق‬ *ٝ ٙ‫اطـخ‬ ‫رلٔذ‬ ‫ح٧ٗق‬ ًَٔ ‫طٜ٘٤ق‬ ْ‫٣ظ‬ٝ ‫ىٍؿش‬ٝ ‫ح٧ٗق‬ ٠ِ‫ػ‬ ‫حُ٠َرش‬ ِ٤ًَ‫ط‬ٌَُٔ‫ح‬ ْٔ‫٣و‬ٝ ٢‫ؿخٗز‬ ًَٔ ٠ُ‫ا‬٢ٓ‫أٓخ‬ ًَٔ ‫ىٍؿخص‬ ‫ػ٬ع‬ ٠ُ‫ا‬ ‫ٜٓ٘ٔخ‬ ًَ ْٔ‫ٝ٣و‬:-‫هل٤ق‬ -٢ٓٞ‫ٓظ‬ -‫ٗي٣ي‬ ٝٝ‫أ‬ ‫ح٧ٗل٤ش‬ ‫حُـ٤ٞد‬ ٕ‫ؿيٍح‬ ٢‫ك‬ ًَٔ ٝ‫أ‬ ٢‫ح٧ٗل‬ ِ‫حُلخؿ‬ ٢‫ك‬ ‫اٛخرش‬ ‫ح٧ٗق‬ ْ‫ػظ‬ ًَٔ ‫٣َحكن‬ ‫هي‬ًَٔٝ‫أ‬ ‫حُٔن‬ ‫هخع‬ ٢‫ك‬‫طـٞ٣ق‬ ْ‫ػظ‬ .‫ٝحُلي‬ ٚ‫حُٞؿ‬ ْ‫ػظ‬ ٝ‫أ‬ ٖ٤‫حُؼ‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 75 *ٜ٘٣ ‫ًٔخ‬ًَٔ "‫أ٣٠خ‬ ‫ق‬‫آخ‬ ‫ح٧ٗق‬:-٢‫هخٍؿ‬ ١‫ؿِي‬ ‫ؿَف‬ ‫٫٣ٞؿي‬ ‫ػ٘يٓخ‬ ٢٤ٔ‫ر‬ ًَٔ، -ٌَُٔ‫ح‬ ‫ٓغ‬ ٢‫هخٍؿ‬ ‫ؿَف‬ ‫رٞؿٞى‬ ‫ٓ٠خػق‬ ًَٔ. *‫حُول٤لش‬ ‫حَُٔػش‬ ًٝ َُٝ‫ح‬ ‫ػخىس‬ ‫ٓززٜخ‬ ‫حُٔؼُِٝش‬ ‫ح٧ٗق‬ ًٍٞٔ ٕ‫ا‬. ٌَُٔ‫ح‬ ٌَٗ ٠ِ‫ػ‬ ‫٣ؼظٔي‬ ‫ح٧ٗق‬ ٌٍُٞٔ ّ‫حُؼخ‬ ‫حُظٜ٘٤ق‬ *: ٚ‫حُٞؿ‬ ٢‫ك‬ ٌٍٞٔ‫ر‬ ‫ػخىس‬ ‫٣ظَحكن‬ ‫ح٧ٗق‬ ًَٔ ٕ‫كب‬ ‫ػخُ٤ش‬ ‫َٓػش‬ ًٝ َُٝ ‫ح٧ٗق‬ َٝ‫طؼ‬ ‫اًح‬. ‫ح٧ٗق‬ ًٍٞٔ ‫طٜ٘ق‬) ٢ُ‫حُـَرخ‬ ‫حًَُٔذ‬ ٝ (ٝ ‫حُ٘يس‬ ٢‫ك‬ ‫ٓظيٍؿش‬ ‫أٛ٘خف‬ ‫ػ٬ػش‬ ٠ُ‫ا‬٩‫ح‬ٖٓ ‫ٓظيحى‬1٠ُ‫ا‬3:‫طٜ٘٤ق‬MARCHOWITZ A-‫حُٜ٘ق‬( ْ‫ٍه‬1): ٖٓ ٝ‫أ‬ ّ‫ح٧ٓخ‬ ٖٓ ‫ح٧ٗق‬ ٠ِ‫ػ‬ ٍٝ ‫رٔزذ‬ ‫ػخىس‬ ٌٕٞ٣ٝ ّ‫ح٧ٓخ‬ًَٔ( ‫حُٞطَس‬ ٢‫ك‬ ١‫ػٔٞى‬ ًَٔ ٠ُ‫ا‬ ١‫٣ئى‬ ‫ٓٔخ‬ ‫حُـخٗذ‬Chevallet) ‫ٓغ‬‫ا‬‫ح٧ٗق‬ ّ‫ػظخ‬ ٖٓ ‫حُزؼ٤ي‬ ْٔ‫حُو‬ ٢‫ك‬ ٍ‫طزي‬ ٝ‫أ‬ ‫ٗؤخف‬.
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 76 B-( ْ‫ٍه‬ ‫حُٜ٘ق‬2): ٠ِ‫ػ‬ ٢‫ؿخٗز‬ ٍٝ ‫رٔزذ‬ ً‫خ‬‫ؿخُز‬ ٞٛ‫كَف‬ ٌَ٘‫ر‬ ٝ‫أ‬ ٢‫أكو‬ ًَٔ ٠ُ‫ا‬ ١‫٣ئى‬ ‫ٓٔخ‬ ‫ح٧ٗق‬C(ًَٔJavjavay)َٔ٘٣ ‫حُٞطَس‬ ٢‫ك‬ ‫حُٜل٤لش‬٢ٌ‫ُِل‬ ٢ٜ‫حُـز‬ ‫حُ٘خطت‬ ٢‫ك‬ ًَٔ ‫ٓغ‬ ‫حُٞطَس‬ ‫ؿ٠َٝف‬ ‫ٓغ‬ ٢ُ‫حُـَرخ‬ ْ‫ُِؼظ‬ ‫حُوخثٔش‬. C-( ْ‫ٍه‬ ‫حُٜ٘ق‬3): ٝ ‫ٗيس‬ َ‫أًؼ‬ َُٝ‫ح‬ ٕ‫أ‬ ٠ِ‫ػ‬ ٍ‫٣ي‬ٝ َ‫أًز‬ ‫َٓػش‬ ًٝ١‫٣ئى‬٢ُ‫حُـَرخ‬ ٚ٤‫حُظ‬ َٔ٘٤ُ ‫٣ٔظي‬ ‫أٗق‬ ًَٔ ٠ُ‫ا‬٢ُ‫ُِـَرخ‬ ‫حُوخثٔش‬ ‫حُٜل٤لش‬ ، ٝ ‫حُوِق‬ ٠ُ‫ا‬ ٍٝ‫طي‬‫حُلظلخص‬ َُٝ‫ٝر‬ ‫ح٧ٗق‬ ‫ًٍٝس‬ ‫ٍكغ‬ ٠ُ‫ا‬ ‫ٓئى٣ش‬ ٚ‫حُٞؿ‬ َ‫ىحه‬ ‫حُٞطَس‬ ٚٔ‫ط٘و‬.‫ح٧ٗل٤ش‬ٝ‫ٛ٘خى‬‫ا‬٢‫ك‬ ‫ٗي٣ي‬ ‫ٗؤخف‬ ٝ ‫ح٧ٗق‬ ّ‫ػظخ‬ْ‫حُؼظ‬ ‫طلض‬ ‫ُظٜزق‬ 4‫غ‬‫يك‬‫ط‬ ٢‫حُظ‬‫ٝٛ٘خى‬ ،٢ٜ‫حُـز‬‫ا‬ٖ٤٘٤‫حُؼ‬ ٖ٤‫ر‬ ‫ُِٔٔخكش‬ ‫ٝحٟق‬ ‫طٔخع‬Telecanthus
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 77 D-ٝ‫ح٧ػَح‬: ‫ح٧ٗق‬ ًَٔ ٝ‫أػَح‬ َٔ٘‫ط‬*:ٝ ‫حٌُيٓخص‬ٍّٞ‫حُظ‬ *ٝ ‫ح٧ٗق‬ ٖٓ ‫ِٗ٣ق‬.ٚ‫حُٞؿ‬ ٖٓ ‫ح٧ٗق‬ ‫ٓ٘طوش‬ *ٙٞ٘‫ط‬ ٝ ُْ‫أ‬:٢‫ك‬ ١ٝ‫طٔخ‬ ّ‫ػي‬ ٝ‫أ‬ ‫ح٧ٗق‬ ‫ٓويٓش‬ ٢‫ك‬ ٝ‫اٗولخ‬ ٝ‫أ‬ ‫ح٧ٗق‬ ْ‫ػظ‬ ٢‫ك‬ ‫طٔطق‬ َٔ٣٧‫ح‬ ٝ‫أ‬ ٖٔ٣٧‫ح‬ ‫حُـخٗذ‬ ٢‫ك‬ ‫ح٧ٗق‬ ٌَٗ، ٖ٤‫حُٔٞه‬ ‫طزخػي‬ * *ْ‫حُظ٘ل‬ ٢‫ك‬ ‫ٛؼٞرش‬ ٞ٣َُٔ‫ح‬ ٚ‫٣ٞحؿ‬ ‫هي‬) ‫ح٧ٗق‬ ‫(اٗٔيحى‬‫طِق‬ ‫كخُش‬ ٢‫(ك‬ ‫ُحثي‬ ‫ٍػخف‬ ٝ‫أ‬ )‫ُ٨ٗق‬ ٢١‫حُٔوخ‬ ‫حُـ٘خء‬ُْ٘‫ح‬ ‫ُلخٓش‬ ٕ‫كويح‬ ٝ‫أ‬ , *ٖ٤٘٤‫حُؼ‬ ٬ً ٝ‫أ‬ ٚ٤٘٤‫ػ‬ ‫أكي‬ ٍٞ‫ك‬ ‫ًيٓخص‬ ٖٓ ً‫خ‬٠٣‫أ‬ ٞ٣َُٔ‫ح‬ ٢ٗ‫٣ؼخ‬ ‫هي‬‫ط٬كع‬ ‫ٓخ‬ ‫ؿخُزخ‬ ( ‫رؼي‬ ‫ؿ٤ي‬ ٌَ٘‫ر‬12) ‫ح٩ٛخرش‬ ‫رؼي‬ ‫ٓخػش‬ ‫ٗلغ‬ ‫ٝؿٞى‬ ‫ٗ٬كع‬ ‫حُ٘ي٣يس‬ ‫ح٩ٛخرخص‬ ٢‫ك‬ * *٠ِ‫ػ‬ ٍ‫٣ي‬ ‫ح٧ٗق‬ ٖٓ ٢‫ٓخث‬ َ‫ٓخث‬ ‫هَٝؽ‬‫حُٔن‬ ‫هخع‬ ْ‫ػظ‬ ٢‫ك‬ ًَٔ ٍ‫حُٔخء‬ ٢‫ك‬ ‫طَٔد‬ ‫ٛ٘خى‬ ٌٕٞ٣ ٕ‫أ‬ َٝ‫٣لظ‬ ٢ُ‫حُـَرخ‬ ‫حًَُٔذ‬ ٝ ‫ح٧ٗق‬ ًٍٞٔ ًَ ٢‫ك‬ ‫حُزيأ‬ ‫٣ـذ‬ ‫ٌُح‬ ٌْ‫حُؼ‬ ‫٣ؼزض‬ ٠‫كظ‬ ‫َٓ٣َ٣خ‬ ‫ٓٞؿٞىح‬ ٌٖ٣ ُْ ٝ ٠‫كظ‬ ٢ًُٞ٘‫ح‬ ٢‫حُيٓخؿ‬ ‫حُٔ٘خٓزش‬ ‫حُيٝحث٤ش‬ ‫رخُٔؼخُـش‬. ٢‫حُيٓخؿ‬ َ‫حُٔخث‬ ‫طَٔد‬ ٝ ‫ح٧ٗل٤ش‬ ‫ح٩كَحُحص‬ ٖ٤‫ر‬ ‫حُظلَ٣ن‬ ٌٖٔ٣‫رؼيس‬ ٢ًُٞ٘‫ح‬ : ‫د‬ ‫ح٩ٓظؼخٗش‬ ٌٖٔ٣ ‫َٓ٣َ٣خ‬ ٌُٖ ٝ ‫ٓوزَ٣ش‬ ‫١َم‬ ‫ُ٪كَحُحص‬ ٢‫حُٜخك‬ ُِٕٞ‫ح‬ ٌْ‫ػ‬ ٢ًُٞ٘‫ح‬ ٢‫حُيٓخؿ‬ َ‫ُِٔخث‬ ٢٘‫حُو‬ ُِٕٞ‫ح‬ *‫ح٧ٗل٤ش‬ ٢‫ح٩٣ـخر‬ ‫حُٜخُش‬ ٍ‫اهظزخ‬ *: ٝ ‫طَٗ٤ق‬ ‫ٍٝهش‬ ٠ِ‫ػ‬ ٚ٘ٓ ‫هطَس‬ ‫ٟٝغ‬ ٌٖٔ٤‫ك‬ ١ٞٓ‫ى‬ ٢‫ح٧ٗل‬ ٕ٬٤ُٔ‫ح‬ ٕ‫ًخ‬ ٍ‫كخ‬ ٢‫ك‬ ًَِٓ ٝ ‫ٗلخكش‬ ‫ٛخُش‬ ‫ك٘٘خٛي‬ ّ‫حُي‬ ٖٓ ‫أَٓع‬ ٢ًُٞ٘‫ح‬ َ‫حُٔخث‬ ٍ‫اٗظ٘خ‬ ٕ‫أ‬ ‫رٔخ‬ ٠ٓ‫ٓي‬. ٢ًُٞ٘‫ح‬ ٢‫حُيٓخؿ‬ َ‫حُٔخث‬ ٖ٤‫ر‬ ًُٞٞ‫حُـ‬ ِ٤ًَ‫ط‬ ٖ٤‫ر‬ ‫ٓوخٍٗش‬ *ّٝ‫ٓؼي‬ ٚ‫(ٗز‬ ٢‫ح٧ٗل‬ َ‫حُٔخث‬ ٝ ) ٢ُ‫ػخ‬ ()
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 78 E-ٚ٤‫حُظ٘و‬ *ٝ‫أ‬ ً‫خ‬٣َٜ‫ر‬ ‫ح٧ٗق‬ ًٍٞٔ ‫طلي٣ي‬ ْ‫٣ظ‬ُ‫ح‬ ٚ‫حُلل‬ ٍ٬‫ه‬ ٖٓ١َ٣َٔ *ٝ ٢َُٜٓ‫ح‬ ‫ح٧ٗق‬ ْ‫ػظ‬ ٚ‫كل‬ ‫٣ـذ‬ ٚ‫حُلل‬ ‫ػ٘ي‬ٝ ‫ح٧ٗق‬ ‫ٓويٓش‬ٝ ‫حُوخٍؿ٤ش‬ ‫ح٧ٗق‬ ‫ؿ٠خٍ٣ق‬ ٝ َٓ‫ًخ‬ ٚ‫حُٞؿ‬ ْ‫ػظ‬ ٠ُ‫ا‬ ‫رخ٩ٟخكش‬ ‫ح٧ٗق‬ َ‫ىحه‬ٝ ‫حُـٔـٔش‬ ْ‫ػظ‬ٝ ٖ٤‫حُؼ‬ ‫طـٞ٣ق‬ ْ‫ػظ‬‫٣ـذ‬ ٝ ‫ح٧ٗق‬ ٢‫ك‬ ٙٞ٘‫ط‬ ١‫أ‬ ‫ٓ٬كظش‬ْ‫ػظ‬ ٢‫ك‬ ‫طلَى‬ ١‫أ‬ٝ ‫ح٧ٗق‬ٝ ‫ح٧ٗق‬ ُْٔ ‫ػ٘ي‬ ُْ‫أ‬ ١‫أ‬‫٫ري‬ ٝ ‫حُـِي‬ ٚ‫كل‬ ٖٓٝ ٌَُٔ‫ح‬ ‫ٓغ‬ ‫هخٍؿ٤ش‬ ‫ؿَٝف‬ ‫ٝؿٞى‬ ّ‫ػي‬ ٖٓ ‫حُظؤًي‬‫ح٧ٗق‬ َ‫ىحه‬ ٚ‫كل‬ ‫٣ـذ‬ ْ٤ً ٝ‫أ‬ ‫ػوذ‬ ٝ‫أ‬ ‫حُٔوخ١٤ش‬ ‫رخ٧ؿ٘٤ش‬ ْٜ٘‫ط‬ ‫ٝؿٞى‬ ّ‫ػي‬ ٖٓ ‫ُِظؤًي‬ ‫ح٧ٗق‬ ٍ‫ٓ٘ظخ‬ ‫١َ٣ن‬ ٖ‫ػ‬ ٝ ‫ح٧ٗل٤ش‬ ‫حُوَٗ٤خص‬ ٢‫ك‬ ْٜ٘‫ط‬ ٝ‫أ‬ ٢‫ح٧ٗل‬ ِ‫حُلخؿ‬ ٢‫ك‬ ١ٞٓ‫ى‬َ‫حُٔخث‬ ‫طَٔد‬ ّ‫ػي‬٠ُ‫ا‬ ٢‫حُيٓخؿ‬ ٝ ‫ح٧ٗق‬‫ح٧ٗق‬ َ‫ىحه‬ ٢‫ك‬ ‫طٜذ‬ ٢‫حُظ‬ ‫حُيٓؼ٤ش‬ ‫حُو٘خس‬ ‫اٛخرش‬ ّ‫ػي‬ ٖٓ ‫حُظؤًي‬. *‫ح٧ُٝٞ٣ش‬٢ِٛ٤٤ٔ‫ُِظ‬ٖ٤‫ر‬ٌٍُٞٔ‫ح‬‫حُزٔ٤طش‬‫حُٔظؼِوش‬ّ‫رؼظخ‬‫ح٧ٗق‬(‫ٗٞع‬1)ٌٍُٝٞٔ‫ح‬٢‫حُظ‬ َٔ٘‫ط‬ً‫خ‬٠٣‫أ‬ّ‫ػظخ‬ٚ‫حُٞؿ‬َٟ‫ح٧ه‬ٝ/ٝ‫أ‬ِ‫كخؿ‬‫ح٧ٗق‬(‫أٗٞحع‬2ٝ3.) ٖ٤‫ر‬ ‫حُٔٔخكش‬ ٚ‫كل‬ ٍ‫اؿلخ‬ ‫ػٔي‬ ‫٣ـذ‬ *ُ ٖ٤٘٤‫حُؼ‬ٖ٤٘٤‫حُؼ‬ ‫ٓآم‬ ٢‫ك‬ ‫طزخػي‬ ١‫أ‬ ‫ٔ٬كظش‬ٖٓ َ‫أه‬ ‫١ز٤ؼ٤خ‬ ْ٤‫طو‬ ٢‫حُظ‬ ٝ35ْٓ ‫طؤً٤ي‬ َ‫أؿ‬ ٖٓ‫١َ٣وش‬ ‫ٗظزغ‬ ٢٘٤‫حُؼ‬ ‫حُٔٞم‬ ‫اٛخرش‬‫ح٧ٛخرغ‬ ‫ٟٝغ‬ ‫ٓغ‬ ‫ُِوخٍؽ‬ ‫حُٞك٘٤ش‬ ٚ‫ؿٜظ‬ ٖٓ ٖ‫حُـل‬ ‫رٔلذ‬ ّٞ‫ٗو‬ : َ‫حُٞط‬ ٍ‫اهظزخ‬ ٢‫ك‬ ٝ ٌَُٔ‫ح‬ ‫هطغ‬ ‫كًَش‬ ْٔ‫ٗظل‬ ‫رٌُي‬ ٝ ‫ٗلٜٔخ‬ ٖ٤‫ُِؼ‬ ‫حُيحهِ٤ش‬ ‫حُِحٝ٣ش‬ ٠ِ‫ػ‬٠ِ‫ػ‬ ٍ‫٣ي‬ ‫كٌُي‬ ‫حُٔلذ‬ ٠ِ‫ػ‬ ‫ٓوخٝٓش‬ ١‫أ‬ ‫ؿ٤خد‬ ٌَُٔ‫ح‬ ‫ٝؿٞى‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 79 ٢ُ‫حُـَرخ‬ ٢‫ح٧ٗل‬ ‫حًَُٔذ‬ ًٍٞٔ ‫كخ٫ص‬ ٢‫ك‬ ‫طٜخد‬ ‫ٓخ‬ ‫ؿخُزخ‬ ٢‫حُظ‬ ٝ ‫حُيٓؼ٤ش‬ ‫حُو٘خس‬ ٝ ‫حُيٓغ‬ َٟ‫ٓـ‬ ْ٤٤‫طو‬ ‫٣ـذ‬ * *‫ٍٝحء‬ ‫ٓخ‬ ‫ٓلخؿجش‬ ‫هِ٤ِش‬ ‫ٓؼِٞٓخص‬ َ‫طٞك‬ ٍٝ٧‫ح‬ ٢٤ٔ‫حُز‬ ‫حُ٘ٞع‬ ٌٍُٞٔ ‫حُٔ٤٘٤ش‬ ‫ح٧ٗؼش‬ ١َ٣َُٔ‫ح‬ ٚ‫حُلل‬‫حُٔ٤٘٤ش‬ ‫رخ٧ٗؼش‬ ٚ٤‫حُظ٘و‬ ‫طؤً٤ي‬ ْ‫٣ظ‬ ‫هي‬ .‫ؿخٗز٤ش‬ ‫ٍٛٞس‬ ( ) ‫ُ٨ٗق‬ٝ ‫حُٔوطؼ٤ش‬ ‫ح٧ٗؼش‬ ٝ‫أ‬٢‫ك‬ َٟ‫أه‬ ‫ربٛخرخص‬ ٙ‫ح٧ٗظزخ‬ ْ‫ط‬ ‫اًح‬ ‫ٓطِٞرش‬ ٌٙٛ ‫ِٓلش‬ َ٤‫ؿ‬ ‫حُزٔ٤طش‬ ‫ح٧ٗق‬ ّ‫ػظخ‬ ًٍٞٔ ‫ػ٬ؽ‬ ٕ‫أ‬ ٖٓ ْ‫حَُؿ‬ ٠ِ‫ػ‬ .ٚ‫حُٞؿ‬٢‫ك‬ ٫‫ا‬ ( ) ٢ُ‫حُـَرخ‬ ‫حًَُٔذ‬ ٢‫ك‬ ‫اٛخرش‬ ‫ٓغ‬ ‫طَحكوٜخ‬ ٍ‫كخ‬ٓ ‫ُؼ٬ؽ‬ ‫ح٩كخُش‬ ْ‫٣ظ‬‫ُٔيس‬ ‫ليى‬5-7 ٢‫ًخك‬ ٌٕٞ٣ ‫ػخىس‬ ّ‫أ٣خ‬. ‫٣ـذ‬ ٢ًُٞ٘‫ح‬ ٢‫حُيٓخؿ‬ َ‫حُٔخث‬ ٢‫ك‬ ‫طَٔد‬ ٝ‫أ‬ ‫ػٜز٤ش‬ ‫ػ٬ٓخص‬ ‫ٝؿٞى‬ ٍ‫كخ‬ ٢‫ك‬ * ‫ح٧رؼخى‬ ‫ػ٬ػ٤ش‬ ٝ ‫ػ٘خث٤ش‬ ‫ٓوطؼ٤ش‬ ٍٞٛ ‫اؿَحء‬ : ‫ٓلٍٞ٣ش‬ ٝ ‫طخؿ٤ش‬ ‫ٓوخ١غ‬ : ‫ح٧رؼخى‬ ‫ػ٬ػ٤ش‬ َ٤ٌ٘‫ط‬ ‫اػخىس‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 80 *‫ػ٬هش‬ ‫ُٜخ‬ ‫اٛخرش‬ ‫ٛ٘خى‬‫ح٧ٗق‬ ٌٍٞٔ‫ر‬ٝ٢ٛٝ ٢‫ح٧ٗل‬ ِ‫حُلخؿ‬ ٢‫ك‬ ١ٞٓ‫ى‬ ٍّٝ‫ط‬‫ليع‬٢‫ك‬٢ُ‫كٞح‬5ٝ ‫حُلخ٫ص‬ ٖٓ %٫‫ط‬‫ػ٬ؽ‬ ‫لظخؽ‬ ٝ ٍ‫ػخ‬‫٣ـذ‬‫ا‬‫ح٧ٗق‬ ‫اٛخرخص‬ ْ٤٤‫طو‬ ‫ػظٔخى‬. *٤‫ؿ‬ ‫حُزٔ٤طش‬ ٌٍُٞٔ‫ح‬ ْ‫ٓؼظ‬ ٢‫ك‬١٧ َٓ٧‫ح‬ ‫٣لظخؽ‬ ٫ ‫حُٔوظِطش‬ َ‫ا‬‫ٓظوٜخءحص‬‫ك‬ ‫هطٍٞس‬ َ‫ح٧ًؼ‬ َُٟٝٞ‫ح‬ ٢‫ك‬ ٌُٖ ،ٍُٜٞ‫ح‬ ٕ‫ب‬ ٩‫ح‬ َ‫أًؼ‬ ٢ٛ ‫حُ٘ؼخػ٤ش‬.‫أٛٔ٤ش‬ ‫ٓظوٜخءحص‬ ‫٣ـذ‬‫ُِـٔـٔش‬ ‫ٗؼخػ٤ش‬ ‫ٍٛٞح‬ ٖٔ٠‫طظ‬ ٕ‫أ‬ٚ‫،حُٞؿ‬ٝ‫ح٧ٗل٤ش‬ ّ‫حُؼظخ‬‫ا‬٠ِ‫ػ‬ ً‫ح‬‫ػظٔخى‬‫ا‬ٝ ‫ٓظيحى‬ٝ‫ُ٨ؿَح‬ ‫ٛخٓش‬ ٌٕٞ‫ط‬ ‫هي‬ .‫ح٧ً٣ش‬ ‫ٗيس‬ ‫حَُ٘ػ٤ش‬ ‫حُطز٤ش‬. ‫حُ٘ي‬ ‫ٝؿٞى‬ ‫ػ٘ي‬ ‫حُٞؿٜ٤ش‬ ‫حُلٌ٤ش‬ ٌٍُٞٔ‫ح‬ ‫٣ٟٞق‬ ‫هي‬ ْ‫حُؼظ‬ ٠ِ‫ػ‬ ِ٤ًَ‫حُظ‬ ‫ٓغ‬ ١ٍٞ‫حُٔل‬ ٢‫حُطزو‬ َ٣ٜٞ‫حُظ‬ ٕ‫ا‬. F-‫ا‬ٌَُٔ‫ح‬ ‫هظ٬١خص‬: ‫حُو٘خس‬ ‫أً٣ش‬‫حُيٓؼ٤ش‬ٝ‫حُٜٔلٞ٣ش‬ ‫حُٜل٤لش‬ ًَْٔٝٗ ‫كوي‬ٝ٢ًٞٗ ٢‫ىٓخؿ‬ َ‫ٓخث‬ ٕ٬٤َٓ‫ح٧ًؼ‬ ٝ ‫هطٍٞس‬ َ‫ح٧ًؼ‬ َ‫٣ؼظز‬ ١ٌُ‫ح‬ ٝ ‫حُٜٔخد‬ ‫ُل٤خس‬ ‫طٜي٣يح‬٣ ٕ‫أ‬ ‫٣ـذ‬ ١ٌُ‫ح‬ ٝ‫ح٧ٗق‬ ًٍٞٔ ‫ػ٬ؽ‬ َ‫هز‬ ٠‫كظ‬ ‫ؼخُؾ‬ ‫ُِٝؿش‬ َ‫أًؼ‬ ٌٕٞ‫ط‬ ٢‫حُظ‬ ( ‫ُ٨ٗق‬ ‫حُطز٤ؼ٤ش‬ ‫حُٔلَُحص‬ ٝ ٢ًُٞ٘‫ح‬ ٢‫حُيٓخؿ‬ َ‫حُٔخث‬ ٕ٬٤ٓ ٖ٤‫ر‬ ‫حُظلَ٣ن‬ ‫٣ـذ‬‫حُٜؼذ‬ ‫حُ٘٢ء‬ ) َُِٝ ٢ُ‫حُظخ‬ ٢‫ح٧ٗل‬ ‫رخُِ٘ف‬ ٕ‫٣وظِطخ‬ ٖ٣َُ‫حُٔل‬ ٬ً ٕ‫أ‬ ‫ٗظَح‬ ‫ٗٔز٤خ‬ ٠ِ‫ػ‬ ١ٞ‫٣لظ‬ ٢ًُٞ٘‫ح‬ ٢‫حُيٓخؿ‬ َ‫حُٔخث‬ ًٕٞ ‫ٓوزَ٣خ‬ ٝ‫أ‬ ‫حُِِٝؿش‬ ‫ر٘ٔزش‬ ‫َٓ٣َ٣خ‬ ‫ر٤ٜ٘ٔخ‬ ‫حُظلَ٣ن‬ ٌٖٔ٣ًُِٞٞ‫حُـ‬ ٝ ٖ٤‫حُزَٝط‬٠ِ‫ػ‬ . ‫ُ٨ٗق‬ ‫حُطز٤ؼ٤ش‬ ‫حُٔلَُحص‬ ٌْ‫ػ‬ G-‫حُؼ٬ؽ‬: *‫ح٧ٗق‬ ًٍٞٔ ٕ‫ربٌٓخ‬ٝ ‫رِ٤ؾ‬ ٢ِ٤ٔ‫طـ‬ ٙٞ٘‫ط‬ ‫ٛ٘خى‬ ْ٤ِ‫ك‬ ‫ٗلٜٔخ‬ ‫طِوخء‬ ٖٓ ‫حُ٘لخء‬ ‫حُطل٤لش‬‫ػ٬ؽ‬ ‫ٝٛق‬ ٌٖٔ٣‫حُؼِؾ‬ ‫ًٔخىحص‬ ّ‫رؼي‬ ٍٞ‫حُ٘ؼ‬ ‫ُظول٤ق‬ ُْ٨ُ‫حُ٘وخٛش‬ ‫ٝهض‬ ‫أػ٘خء‬ ‫حَُحكش‬. *ْ‫٣ظ‬ٍ ‫ح٧ٗق‬ ٠ِ‫ػ‬ ‫رخٍىس‬ ‫ًٔخىس‬ ٝ‫أ‬ ‫حُؼِؾ‬ ‫ططز٤ن‬15-20‫ىه٤وش‬‫ُؼيس‬ ّٞ٤ُ‫ح‬ ٢‫ك‬ ‫َٓحص‬ ‫ػيس‬ ,‫ٓخػخص‬ُْ٧‫ح‬ َ٤ِ‫طو‬ ٢‫ك‬ ‫٣ٔخػي‬ ‫ٌٛح‬ . ٍّٞ‫ٝحُظ‬. ‫طـِ٤ق‬ ‫٣ـذ‬ٝ‫أ‬ ‫حُؼِؾ‬ُ‫ح‬‫ٌٔخىس‬ُ‫ح‬‫ٓ٘٘لش‬ ٢‫ك‬ ‫زخٍىس‬ٝ٫‫ططز٤ن‬ ْ‫٣ظ‬‫حُـِي‬ ٠ِ‫ػ‬ ‫ٓزخَٗس‬ ‫حُؼِؾ‬. *ٝ ً‫ح‬‫ؿ٤ي‬ ‫حُـَٝف‬ ‫ط٘ظ٤ق‬ ‫٣ـذ‬.‫حُٔٞؿٞىس‬ ‫ح٧ؿ٘ز٤ش‬ ّ‫ح٧ؿٔخ‬ ًَ ‫اُحُش‬ *‫ٓلظٞكش‬ ‫حُٔلـخص‬ ‫طَى‬ َ٠‫٣ل‬ .‫حُٔ٘خٓذ‬ ‫رخُٜخى‬ ٞ٣َُٔ‫ح‬ ‫طـط٤ش‬ ‫ًٌُٝي‬ ُ‫حٌُِح‬ ‫ٓ٠خىحص‬ ‫اػطخء‬ ‫٣ـذ‬. ‫حُـَٝف‬‫ر‬ ‫اؿ٬هٜخ‬ ٌٖٔ٣ ‫حُٜـ٤َس‬‫ب‬٢‫١ز‬ ‫٫ٛن‬ ٍ‫ٓظؼٔخ‬(Steristrips)‫حُٔ٘خٓذ‬ ٢٤‫رخُو‬ ‫ه٤خ١ظٜخ‬ ‫ك٤ـذ‬ ‫حٌُز٤َس‬ ‫حُـَٝف‬ ‫أٓخ‬. *ٞ‫رؼ‬‫حُلخ٫ص‬‫هي‬٫‫طظطِذ‬‫ٓؼخُـش‬‫٧ٜٗخ‬٫‫طظَحكن‬ٙٞ٘‫رظ‬‫ٝحٟق‬ٝ‫أ‬ٚٗ٧٫‫٣ٞؿي‬ًَٔ.‫٣ـذ‬ٖ٤ٔ‫طط‬ٞ٣َُٔ‫ح‬ٝ‫اػخىس‬ٜٚ‫كل‬ ً‫ش‬٤ٗ‫ػخ‬‫رؼي‬ٕ‫أ‬ٌٕٞ‫ط‬‫حًُٞٓش‬‫هي‬‫هلض‬.‫ًٔخ‬ٚٗ‫أ‬‫٣ـذ‬ّ‫ػي‬‫ٓلخُٝش‬‫ٍى‬ًَْٔ٣‫هي‬‫ٌُٜٞٗخ‬‫ٓلخُٝش‬‫ٓلظٞٓش‬َ٘‫حُل‬. *ْ‫٣ظ‬ ٕ‫أ‬ ‫٣ـذ‬ ‫كخى‬ ‫رِ٘٣ق‬ ‫ح٧ٗق‬ ًَٔ ‫طَحكن‬ ‫ٓخ‬ ‫اًح‬‫ٍى‬‫ٓخ‬ ‫رؤَٓع‬ ْ‫حُؼظ‬ٝ ، ٌٖٔ٣ٝ ٍُّٞ‫ح‬ ‫٣وق‬ ٠‫كظ‬ ّ‫أ٣خ‬ ‫ُؼيس‬ َ‫حُٜز‬ ‫٣ـذ‬ ٫‫ا‬ ٝ ٚ‫حُٞؿ‬ ٖ‫ػ‬ ‫ح٩ٍُهخم‬، ‫ح٧ٗق‬‫ر‬ ‫ُِٔٔخف‬ٝ َ٠‫أك‬ ٌَ٘‫ر‬ ٚٗ‫ٌٓخ‬ ٠ُ‫ا‬ ٌٍُٞٔٔ‫ح‬ ْ‫حُؼظ‬ ‫بػخىس‬‫أىم‬ ‫كيٝع‬ ٍ‫كخ‬ ٢‫ك‬ *ٝ ً‫خ‬٣ٝ‫٣ي‬ ِٚ٣‫طؼي‬ ‫ٓلخُٝش‬ ْ‫٣ظ‬ ‫ح٧ٗق‬ ًٍٞٔ ٢‫ك‬ ‫ح٧ٗق‬ ٙٞ٘‫ط‬.‫ؿ٤يس‬ ‫حُ٘ظخثؾ‬ ٌٕٞ‫ط‬ ‫ٓخ‬ ً‫خ‬‫ؿخُز‬ٞ‫رؼ‬ ٍ‫آظؼٔخ‬ ٌٖٔ٣ ٝ‫أ‬ ) ‫هخٛش‬ ‫ٜٓ٘خ‬ ‫(حُٔ٘لَٜس‬ ‫ح٧ٗل٤ش‬ ٌٍُٞٔ‫ح‬ ‫ٍى‬ ٠ِ‫ػ‬ ‫ُِٔٔخػش‬ ‫ح٧ىٝحص‬ ٚ٤‫ط٘و‬ ‫٣ـذ‬ *‫ح٩ٛخرخص‬‫حَُٔحكوش‬٧‫ح‬‫(أٗٞحع‬ َٟ‫ه‬2ٝ3ٝ ‫ػِ٤ٜخ‬ ‫حُظؼَف‬ ‫٣ـذ‬ ٢‫حُظ‬ )ٓ‫حُظؼخ‬‫ؿَحك٤خ‬ ‫ٓؼٜخ‬ َ. : ٖ٤‫رطَ٣وظ‬ ‫ح٧ٗق‬ ًٍٞٔ ‫ٍى‬ ْ‫٣ظ‬ *
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 81 ) +‫اىَفرىحح‬ ‫تاىطشٌقح‬ ‫اىنسش‬ ‫سد‬: ُ‫ح‬ )**َ‫ٔيحه‬ُ‫ح‬: ‫ـَحك٤ش‬ 1-: ٢‫هخٍؿ‬ َ‫ٓيه‬ -‫حُظِٔهخص‬‫حَُٟ٤ش‬‫حُٔٞؿٞىس‬: -‫ر‬ ‫ٗن‬ٌَ٘‫كَف‬H: -‫ٗن‬‫ح٫ًِ٤ِ٤ش‬Bicoronal: -‫ٗن‬ٌَ٘‫ر‬‫كَف‬W:
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 82 -‫ٗن‬‫ػٔٞى‬: ‫ٜق‬٘ٓ ١ -‫ٗن‬Z: ‫ِٓىٝؽ‬ -‫ٗوٞم‬ٖ‫حُـل‬Eyelid. ‫حُلـخؽ‬ ‫طلض‬ ٝ‫أ‬ ٖ‫حُـل‬ ‫طلض‬ ، ٢٘‫ؿل‬ : -‫ٗن‬ٖ٘٤ُ(Lynch):
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 83 2-ٝ‫أ‬ ) ٢١‫ٓوخ‬ ( ٢ِ‫ىحه‬ َ‫ٓيه‬‫ح٧ٗق‬ ‫ٓوخ١٤ش‬ َ‫ػز‬: : ‫حُظؼز٤ض‬ ٝ ‫حَُى‬ ** ) +‫حُٔـِوش‬ ‫رخُطَ٣وش‬ ٌَُٔ‫ح‬ ‫ٍى‬: -)ٖٓ ٢٤ٔ‫ر‬ ًَٔ ‫ٍى‬ ٌُٖٔٔ‫ح‬ ٖٓ‫رؼي‬ ً‫ح‬ًَ‫رخ‬ ٞ٣َُٔ‫ح‬ ‫ٗٞٛي‬ ‫اًح‬ ‫حًُٞٓش‬ ٍٜٞ‫ك‬ َ‫هز‬ ٢‫حُٟٔٞؼ‬ َ٣‫حُظوي‬ ‫طلض‬ ٍٝ٧‫ح‬ ‫حُٜ٘ق‬ َُٝ‫ح‬. ٌٙٛ ‫ٍى‬ ٌٖٔ٣ّ‫ُٝ٘خ‬ ٢‫ِٓو‬ ٍ‫رخٓظؼٔخ‬ ٝ‫أ‬ ٢‫حُـخٗز‬ ٢‫ح٩ٛزؼ‬ ٢‫حُ٠ـ‬ ‫رٞحٓطش‬ ‫ػخىس‬ ٌٍُٞٔ‫ح‬ (Walsham’s Forceps)) ‫حٍُٜٞس‬ (( ٝ‫أ‬ASH Septum Forceps). ِٚ٤‫طؤؿ‬ ‫٣ـذ‬ ٌَُٔ‫ح‬ ‫ٍى‬ ٕ‫كب‬ ‫طٌِ٘ض‬ ‫هي‬ ‫حًُٞٓش‬ ٌٕٞ‫ط‬ ٕ‫أ‬ ‫رؼي‬ ٞ٣َُٔ‫ح‬ ٚ‫كل‬ ْ‫ط‬ ‫اًح‬5-7.ّ‫أ٣خ‬ ٖٓ َ‫أًؼ‬ ٌَُٔ‫ح‬ ‫ٍى‬ ً‫ح‬‫أري‬ َ‫٣ظؤه‬ ٫ ٕ‫أ‬ ‫٣ـذ‬ٝ ‫طؼزظض‬ ‫هي‬ ٌٕٞ‫ط‬ ‫ح٧ٗق‬ ّ‫ػظخ‬ ٕ٧ َُٝ‫ح‬ ‫رؼي‬ ٖ٤‫أٓزٞػ‬ٌٖ٣ ُْ ٕ‫ا‬ ً‫خ‬‫ٛؼز‬ ‫حَُى‬ ‫٣ٜزق‬ ً٬٤‫ٓٔظل‬. ‫٫كن‬ ٍ‫طزي‬ ١‫أ‬ ‫كيٝع‬ ‫ُٔ٘غ‬ ‫ٓؼيٗ٤ش‬ ٝ‫أ‬ ‫ؿزٔ٤ش‬ ‫ؿز٤َس‬ ‫ٟٝغ‬ ٌٖٔ٣
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 84 +)ٌٍُٞٔ‫ح‬ ٖٓ ٢ٗ‫حُؼخ‬ ‫حُٜ٘ق‬ ٕ‫ا‬(Class 2)‫حُؼٞىس‬ ٠ُ‫ا‬ ‫حٌٍُٔٔٞس‬ ‫حُوطغ‬ ‫ك٤ٜخ‬ َ٤ٔ‫ط‬ ‫رٔزذ‬ ‫ٍىٛخ‬ ‫رؼي‬ ٌَُٔ‫ح‬ ‫ٟٝؼ٤ش‬ ٠ُ‫ا‬‫حُٞطَس‬ ‫ُـ٠َٝف‬ ‫حٌٍُٔٔٞس‬ ‫حُٜ٘خ٣خص‬ ٖ٤‫ر‬ ‫حُظَحًذ‬ ٝ٢ُ‫ُِـَرخ‬ ‫حُوخثٔش‬ ‫حُٜل٤لش‬ٍ ٕ‫ا‬ .ٚ‫٣َحكو‬ ٕ‫أ‬ ‫٣ـذ‬ ‫ح٧ٗق‬ ّ‫ػظخ‬ ًَٔ ‫ى‬‫ا‬ٍ‫ٓظجٜخ‬ ٝ ‫حٌٍُٔٔٞس‬ ّ‫ح٧هٔخ‬ٕ‫ً٤ِ٤خ‬ ‫ٗن‬ َ‫ػز‬ ‫حُٞطَس‬ ٖٓ ‫حُٔظَحًزش‬(Killian Incision)ٝ‫أ‬ Hemitransfixion Incision. +)‫حُؼخُغ‬ ‫حُٜ٘ق‬ ‫أٓخ‬(Class 3)ً‫ح‬‫ٍى‬ ‫ك٤ظطِذ‬ ٌٍُٞٔ‫ح‬ ًٖٓ‫خ‬‫ٓلظٞك‬ ً‫خ‬٤‫ؿَحك‬. ٝ ‫ٍكغ‬ ٠ُ‫ا‬ ‫حُٔ٘ؤلش‬ ‫ح٧ٗق‬ ّ‫ػظخ‬ ‫طلظخؽ‬‫ٗن‬ َ‫ػز‬ ٢ٗ‫ٓؼي‬ ‫ِٓي‬ ‫رٞحٓطش‬ ‫طؼز٤ض‬ ‫حُـزٜ٤ش‬ ‫ح٧ٗل٤ش‬ ‫حُِحٝ٣ش‬ ‫كٞم‬. :ٖ٤‫حُؼ‬ ‫ٓآم‬ ‫اٗو٬ع‬ ) +‫ٓخ‬ ‫ؿخُزخ‬ٖ٤‫ُِؼ‬ ٢ٔٗ٧‫ح‬ ‫حُٔآم‬ َٜ‫٣٘ل‬ٌَٗ ٠ِ‫ػ‬ ‫ُِللخظ‬ ‫حٌُِٔ٤ش‬ ‫رخُو٤خ١ش‬ ‫ِٗٔش‬ ‫٣ٔظٞؿذ‬ ‫ٓٔخ‬ ٖ٤‫حُؼ‬ ‫كظلش‬‫حُٔآم‬ ‫طؼز٤ض‬ ٞٛ ٝ ‫ٝحكي‬ ‫رٔزيأ‬ ٌُٖ ٝ ) ٍُٜٞ‫رخ‬ ‫ٟٓٞق‬ ٞٛ ‫(ًخ‬ ‫١َم‬ ‫ػيس‬ ٠ِ‫ػ‬ ‫طؼظٔي‬ ٢‫حُظ‬ ٝ ّ‫ح٧ٓخ‬ ٠ُ‫ا‬ ١ٞ‫حُِٔظ‬ ‫حُٞطَس‬ ‫ؿ٠َٝف‬ ‫ٓلذ‬ ْ‫ػ‬ ٕ‫ً٤ِ٤خ‬ ‫ٗن‬ َ‫ػز‬ ‫حُٞطَس‬ ٠ِ‫ػ‬ َ‫حُظيحه‬ ْ‫٣ظ‬.َ‫ح٧ٓل‬ ٩‫ح‬ ‫(ٓٞء‬ ‫حَُى‬ ‫ٓٞء‬ ٕ‫ا‬ّ‫ُظلخ‬)ٝ ‫ح٧ٗق‬ ‫طٜ٘٤غ‬ ٍ‫أٌٗخ‬ ٖٓ ً٬ٌٗ ٚ‫ٓؼخُـظ‬ ‫طظطِذ‬ ‫ٓٞف‬ ‫ح٧ٗق‬ ٍٝ ‫رؼي‬‫حُٞطَس‬ ‫ػيح‬ ( ‫كخُ٤خ‬ ٫‫آظؼٔخ‬ َ‫ح٧ًؼ‬ ٢ٛ ٝ ٌَُٔ‫ح‬ ١ٞ‫هط‬ ‫ُظؼز٤ض‬ َ‫ح٧ٓؼ‬ َ‫حُل‬ ‫حُٜلخثق‬ َ‫طؼظز‬ ‫حُؼخُغ‬ ٝ ٢ٗ‫حُؼخ‬ ‫حُٜ٘ق‬ ٖٓ ‫ح٧ٗق‬ ًٍٞٔ ٢‫ك‬ ) ٖ٤‫ُِؼ‬ ٢ٔٗ٧‫ح‬ ‫حُٔآم‬ ‫طؼز٤ض‬ ٢‫ك‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 85 )+‫حُيٓؼ٤ش‬ ‫حُو٘خس‬ ‫اٛخرش‬َ‫طؼظز‬ :‫ػيس‬ ‫ٗـي‬ ٝ ٌٍُٞٔ‫ح‬ ٌٙٛ َ‫ٓؼ‬ ٢‫ك‬ ‫ٗخثؼش‬ : ‫ُ٪ٛخرش‬ ‫اكظٔخ٫ص‬ -‫ٓلظض‬ ًَٔ ‫ٗظخ٣خ‬ ‫رٔزذ‬ ٢‫حُيٓؼ‬ ْ٤ٌُ‫ح‬ ‫طِٔم‬ -٢‫حُيٓؼ‬ ُ‫حُـٜخ‬ ٠ِ‫ػ‬ ٢‫ٟـ‬ ُ‫ح‬ ‫اٗٔيحى‬ ٢ٛ ‫حُ٘ظ٤ـش‬ ٝ‫و٘خس‬٧‫ح‬٤‫ٗل‬‫ش‬ُ‫ح‬٤‫يٓؼ‬‫ٗ٘خٛي‬ ٝ ‫ش‬‫ىٓخع‬ٝ‫ا‬‫حُيٓغ‬ ْ٤ً ‫ُظٜخد‬ : ‫ح٩ٛخرش‬ ْ٤َٓ‫ُظ‬-ّ‫حُو٤خ‬ ٌٖٔ٣‫حُ٘يٝد‬ َ‫ػز‬ ‫حُٔٞم‬ ‫ٍأد‬ ‫ٓغ‬ ٚٔ‫ٗل‬ ‫حُٞهض‬ ٢‫ك‬ ٚ‫ر‬ ٢ِ٤ًِ٩‫ح‬ ‫رخُ٘ن‬ ٝ‫أ‬ )ٖ٘٤ُ( ‫ٗن‬ ‫ُ٨ٗق‬ ٢‫حُـخٗز‬ ‫رخُ٘ن‬ ٝ‫أ‬ ‫ح٧ِٛ٤ش‬ -( ‫رخ٧ٗق‬ ‫حُيٓغ‬ ْ٤ً ‫ٓلخؿَس‬Dacryocystorhinostomy):ٕ‫ًخ‬ ‫اًح‬ ‫ح٧ٗق‬ ٢‫ك‬ ٢‫حُيٓؼ‬ َ‫حُٔخث‬ ‫طَٜ٣ق‬ ٠ِ‫ػ‬ َٔ‫ٗؼ‬ ،‫ِٓ٤ٔخ‬ ْ٤ٌُ‫ح‬ -Conjunctivo-rhinostomyٝ ‫حُو٘خس‬ َ‫ٓؼ‬ ٖ٤‫حُزُٞ٤ؼ‬ ‫أٗزٞد‬ ‫ٍُع‬ َ‫ػز‬ : ‫ه٘خس‬ ٍَٟ ‫كيٝع‬ ‫كخُش‬ ٢‫ك‬ ‫ًُي‬ *‫حُٞطَس‬ ٢‫ك‬ ١ٞٓ‫حُي‬ ٍُّٞ‫ح‬Septal Haematoma:‫ح٧ٗل٤ش‬ ‫ُِٞطَس‬ ‫حُـ٠َٝف‬ ‫ٓٔلخم‬ ‫طلض‬ ّ‫حُي‬ ‫طـٔغ‬ ‫رٔزذ‬ ‫٣ليع‬ٌٕٞ٣ ‫هي‬ . َُ‫ح‬ ‫ٓززٜخ‬ً‫خ‬٠٣‫أ‬ ‫طليع‬ ‫هي‬ ‫ٌُٜ٘خ‬ ،٢‫ح٧ٗل‬ ًٝ‫ب‬( ‫حُٞطَس‬ ٠ِ‫ػ‬ ‫ؿَحكش‬ ‫رؼي‬ ١٬‫هظ‬‫ا‬‫حُٔوخ١٤ش‬ ‫طلض‬ ٍ‫ٓظجٜخ‬SMR)ٝ‫ٗظ٤ـش‬ ً‫ح‬ٍ‫ٗخى‬ ‫حُيٓٞ٣ش‬ ٝ‫ح٧َٓح‬ ‫رؤكي‬ ‫ح٩ٛخرش‬‫ػخى‬ ‫٣ٞؿي‬ .‫س‬‫ا‬ٗ‫رٞحٓطش‬ ٖ٤‫رخُـٜظ‬ ‫ُ٨ٗق‬ ّ‫طخ‬ ‫ٔيحى‬‫ا‬١َ١ ‫ٗظلخم‬‫ٓؼخُـش‬ ْ‫طظ‬ ٝ‫أ‬ ٚ‫ط٘و‬ ُْ ‫اًح‬ . ٝ ‫حُـ٠َٝف‬ ٢‫ك‬ َ‫ط٘و‬ ‫ٓغ‬ ‫ٝطَس‬ ‫هَحؽ‬ ٠ُ‫ا‬ ٍٞ‫طظل‬ ‫هي‬ ‫كبٜٗخ‬ ‫ٛل٤ق‬ ٌَ٘‫ر‬ ‫حُلخُش‬٢‫حَُٔؿ‬ ‫ح٧ٗق‬ ٍٜٞ‫ك‬ٍُّٞ‫ح‬ ٟٞ‫ٓلظ‬ ‫ٓلذ‬ ٕ‫ا‬ . ً‫خ‬٤‫ًخك‬ ٌٕٞ٣ ‫هي‬ ‫رخ٩رَس‬ َ٤‫حُٜـ‬ ١ٞٓ‫حُي‬ٝ ‫حُ٘ن‬ َٓ٧‫ح‬ ‫٣ظطِذ‬ ‫هي‬ ٌُْ٘‫ح‬ ٍ‫كخ‬ ٢‫ك‬ ٌُٖ ،‫حُلَحؽ‬ ْٔ‫(ُط‬ ‫حُؼخرَس‬ ‫حُو٤خ١ش‬ ‫ٓغ‬ ‫حُظلَ٣ؾ‬ )‫حُٔ٤ض‬١ُ‫حُـٜخ‬ ٝ‫أ‬ ٢‫حُٟٔٞؼ‬ ٕ‫ح٩ٗظخ‬ ‫كيٝع‬ َ‫هط‬ ٙ‫٩ٗوخ‬ ‫رخُٜخىحص‬ ‫ٓؼخُـش‬ ٞ٣َُٔ‫ح‬ ‫اػطخء‬ ‫٣ـذ‬ .. *‫حُٔخث‬ ٕ٬٤ٓ٢ًُٞ٘‫ح‬ ٢‫حُيٓخؿ‬ َ:َ‫حُٔخث‬ ٕ٬٤ٔ‫ر‬ ‫حُ٘ي‬ َ٤‫٣ؼ‬ ٕ‫أ‬ ‫٣ـذ‬ ٢‫ح٧ٗل‬ َُٝ‫ح‬ ‫رؼي‬ ‫ح٧ٗق‬ ٖٓ ‫ٍحثن‬ ٕ٬٤ٓ ‫ٝؿٞى‬ ٕ‫ا‬ ٝ ً‫ح‬‫ؿي‬ ‫ٍه٤وش‬ ٢ُ‫ُِـَرخ‬ ‫حُٜٔلٞ٣ش‬ ‫حُٜل٤لش‬ ٕ‫ا‬ .٢ًُٞ٘‫ح‬ ٢‫حُيٓخؿ‬ٌَُٔ‫ح‬ ‫ُليٝع‬ ٕ‫ٌٓخ‬ ‫أٗ٤غ‬ ٢ٛٚ٤‫حُظ٘و‬ ٖٓ ‫حُظؤًي‬ ْ‫٣ظ‬ . ٝ َ‫حُٔخث‬ ٚ‫رلل‬ٖٓ ‫هَ٣زش‬ ٚ‫ٗٔزظ‬ ٌٕٞ‫ط‬ ‫ك٤غ‬ ٚ٤‫ك‬ ًُِٞٞ‫حُـ‬ ١َ‫طل‬‫ٓؼخ٣َس‬ ٢ٛ َٟ‫ح٧ه‬ ‫حُطَ٣وش‬ .َُٜٔ‫ح‬ ٢‫ك‬ ًُِٞٞ‫حُـ‬ ‫ٗٔزش‬ B2 Transferrin(ٝٝ َٛ‫حُظخ‬ ‫حُِٔق‬ ٢‫ك‬ ٢‫كو‬ ‫ٓٞؿٞىس‬ ‫رَٝط٤٘٤ش‬ ‫ٓخىس‬ ٢ٖٛ‫كو‬ ٕ‫أ‬ ‫ًٔخ‬ .)٢ًُٞ٘‫ح‬ ٢‫حُيٓخؿ‬ َ‫حُٔخث‬ ٢‫ك‬ ٖ٤ٔ٣ٍِٞ‫حُل‬Fluorescein٢‫ك‬ ٢‫ح٧ٗل‬ ٕ٬٤ُٔ‫ح‬ ٖٓ ‫ؿٔؼٜخ‬ ٌٖٔ٣ ٢٘‫هط‬ ٍِ‫ر‬ ٍ٬‫ه‬ ٖٓ ٢ًُٞ٘‫ح‬ ٢‫حُيٓخؿ‬ َ‫حُٔخث‬ ٢‫ك‬‫ٝؿٞى‬ ٍ‫كخ‬ ٕ٬٤ٓ٢ًُٞ٘‫ح‬ ٢‫حُيٓخؿ‬ َ‫حُٔخث‬. .ًَٔ ‫ٝؿٞى‬ َٜ‫٣ظ‬ ٕ‫أ‬ ٌٖٔ٣ ‫حُيهش‬ ٢ُ‫ػخ‬ ١ٍٞ‫حُٔل‬ ٢‫حُطزو‬ َ٣ٜٞ‫حُظ‬ ٕ‫ا‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 86 ٝ ،٢ًُٞ٘‫ح‬ ٢‫حُيٓخؿ‬ َ‫ُِٔخث‬ ٕ٬٤ٓ ‫ٛ٘خى‬ ٕ‫أ‬ ‫١خُٔخ‬ ‫رخُٜخىحص‬ ٞ٣َُٔ‫ح‬ ‫طـط٤ش‬ ‫٣ـذ‬٩ ‫حُٔٔززش‬ ْ٤‫حُـَحػ‬ ‫ِٗ٤غ‬‫أ‬ ٕ‫أ‬ ‫رٔخ‬‫ُظٜخد‬ ‫٣ـذ‬ ‫حُظـط٤ش‬ ٕ‫كب‬ ‫حَُثٞ٣ش‬ ‫حٌٍُٔٞحص‬ ٢ٛ ‫حُٔلخ٣خ‬ٝ ٖ٤ِٔ٘‫حُز‬ ٖٔ٠‫طظ‬ ٕ‫أ‬ٖ٣‫حُِٔلخى٣ٔ٤ي‬Sulphadimidine.‫ٝهخث٤ش‬ ‫ًٔؼخُـش‬ *ٌُ ً‫خ‬٣ٞ‫ػل‬ ‫طظٞهق‬ ‫ٓٞف‬ ‫حُٔ٤٬ٗخص‬ ٖٓ ‫حُؼي٣ي‬ ٕ‫ا‬ .‫ٍَٟٝ٣ش‬ ‫ُ٤ٔض‬ ‫رخُٜخىحص‬ ‫حُٞهخث٤ش‬ ‫حُٔؼخُـش‬ ٕ‫أ‬ ٍ‫أٗخ‬ ٞ‫حُزؼ‬٠ُ‫ا‬ ‫٣لظخؽ‬ ‫رؼ٠ٜخ‬ ٖ ‫ر‬ ٢‫ؿَحك‬ ‫اؿ٬م‬‫ب‬ٝ‫أ‬ ‫حُٜيؿ٤ش‬ ‫حُؼ٠ِش‬ ‫ٛلخم‬ ٍ‫ٓظؼٔخ‬Fascia Lateٖٓ ‫ٓوخ١٤ش‬ ‫َٗ٣لش‬ ٝ‫أ‬‫حُٞطَس‬‫ح٩ؿ٬م‬ ْ‫٣ظ‬ ٕ‫أ‬ ٌٖٔ٣ .‫ح٧ٗل٤ش‬ ‫ر‬‫ب‬ٖٔ٠‫٣ظ‬ ٢‫هخٍؿ‬ َ‫ٓيه‬ ٍ‫ٓظؼٔخ‬‫ا‬‫حُـَرخُ٤ش‬ ‫حُو٬٣خ‬ ٍ‫ٓظجٜخ‬External Ethmoidectomy‫رخُطَ٣وش‬ ٝ‫أ‬ ‫حُٞطَس‬ َ‫ػز‬ َ‫رٔيه‬ ٝ‫أ‬ ٢ٜ‫حُـز‬ ‫ػوذ‬ ‫رٞحٓطش‬ ٝ‫أ‬ ‫ح٧ٗق‬ َ‫ػز‬ ‫حُظ٘ظ٤َ٣ش‬Frontal Craniotomْٝ‫حُطؼ‬ ‫ٟٝغ‬ ‫ٓغ‬ ‫حٌٍُٔٔٞس‬ ‫حُؼظٔ٤ش‬ ‫حُوطغ‬ ‫ٍى‬ ‫رؼيٛخ‬ ْ‫٣ظ‬ ‫ح‬‫ُِٔلخ٣خ‬ ‫ُٔ٘خٓذ‬. H-ُ‫ح‬: ‫ٔ٠خػلخص‬ -‫ٓئهض‬ ٝ‫أ‬ ْ‫ىحث‬ ٍ‫هي‬ -٢ًُٞ٘‫ح‬ ٢‫حُيٓخؿ‬ َ‫حُٔخث‬ ٕ٬٤ٓ -‫حُٔلخ٣خ‬ ‫اُظٜخد‬ -‫ٓوخ١٤ش‬ ‫ه٤ِش‬ ٝ‫أ‬ ‫ح٧ٗل٤ش‬ ‫حُـ٤ٞد‬ ‫اُظٜخد‬ -ٕ‫اٗظخ‬ -ُْ٘‫ح‬ ‫كخٓش‬ ‫كوي‬ -١٬‫ًبهظ‬ ٖ٤‫حُٔٞه‬ ‫طزخػي‬ -‫حُِحثق‬ ٖ٤‫حُٔٞه‬ ‫طزخػي‬ -‫هخع‬ ٝ‫أ‬ ٢‫حُلـخؿ‬ ٍ‫حُـيح‬ ْ٤َٓ‫ط‬ َ٘‫ك‬ ‫رٔزذ‬ ٙٞ‫ه‬‫حُلـخؽ‬ -‫حُٔوِش‬ ‫ٟؼق‬ -٠ٔ‫حُؼ‬ -. ‫اٟخك٤ش‬ ‫ؿَحك٤ش‬ ‫ُؼِٔ٤خص‬ ‫حُلخؿش‬ I-‫حُ٘وخٛش‬ ‫ا‬ٖ٤‫ر‬ ‫ٓخ‬ َٜ‫٣ل‬ ٌَُٔ‫ح‬ ‫رؼي‬ ّ‫حُؼظخ‬ ٍ‫ٓظوَح‬3٠ُ‫ا‬4ٝ ‫أٓخر٤غ‬‫رؼي‬ ‫حُوزَحء‬ ٞ‫رؼ‬ ‫٣وظَف‬ّ‫ا‬‫حُ٘ظخٍحص‬ ‫ٍطيحء‬‫أ‬‫حُٞهض‬ ‫ٌٛح‬ ٍ٬‫ه‬ ٢‫حُظٔو‬ ٝ ّ‫حُؼظخ‬ ‫ٓلخًحس‬ ٠ِ‫ػ‬ َ‫٣ئػ‬ ‫هي‬ ٚٗ٧. ‫٣ليع‬‫ا‬ٖ٤‫ر‬ ‫ٓخ‬ َٓ‫حٌُخ‬ ّ‫حُؼظخ‬ ‫ٗيٓخؽ‬4٠ُ‫ا‬8ٝ ‫أٓخر٤غ‬ٝ ٖ٤‫أٓزٞػ‬ ٠ُ‫ا‬ ‫أٓزٞع‬ ‫رؼي‬ ُ‫ٓٔظخ‬ ٌٕٞ٣ ّ‫حُؼخ‬ ١‫حُ٘٘خ‬ٌُٖ:‫د‬ ‫٣ٜ٘ق‬ *٫‫٣ـذ‬‫طظطِذ‬ ٢‫حُظ‬ ‫حَُ٣خٟش‬ ‫ٓٔخٍٓش‬‫ا‬ٝ َ‫ح٧ه‬ ٠ِ‫ػ‬ َٜٗ‫أ‬ ‫ػ٬ػش‬ ٠ُ‫ا‬ ٖ٣َٜٗ ‫ُٔيس‬ ١‫ؿٔي‬ ‫كظٌخى‬ٟ‫ٓي‬ ٠ِ‫ػ‬ ‫٣ؼظٔي‬ ‫ًُي‬ .‫ح٩ٛخرش‬ ‫ٓٞء‬ *‫حُؼو٤ِش‬ ‫ح٧ٗ٤خء‬ َٔ‫ك‬ ّ‫ػي‬ ‫ٓلخُٝش‬. ‫اٍطيحء‬ َ٠‫٣ل‬ *‫ؿ‬‫ز٤َس‬‫أٗل٤ش‬. *‫ُٔيس‬ ‫رخَُ٣خٟش‬ ‫حُٔ٘خًٍش‬ ‫ػ٘ي‬ ٚ‫حُٞؿ‬ ‫هًٞس‬ ‫اٍطيحء‬ ‫٣ـذ‬ ٚٗ‫أ‬ ٠ُٛٞٔ‫ح‬ ٖٓ6ٛ٩‫ح‬ ‫رؼي‬ َ‫ح٧ه‬ ٠ِ‫ػ‬ ‫أٓخر٤غ‬‫خرش‬. K-‫حٌُحط٤ش‬ ‫حُؼ٘خ٣ش‬ *٫‫٣ـذ‬.٢‫١ز‬ ًٕ‫ا‬ ٠ِ‫ػ‬ ٍٜٞ‫حُل‬ ٕٝ‫ى‬ َ‫ؿزخث‬ ١‫أ‬ ‫اُحُش‬ *‫حٌُظٔش‬ ٝ‫أ‬ ‫رخُو٘وش‬ ٍٞ‫حُ٘ؼ‬ ‫ػ٘ي‬َ٠‫٣ل‬ٝ ٍ‫روخ‬ ٢‫ك‬ ْ‫ط٘ل‬ ٝ‫أ‬ ٖ‫ٓخه‬ ّ‫كٔخ‬ ٌ‫رؤه‬ٕ‫أ‬ ٌٖٔ٣ ‫ٌٛح‬٣٢‫ك‬ ‫ٔخػي‬ٝ ١‫حُٔوخ‬ ٞ‫ك‬ّ‫حُي‬ .‫ح٩ٛخرش‬ ٝ‫أ‬ ‫حُـَحكش‬ ‫رؼي‬ ًْ‫٣ظَح‬ ١ٌُ‫ح‬ ‫حُـخف‬ *‫ح٧ٗق‬ ‫أىٝ٣ش‬ ٌ‫أه‬ ٌٖٔ٣) ٕ‫اكظوخ‬ ‫ٓ٠خى‬ ٝ‫أ‬ َّٝ٤ٓ ‫أٗل٤ش‬ ‫هطَس‬ (‫ٓليىس‬ ‫١ز٤ش‬ ‫ٝٛلش‬ ٕٝ‫ى‬ ُْ٧‫ح‬ ‫ُظول٤ق‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 87 ُ‫ح‬ ٍ‫آظؼٔخ‬ ٌٖٔ٣ *ٝ ‫ٌٔٔ٘خص‬‫ٓ٠خىحص‬٩‫ح‬‫حُٔظ٤َٝ٣ي٣ش‬ َ٤‫حُـ‬ ‫ُظٜخرخص‬‫كٔٞ٣خ‬ L-‫حُٞهخ٣ش‬: ‫ٓ٘غ‬ ٌٖٔ٣ ٫ ‫ؿخُزخ‬ًٍٔٞ‫ح٧ٗق‬ٌُٖ ٝ٩‫ح‬ َ‫هط‬ ٖٓ ‫ُِلي‬‫ٛخرش‬: ‫ا‬ *‫ه٘خع‬ ‫ٓغ‬ ‫حُٞحه٤ش‬ ّ‫حَُأ‬ ‫أؿط٤ش‬ ‫ٍطيحء‬‫ٍ٣خٟخ‬ ٢‫ك‬ ‫ط٘خٍى‬ ‫ػ٘يٓخ‬ ,٩‫ح‬ ‫طظطِذ‬ ‫ص‬ٝ ,١‫حُـٔي‬ ‫كظٌخى‬ٝ‫أ‬ ‫حُيٍحؿخص‬ ‫ًٍٞد‬ ‫ًٌُي‬ ‫حُ٘خٍ٣ش‬ ‫حُيٍحؿخص‬‫رخُؼ٘ق‬ ْٔ‫طظ‬ ٢‫حُظ‬ ‫حَُ٣خٟخص‬ ٝ‫أ‬. ‫ا‬ *‫ٓ٤خٍس‬ ٢‫ك‬ ‫ًٍٞد‬ ‫ػ٘ي‬ ٕ‫ح٧ٓخ‬ ّ‫كِح‬ ‫ٍطيحء‬.
‫الوجه‬ ‫عظام‬ ‫كسور‬ ‫كساب‬ ‫جودت‬ ‫فراس‬ .‫د‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 88 ًٍْٞٔ‫حُؼظ‬٢٘‫حُٞؿ‬ A-: ‫ٓويٓش‬ ( ٢٘‫حُٞؿ‬ ْ‫حُؼظ‬Zygomatic bone):‫ؿخٗذ‬ ًَ ٢‫ك‬ ‫(ٝحكي‬ ‫حُـٔـٔش‬ ّ‫ػظخ‬ ‫أكي‬ ٞٛ‫حُلي‬ ٖٓ ًَ ‫ٓغ‬ ٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ َٜ‫٣ظٔل‬ .) ٝ ١ِٞ‫حُؼ‬ٝ ٢ٜ‫حُـز‬ ْ‫حُؼظ‬ٝ ٢‫حُٜيؿ‬ ْ‫حُؼظ‬١‫حُٞطي‬ ْ‫حُؼظ‬. ٝ ‫حُلـخؽ‬ ٖٓ ً‫ح‬‫ؿِء‬ ٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ٌَ٘٣‫حُوي‬ ْ‫رؼظ‬ ُٚ ٍ‫٣٘خ‬٢‫ك‬ ْ‫حُؼظ‬ ‫٣ظٟٞغ‬ .ٌَ٘٣ ‫ك٤غ‬ ٚ‫حُٞؿ‬ ٖٓ ٢٘‫حُٞك‬ ١ِٞ‫حُؼ‬ ‫حُـِء‬ ٝ ،‫حُوي‬ َُٝ‫ر‬ٝ ٢٘‫حُٞك‬ ‫حُـِء‬ٝ ،‫حُلـخؽ‬ ‫أٍٟ٤ش‬ٝ ‫حُٜيؿ٤ش‬ ٖ٤‫حُللَط‬ ٖٓ ‫أؿِحء‬‫حُٜيؿ٤ش‬ ‫طلض‬. : ‫حُٞؿ٘ش‬ ًٍٞٔ َٔ٘‫ط‬-) ٢ٜ‫حُـز‬ ٝ ٢‫حُٜيؿ‬ ٝ ١ِٞ‫حُؼ‬ ٢ٌ‫حُل‬ ( ‫حُٞؿ٘٤ش‬ ٍُٝ‫حُي‬ -( ‫حُيػخٓش‬buttress‫حُؼِٞ٣ش‬ ‫حُلٌ٤ش‬ ‫حُٞؿ٘٤ش‬ ) -‫حُٞؿ٘٤ش‬ ّٞ‫حُو‬ -١‫حُٞطي‬ ٢٘‫حُٞؿ‬ ٍُ‫حُي‬ -‫ُِلـخؽ‬ ‫حُٔلِ٤ش‬ ‫حُلخكش‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 89 B-: ‫ح٧ٓزخد‬ ‫ٓغ‬ َٜ‫٣ظٔل‬ ٚٗ‫أ‬ ٫‫ا‬ ٚ‫حُٞؿ‬ ّ‫ػظخ‬ ٠ٔ‫أه‬ ٖٓ ٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ َ‫٣ؼظز‬‫ٗٔز٤خ‬ ‫ٛ٘ش‬ ّ‫ػظخ‬ ٠ِ‫ػ‬ ًٍٞٔ ٌٕٞ‫ط‬ ‫ٓخ‬ ‫ؿخُزخ‬ ٢‫ُظ‬ ٝ ْ‫حُؼظ‬ ‫ٌُٜح‬ ‫حُ٠ج٤ِش‬ ٌٍُٞٔ‫ح‬ ‫ٗٔزش‬ َٔ‫٣ل‬ ‫ٓخ‬ ‫ٌٛح‬ ٝ ) ‫حُٜيؿ٤ش‬ ٝ ‫حُؼِٞ٣ش‬ ‫حُلٌ٤ش‬ ٝ ‫حُـزٜ٤ش‬ ( ‫حُٞؿ٘٤ش‬ ٍُٝ‫حُي‬ ٟٞ‫ٓٔظ‬ ٞ‫رؼ‬ ‫ٜٓ٘خ‬ ٝ ‫حُؼ٘ق‬ ٝ ‫حُٔزخَٗس‬ ‫حُٜيٓخص‬ ٖ‫ػ‬ ٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ًٍٞٔ ‫ط٘ظؾ‬ ‫ٓخ‬ ‫ؿخُزخ‬ ‫ًخُٔ٬ًٔش‬ ‫حُؼ٘٤لش‬ ‫حَُ٣خٟخص‬ C-: ‫حُظٜ٘٤ق‬ : ‫ٜٓ٘خ‬ ًٌَ٘ٓ ٝ ‫حُٞؿ٘٤ش‬ ٌٍُٞٔ‫ح‬ ‫طٜخٗ٤ق‬ ٖٓ َ٤‫ًز‬ ‫ػيى‬ ‫٣ٞؿي‬ ‫طٜ٘٤ق‬ **Knight & North: -‫حُٜ٘ق‬1ٍ‫ٓظزي‬ َ٤‫ؿ‬ ًَٔ : -‫حُٜ٘ق‬2ٍِٝ‫ٓؼ‬ ٍ‫ٓظزي‬ ًَٔ : -‫حُٜ٘ق‬3ٍ‫اٗلظخ‬ ٕٝ‫ى‬ ٍ‫ٓظزي‬ ًَٔ : -‫حُٜ٘ق‬4٢ٔٗ‫أ‬ ٕ‫ىٍٝح‬ ‫ٓغ‬ ًَٔ : ‫ُِوخٍؽ‬ .. ٢٘‫حُٞؿ‬ ٢ٜ‫حُٞؿ‬ ٍُ‫حُي‬ ٖٓ َ‫ُِيحه‬ .. -‫حُٜ٘ق‬5٢٘‫ٝك‬ ٕ‫ىٍٝح‬ ‫ٓغ‬ ًَٔ : ..‫حُلـخؽ‬ ‫طلض‬ ‫حُلخكش‬ ٖٓ ٠ِ‫ُ٨ػ‬ ..ُِ‫وخٍؽ‬ٍُٖٓ‫حُي‬٢ٜ‫حُٞؿ‬٢٘‫حُٞؿ‬ -‫حُٜ٘ق‬6ٌَُٔ‫ح‬ ١ٞ‫هط‬ ‫ٓظؼيى‬ :
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 90 ‫طٜ٘٤ق‬ **Killey`s: 1)-‫ٓغ‬ ٢٘‫حُٞؿ‬ ْٔ‫ؿ‬ ًَٔ: ‫كـخؿ٤ش‬ ‫اٛخرش‬ -٢٤ٔ‫ر‬ ٍ‫طزي‬ -َ‫ح٧ٓل‬ ٝ َ‫ُِيحه‬ ٍ‫طزي‬ -‫حُوِق‬ ٝ َ‫ُِيحه‬ ٍ‫طزي‬ -‫ُِوخٍؽ‬ ٍ‫طزي‬ -‫ٓلظض‬ 2)-‫كـخؿ٤ش‬ ‫اٛخرش‬ ٕٝ‫ى‬ ٢٘‫حُٞؿ‬ ّٞ‫حُو‬ ًَٔ **‫طٜ٘٤ق‬Özyazganٝ ٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ًٍٞٔ ٖ٤‫ر‬ ‫حُِٔؽ‬ ٠ِ‫ػ‬ ‫٣ؼظٔي‬ ١ٌُ‫ح‬ ٝ ‫حُٞؿ٘٤ش‬ ّٞ‫حُو‬ 1)-‫حُٜ٘ق‬1ٍِ‫ٓ٘ؼ‬ ‫ٝؿ٘٤ش‬ ّٞ‫ه‬ ًَٔ : A-ٍِ‫ٓ٘ؼ‬ ٢٘‫ٝؿ‬ ّٞ‫ه‬ ًَٔ B-ٖ٣ًَٔ ٖٓ َ‫أًؼ‬ B-V–‫كَف‬ ٌَ٘‫ر‬ ًَٔV B-D–ٍ‫ٓظزي‬ ًَٔ 2)-‫حُٜ٘ق‬2‫ٓ٘ظًَش‬ ‫ٝؿ٘٤ش‬ ّٞ‫ه‬ ٝ ْ‫ػظ‬ ًَٔ : A-‫ٓلَى‬ ًَٔ B-‫ٓظؼيىس‬ ًٍٞٔ B-R-ٍ‫ٓظزي‬ َ٤‫ؿ‬ ًَٔ B-D–ٍ‫ٓظزي‬ ًَٔ : ٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ًٍٞٔ ‫طٜ٘٤ق‬ ** ‫ٗٞع‬1:ًٍَٔ‫ٓظزي‬ َ٤‫ؿ‬. ‫ٗٞع‬2:٢‫كو‬ ّٞ‫حُو‬ ًَٔ. ‫ٗٞع‬3:ًَٔ٢٘‫ٝؿ‬ْ‫حُوٞحث‬ ٢‫ػ٬ػ‬٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ (ْ٤ِٓ) ‫ٗٞع‬4:ًَٔ٢٘‫ٝؿ‬ْ‫حُوٞحث‬ ٢‫ػ٬ػ‬) ‫ٓ٘لِٜش‬ ٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ( ‫ٗٞع‬5:ًَٔ١ٍ‫اٗلـخ‬.. ‫ٗٞع‬6:‫كخكش‬ ًَٔ٢‫حُلـخؿ‬. ‫ٗٞع‬7ًٍٞٔ :َٟ‫أه‬ ًٍٞٔٝ ‫ٓلظظش‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 91 D-ٝ‫ح٧ػَح‬: ‫حُٞؿ‬ ّ‫ػظخ‬ ًٍٞٔ ‫ػ٘ي‬‫٘ش‬٧‫ح‬ ٌٕٞ‫ط‬ٝ ٌَُٔ‫ح‬ ‫رٔ٘طوش‬ ‫ؿخُزخ‬ ٚ‫َٓطزط‬ ٝ‫ػَح‬ٝ ٚ‫ٗيط‬‫أ‬‫ٜٛٔخ‬: -ٝ ‫ح٩ٛخرش‬ ٕ‫ٌٓخ‬ ُْٔ ‫ػ٘ي‬ ُْ‫أ‬‫ح٩ٛخرش‬ ٕ‫ٌٓخ‬ ٢‫ك‬ ‫كخى‬ ُْ‫أ‬. -٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ‫ػ٘ي‬ ‫حُلي‬ ‫طلَ٣ي‬ ٢‫ك‬ ٚ‫حُٜؼٞر‬ َ‫ٓؼ‬ ٚ‫حُٞظ٤ل‬ ٕ‫كويح‬‫حُ٘خطت‬ ‫ٓغ‬ ‫حٌٍُٔٔٞس‬ ‫حُٞؿ٘ش‬ ‫طَحًذ‬ ‫رٔزذ‬ ‫ؿخُزخ‬ ( ٢ِ‫حُٔل‬ ‫ُِلي‬ ١ٍ‫حُٔ٘وخ‬‫اٗلٜخ‬ ‫رٔزذ‬ ٝ‫أ‬‫حُٔخٟـش‬ ٝ‫أ‬ ‫حُـ٘خك٤ش‬ ٝ‫أ‬ ‫حُٜيؿ٤ش‬ ‫حُؼ٠ِش‬ ٍ)‫ا‬٧‫ح‬ ٠ُ‫ح‬ ‫ٟخكش‬ُْ -‫حُٔوِش‬ ‫كًَش‬ ‫طليى‬ ‫ٓغ‬ ٖ٤‫حُؼ‬ ٢‫ك‬ ‫ٗلغ‬ -ٝ ٕ‫ح٧ٓ٘خ‬ ‫طلَى‬ ‫ٓغ‬ ُْ٧‫ح‬ ‫ٝ٣ليع‬ ٚ‫حُ٘ل‬ ٢‫ك‬ ٍ‫هي‬ ‫٣ليع‬ ‫هي‬ٝ ّ‫طخ‬ ٌَ٘‫ر‬ ‫ا١زخهٜخ‬ ‫آٌخٗ٤ش‬ ّ‫ػي‬٧‫ح‬، ‫ح٧١زخم‬ ‫ػ٘ي‬ ‫حُ٘ي٣ي‬ ُْ -٧‫ح‬ ٍّٞ‫ط‬ٚ‫حُٔل٤ط‬ ٚ‫ٗٔـ‬ٖ٤‫حُؼ‬ ٍٞ‫ك‬ ‫ًيٓش‬ ٕٝ‫ح٧ؿلخ‬ ‫كظلش‬ ٌَٗ ٢‫ك‬ َ٤‫طـ‬ ‫ٓ٘خٛيس‬ ٌٖٔ٣ ‫ًٔخ‬ -١ِٞ‫حُؼ‬ ‫ُِلي‬ ١ِ٤ِٛ‫حُي‬ ‫حُٔ٤ِحد‬ ‫هخع‬ ٢‫ك‬ ‫ًيٓش‬ -‫ٝحٟق‬ ٙٞ٘‫ط‬‫حُٞؿ٘٤ش‬ ّٞ‫حُو‬ ‫اٗؤخف‬ ٝ‫أ‬ ‫حُلـخؽ‬ ‫كٞحف‬ ٝ‫أ‬ ٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ٢‫ك‬ٝ ً٬ٓ‫ًخ‬ ٌَُٔ‫ح‬ ٕ‫ًخ‬ ‫اًح‬‫حٌٍُٔٔٞس‬ ّ‫حُؼظخ‬ ‫أؿِحء‬ ٝ ‫ٌٓخٜٗخ‬ ٖٓ ‫طلًَض‬ٖ٤‫حُؼ‬ َ‫ٓلـ‬ ّ‫ػظخ‬ ًَٔ ‫ػ٘ي‬ ٚ‫حُٞؿ‬ ٢‫ك‬ ٙٞ٘‫ط‬ٝ٧‫ح‬ ّ‫ػظخ‬ٝ ٍّٞ‫حُظ‬ ٖ‫ػ‬ ٬٠‫ك‬ ‫ٗق‬ٝ ‫حٌُيٓخص‬‫حُِ٘ف‬ -.. ٖ٤‫حُؼ‬ ‫ٓوِش‬ ٍٝ‫ؿئ‬ ، ‫حُِٔظلٔش‬ ‫ًيٓش‬ , ‫ٍػخف‬ ‫ٗ٘خٛي‬ ‫ٓخ‬ ‫ٗخىٍح‬ E-١َ٣َُٔ‫ح‬ ٚ‫حُلل‬: ٚ٤‫حُظ٘و‬ ٝ : ‫أٓخٓ٤ش‬ ٍٝ‫ٓلخ‬ ‫ػ٬ع‬ ٠ِ‫ػ‬ ٚ٤‫حُظ٘و‬ ‫٣ؼظٔي‬ 1-: ‫حَُٔ٣َ٣ش‬ ‫حُوٜش‬ ‫اٍطٌخُٛخ‬ ‫ٗوطش‬ ٝ‫ح‬ ٟٞ‫حُو‬ ٙ‫اطـخ‬ ٠ِ‫ػ‬ ٝ َُٝ‫ح‬ ‫١ز٤ؼش‬ ٠ِ‫ػ‬ ‫٣ؼظٔي‬‫حُٞؿٜ٤ش‬ 2-: ١َ٣َُٔ‫ح‬ ٚ‫حُلل‬ ‫ؿخٗز٤ش‬ ‫اهظ٬١خص‬ ١‫أ‬ ‫ٓ٘غ‬ ٝ ٢ٔ‫حُؼظ‬ ‫ح٩ِٗ٣خف‬ ‫ٗيس‬ ْ‫طلخه‬ ‫ُٔ٘غ‬ ‫ُط٤لخ‬ ١َ٣َُٔ‫ح‬ ٚ‫حُلل‬ ٌٕٞ٣ ٕ‫أ‬ ‫٣ـذ‬ ٢‫حُٜيؿ‬ ٝ ١ِٞ‫حُؼ‬ ٢ٌ‫حُل‬ ٝ ٢ٜ‫حُـز‬ ْ‫حُؼظ‬ ‫ٓغ‬ ‫حُٞؿ٘٤ش‬ ٍُٝ‫حُي‬ ْ‫رـ‬ ّٞ‫ٗو‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 92 ٝ ١ٞ‫حُؼل‬ ٖ٤‫حُؼ‬ ‫كًَخص‬ ٚ‫رلل‬ ١َ٣َُٔ‫ح‬ ٚ‫حُلل‬ ّ‫اطٔخ‬ ‫٣ـذ‬ ١َٔ‫حُو‬: 3-ٚ‫حُلل‬٢‫حُ٘ؼخػ‬: ‫حُوخػي٣ش‬ ‫حٍُٜٞس‬ ٠ِ‫ػ‬ ٌِ‫٣َط‬: Submentovertex viewُ‫ٓٔظخ‬ ٌَ٘‫ر‬ ‫حُٞؿ٘٤ش‬ ّٞ‫حُو‬ َٜ‫طظ‬ ٢‫حُظ‬ ٝ ‫أٓخٓ٤ش‬ ‫هِل٤ش‬ ‫ؿٔـٔش‬ ‫رٍٜٞس‬ ‫ح٩ٓظؼخٗش‬ ٌٖٔ٣ ٝ‫رٟٞؼ٤ش‬Water’s:
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 93 ٍِ‫ٓ٘ؼ‬ ٢٘‫ٝؿ‬ ْ‫ػظ‬ ًَٔ ‫ٝؿٞى‬ ٍ‫كخ‬ ٢‫ك‬ ‫طٔظطذ‬ ٢‫حُظ‬ ٝ ‫هٔ٤ش‬ ‫ًه٘٤ش‬ ‫ٍٛٞس‬ ٝ‫أ‬ ‫ٝؿٞى‬ ٍ‫كخ‬ ٢‫ك‬‫ح٧رؼخى‬ ‫ػ٬ػ٤ش‬ ‫ٓوخٍرش‬ ‫ٓغ‬ ٢‫ٓوطؼ‬ َ٣ٜٞ‫ط‬ ‫اؿَحء‬ َ٠‫٣ل‬ ‫ٗي‬ F-‫حُٔ٠خػلخص‬ -‫حُِ٘ف‬ ‫ٗيس‬ ‫رٔزذ‬ ٚٓ‫حُٜي‬ -‫ا‬ٖ٤‫حُؼ‬ ‫ٛخرش‬ٝ‫أ‬ ‫حُوَ٣زش‬ ‫ح٧ػٜخد‬ ٝ‫أ‬ ‫ح٧ٗق‬ ,ٝ ‫ح٧ٍرطش‬ ( ٚ‫حُٔل٤ط‬ ‫حُظَحً٤ذ‬ٝ ٍ‫ح٧ٝطخ‬‫حُٔل٤طش‬ ‫ح٧ٗٔـش‬ ٝ‫أ‬ ‫حُيٓٞ٣ش‬ ‫ح٧ٝػ٤ش‬. )
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 94 -٢‫ك‬ ٍ‫هي‬ ٝ ‫حُلـخؽ‬ ‫طلض‬ ‫حُؼٜذ‬ ‫اٛخرش‬‫حُؼِٞ٣ش‬ ‫حُ٘لش‬ ٝ ٢ِ‫حُٔل‬ ٖ‫حُـل‬ -َٓ‫ًخ‬ ٌَ٘‫ر‬ ٢ِ‫حُٔل‬ ٖ‫حُـل‬ ‫اؿ٬م‬ ٠ِ‫ػ‬ ‫حُويٍس‬ ّ‫ػي‬ ٢ُ‫رخُظخ‬ ٝ ٢ٜ‫حُٞؿ‬ ‫ُِؼٜذ‬ ٢٘‫حُٞؿ‬ ‫حُلَع‬ ‫اٛخرش‬ -ْ‫حُظ٘ل‬ ٢‫ك‬ ‫اػخهش‬) ‫ٗخىٍح‬ (. -ٝ‫ٓخ‬ ‫ٓ٠خػلخص‬ َٜ‫طل‬ ‫هي‬٣‫حُ٘ي‬ ‫ًخُِ٘ف‬ ٚ‫حُـَحك‬ ‫رؼي‬ٝ‫أ‬ ‫ي‬‫حُظِٞع‬ ‫ٗظ٤ـش‬‫أ‬ٝ‫ط‬‫ٔٞص‬٢ٔ‫ػظ‬‫حُظ‬ ‫هطغ‬ ‫رٔزذ‬‫َٝ٣ش‬ٚ٣ٞٓ‫حُي‬. G-‫حُؼ٬ؽ‬: : ١‫ٗوخ‬ ‫ػيس‬ ٢‫ك‬ ‫حُؼ٬ؽ‬ ٚ٤‫طِو‬ ٌٖٔ٣ 1-‫ػ٬ؽ‬ ٕٝ‫ى‬ 2-: ‫ٓغ‬ َٗ‫ٓزخ‬ َ٤‫ؿ‬ ‫ٍى‬-. ‫طؼز٤ض‬ ٕٝ‫ى‬ -. ‫ٓئهض‬ ْ‫ىػ‬ -. َٗ‫ٓزخ‬ ‫طؼز٤ض‬ -. َٗ‫ٓزخ‬ َ٤‫ؿ‬ ‫طؼز٤ض‬ 3-. َٗ‫ٓزخ‬ ‫طؼز٤ض‬ ٝ ‫ٍى‬ َ٣‫ٓـخ‬ ٌَ٘‫ر‬ ٌُٖ ٝ ١‫حُ٘وخ‬ ٌٙٛ َ٤ٜ‫طل‬ ْ‫ٓ٤ظ‬ a)-: ‫اىَحافظ‬ ‫اىؼالج‬ ٠ُ‫ا‬ ‫حُؼ٬ؽ‬ ‫٣ٜيف‬:-‫اػخىس‬‫طؼز٤ظٜخ‬ ٝ ‫حٌٍُٔٔٞس‬ ‫حُوطغ‬ ‫طٟٔٞغ‬ -‫اػخىس‬‫حُٞؿٜ٤ش‬ ّٞ‫ُِو‬ ٢‫حُطز٤ؼ‬ ٌَُ٘‫ح‬ -ُْ٧‫ح‬ ‫اُحُش‬ -٢ِ‫حُٔل‬ ‫حُلي‬ ‫ُلًَش‬ ‫اػخهش‬ ١‫أ‬ ‫اُحُش‬ -‫حُلـخؿ٤ش‬ ‫حُلخكش‬ َ٤ٌ٘‫ط‬ ‫اػخىس‬ -‫ٝؿيص‬ ٕ‫ا‬ ‫حُِٔىٝؿش‬ ‫حَُإ٣ش‬ ‫طٜل٤ق‬ ‫ط‬ ١‫أ‬ ‫ؿ٤خد‬ ‫ٓغ‬ ٌَُٔ‫ح‬ ٢‫ه‬ ٢‫ك‬ ٍ‫طزي‬ ١‫أ‬ ‫ؿ٤خد‬ ٍ‫كخ‬ ٢‫ك‬ ‫ًُي‬ ٝ ‫ػ٬ؽ‬ ١٧ ‫ٗلظخؽ‬ ٫ ‫حُلخ٫ص‬ ٞ‫رؼ‬ ٢‫ك‬ٙٞ٘‫حَُإ٣ش‬ ‫اٟطَحد‬ ٝ‫أ‬ٍ‫هي‬ ٝ‫أ‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ‫كًَش‬ ٢‫ك‬ ‫اػخهش‬ ٝ‫أ‬ ‫ٟٓٞؼ٤ش‬ ‫ػٜز٤ش‬ ‫اهظ٬١خص‬ ١‫أ‬ ‫ؿ٤خد‬ ٝ ٙٞ٘‫ط‬ ‫ٝؿٞى‬ ّ‫ػي‬ ٍ‫كخ‬ ٢‫ك‬ ٢‫حُ٬ؿَحك‬ ‫حُؼ٬ؽ‬ ‫طؼظٔي‬٢‫هخٍؿ‬ ‫ٓؼزض‬ ٍ‫آظؼٔخ‬ ٌٖٔ٣ ٝ (‫٫كن‬ ٍ‫طزي‬ ١‫أ‬ ‫ُٔ٘غ‬ ‫حُٜٔخرش‬ ‫حُٔ٘طوش‬ ‫كٞم‬ ٚ‫ه٤خ١ظ‬ ْ‫طظ‬ ) ‫ِٛزش‬ ‫أىحس‬ ١‫أ‬ ٝ‫أ‬ ٕ‫ُٔخ‬ ‫هخكع‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 95 b)-: ً‫اىجشاح‬ ‫اىؼالج‬ : ‫حُظخُ٤ش‬ ‫حُلخ٫ص‬ ٢‫ك‬ ٢‫حُـَحك‬ ‫حُؼ٬ؽ‬ ‫٣ٔظطذ‬ -‫حَُإ٣ش‬ َ‫طؤػ‬ -ٖ٤‫ُِؼ‬ ‫حُٔلًَش‬ ‫حُؼ٠٬ص‬ ٍ‫اٗلٜخ‬ -‫حُلـخؽ‬ ‫هخع‬ ًٍٞٔ -‫ٓظزيُش‬ ًٍٞٔ -‫ٓوظِطش‬ ًٍٞٔ -٢ِ‫حُٔل‬ ‫حُلي‬ ‫كًَش‬ ‫اٟطَحد‬ -٢‫حُٟٔٞؼ‬ ‫ح٧ػٜخد‬ ‫اٟطَحد‬ ُ‫ح‬‫ٜيف‬٢ٔ٤‫حَُث‬‫ُؼ٬ؽ‬ًَّٔٞ‫حُو‬٢٘‫حُٞؿ‬ْٝ‫ػظ‬‫حُٞؿ٘ش‬ٞٛ‫اػخىس‬‫طٟٔٞغ‬‫حُـَحك٤ش‬. ‫حَُى‬ )* ‫ٛ٘خى‬‫ػيس‬‫أٓخُ٤ذ‬‫ٓوظِلش‬: 1-ْ‫حُل‬ َ‫ىحه‬ ٖٓ(Keen 1909): ‫حُؼِٞ٣ش‬ ‫ح٧ٍكخء‬ ٟٞ‫ٓٔظ‬ ٠ِ‫ػ‬ ١ِ٤ِٛ‫ى‬ ‫ٗن‬ ‫اؿَحء‬ ٝ ْ٤‫حُظؼو‬ ‫رؼي‬َ‫ر‬ ّٞ‫ٗو‬ ‫حَُ٘٣لش‬ ‫ٍكغ‬ ٝ٢٘‫حُٞؿ‬ ّٞ‫حُو‬ ًَٔ ‫ى‬‫ٍحكغ‬ ‫١َ٣ن‬ ٖ‫ػ‬ ‫ٓٔظو٤ٔش‬ ‫أىحس‬ ١‫أ‬ ٝ‫أ‬ ‫ٓٔلخم‬٫ٞٛ‫أ‬ ‫حُ٘ن‬ ‫ه٤خ١ش‬ ‫رؼيٛخ‬ ْ‫٣ظ‬ ٝ.
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 96 2-‫حُٜيؿ٤ش‬‫١َ٣وش‬ (Gillies1927): ٍٞ‫رط‬ ‫حُ٘ن‬ َٟ‫٣ـ‬2ّٞ‫حُو‬ ٠‫كظ‬ ‫حُٜيؿ٤ش‬ ‫حُؼ٠ِش‬ ‫ٛلخم‬ ‫طلض‬ ‫حُظِٔ٤ن‬ ْ‫٣ظ‬ ٝ ‫حُٜيؿ٤ش‬ ‫حُٔ٘طوش‬ ٢‫ك‬ َ‫حُ٘ؼ‬ ‫كخكش‬ ٠ِ‫ػ‬ ْٓ ‫حُؼٌحٍ٣ش‬ ‫ػزخص‬ ‫ٝؿٞى‬ ‫ٓغ‬ ‫حُٔؼُِٝش‬ ٌٍُٞٔ‫ح‬ ‫كخ٫ص‬ ٢‫ك‬ ‫حُطَ٣وش‬ ٌٙٛ ‫طٔظطذ‬‫َُِى‬ ٢ُ‫طخ‬ ْ‫ػ‬ ‫حُ٘ٔؾ‬ ٍٝ ّ‫ػي‬ ٝ ْ‫ُِيػ‬ ‫حَُحكؼش‬ ‫طلض‬ ‫طٟٞغ‬ ٕ‫ٗخ‬ ‫هطؼش‬ ٠ِ‫ػ‬ ‫رخ٩ػظٔخى‬ ‫حُٔ٘ـَُس‬ ّٞ‫حُو‬ ‫ٍكغ‬ ٝ ِ٤٤ِ٤‫ؿ‬ ‫ٍحكؼش‬ ٍ‫اىهخ‬ ْ‫٣ظ‬ ٝ ‫حُٔ٘خٓذ‬ ٢٤‫رخُو‬ ‫حُ٘ن‬ ‫ه٤خ١ش‬ ْ‫٣ظ‬ ٌٖٔ٣‫ح٩ٓظؼخٗش‬‫رَحكؼش‬Rowe: 43 2 1
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 97 3-( ‫حُوطخف‬ ‫١َ٣ن‬ ٖ‫ػ‬Hock): ‫حُوطخف‬ ّ‫ٍأ‬ ‫طؼز٤ض‬ ْ‫٣ظ‬ ‫ىحثَ٣ش‬ ‫ٜٗق‬ ‫رلًَش‬ ٝ ‫ٓزخَٗس‬ ‫حُٞؿ٘٤ش‬ ّٞ‫حُو‬ ٟٞ‫ٓٔظ‬ ‫طلض‬ ‫حُوطخف‬ ٖٓ ‫حُٔٔظيم‬ ‫حُـِء‬ َُ‫ؿ‬ ْ‫٣ظ‬ ٝ ٍٞ‫حُيه‬ ‫ٗوطش‬ ‫ُو٤خ١ش‬ ‫ٛ٘خ‬ ‫كخؿش‬ ٫ ٝ ٢ٜ‫حُٞؿ‬ ْ‫حُؼظ‬ ٝ‫أ‬ ّٞ‫حُو‬ ‫ٍى‬ ْ‫٣ظ‬ ‫طٞؿ٤ٜ٤ش‬ ‫رلًَخص‬ ٝ ٢٘‫حُٞؿ‬ ْ‫ُِؼظ‬ ٢‫حُوِل‬ ٚ‫حُٞؿ‬ ٠ِ‫ػ‬ 4-‫١َ٣وش‬Dingman`s: ٢‫حُلخؿز‬ ‫حُ٘ن‬ ٝ‫أ‬ ‫حُظِٔ٤ن‬ ْ‫ػ‬ ‫ُِلخؿذ‬ ‫حُٞك٘٤ش‬ ٝ ‫حُؼِٞ٣ش‬ ‫حُلخكش‬ ٟٞ‫ٓٔظ‬ ٠ِ‫ػ‬ ‫حُ٘ن‬ ٌٕٞ٣٠ُ‫ا‬ ٫ٞٛٝ ٝ ‫ح٧ٓخٓ٤ش‬ ‫حُـزٜ٤ش‬ ‫حُؼ٠ِش‬ ‫ٛلخم‬ ‫كٞم‬ ‫ٓٔظو٤ٔش‬ ‫رؤىحس‬ ٌَُٔ‫ح‬ ‫ٍكغ‬ ْ‫ػ‬ ٖٓ ٝ ‫حُٜيؿ٤ش‬ ‫حُؼ٠ِش‬ ‫ٛلخم‬ َّٛ ‫كيٝع‬ ‫ُٔ٘غ‬ ‫اٍطٌخُٛخ‬ ‫ٗوطش‬ ٟٞ‫ٓٔظ‬ ٠ِ‫ػ‬ ٠ِٔ‫حُٔٔظؼ‬ ‫ح٧ىحس‬ ‫طلض‬ ٕ‫ٗخ‬ ‫هطؼش‬ ‫ٟٝغ‬ ‫حُلخ٫ص‬ ٌٙٛ َ‫ٓؼ‬ ٢‫ك‬ َ٠‫٣ل‬‫ُِ٘ٔؾ‬ 5-: ٢‫حُزَحؿ‬ ٍ‫ربٓظؼٔخ‬ ‫حُٔ٘خٓزش‬ ‫حُٟٞؼ٤ش‬ ٠ُ‫ا‬ ٍُٞٛٞ‫ح‬ ٠‫كظ‬ ‫حُٞؿ٘ش‬ ‫رظلَى‬ ٌْ‫حُظل‬ ٌٖٔ٣ ‫رٌُي‬ ٝ ٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ‫ٓ٘ظٜق‬ ٢‫ك‬ ٢‫رَؿ‬ ‫طؼز٤ض‬ ٠ِ‫ػ‬ ‫طؼظٔي‬ ُ‫ح‬ ٍ‫آظزيح‬ ٌٖٔ٣‫ز‬‫رؤىحس‬ ٢‫َؿ‬Carroll-Girard)‫(حٍُٜٞس‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 98 5-ّ‫ربٓظويح‬ ‫حَُى‬Towel Clip: )*‫حُ٘ن‬٢‫حُـَحك‬: ٕ‫أ‬ ‫آخ‬ *ٌَُٔ‫ح‬ ٢‫ه‬ ٠ِ‫ػ‬ َٗ‫ٓزخ‬ ٌَ٘‫ر‬ ٌٕٞ٣ ٢‫حُزَحؿ‬ ٝ ‫حُٜلخثق‬ ‫رٞحٓطش‬ ٝ‫أ‬ ‫رخ٧ٓ٬ى‬ ‫آخ‬ َٗ‫ٓزخ‬ ٌَ٘‫ر‬ ‫حُظؼز٤ض‬ ٝ ‫حَُى‬ ْ‫٣ظ‬ ٝ ٌَُٔ‫ح‬ ٢‫ه‬ ‫كٞم‬ ‫حُٜٔخد‬ ‫حُـخٗذ‬ ٠ِ‫ػ‬ ُّٞ٘‫ح‬ ٖ‫ػ‬ ‫ح٩ٓظ٘خع‬ ٝ َُٟٝٞ‫ح‬ ٖٓ ‫ٗٞع‬ ١‫أ‬ ‫طـ٘ذ‬ ‫٣ـذ‬ ‫حُ٘لخء‬ ‫كظَس‬ ٍ٬‫ه‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 99 : ٢‫ؿخٗز‬ ٢‫كـخؿ‬ ‫ٗن‬ * ١ِٞ‫ػ‬ ٢٘‫ؿل‬ ‫ٗن‬ * ٢‫كـخؿ‬ ‫طلض‬ ‫ٗن‬ * : ‫حُِٔظلٔش‬ َ‫ػز‬ ‫ٗن‬ *
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 100 :٢‫طخؿ‬ ‫ٗن‬ * : ‫حُظؼز٤ض‬ )* -: ‫حٌُِٔ٤ش‬ ‫حُو٤خ١ش‬ ‫١َ٣ن‬ ٖ‫ػ‬ ‫آخ‬ ‫ٓزخَٗس‬ ٌَُٔ‫ح‬ ٢‫ه‬ ‫كٞم‬ ‫ُ٘ن‬ ٢ٓ‫أٓخ‬ ٌَ٘‫ر‬ ‫طلظخؽ‬ ٝ ‫حُلـخؽ‬ ‫طلض‬ ‫حُلخكش‬ ٝ ٢٘‫حُٞؿ‬ ٢ٜ‫حُـز‬ ٍُ‫ُِي‬ ‫حُو٤خ١ش‬ ٌٕٞ‫ط‬ ‫ٓخ‬ ‫ؿخُزخ‬ -: ‫حُٜلخثق‬ ٝ ٢‫حُزَحؿ‬ ٍ‫آظؼٔخ‬ ٝ ٫‫آظؼٔخ‬ َ‫ح٧ًؼ‬ ‫حُطَ٣وش‬ ٢ٛ ٝ٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ْٔ‫ؿ‬ ٝ ‫حُلـخؽ‬ ‫طلض‬ ‫حُلخكش‬ ٝ ٢ٜ‫حُـز‬ ٢٘‫حُٞؿ‬ ٍُ‫حُي‬ ًٍَٔ ٢‫ك‬ ‫طٔظطذ‬ ‫ٌُٜ٘خ‬ : ‫حُٜلخثق‬ ٍ‫آظؼٔخ‬ ‫ٓغ‬ ‫اطزخػخ‬ َ‫ح٧ًؼ‬ ‫حُـَحك٤ش‬ َ‫حُٔيحه‬-‫ُِلـخؽ‬ ‫حُـخٗز٤ش‬ ‫حُلخكش‬ ‫ٗن‬ -‫حُلـخؽ‬ ‫طلض‬ َ‫حُٔيحه‬ -ٖ‫حُـل‬ َ‫ػز‬ َ‫حُٔيه‬ -‫حُِٔظلٔش‬ َ‫ػز‬ َ‫حُٔيه‬ -‫حُل‬ َ‫ىحه‬ ‫حُ٘ن‬١ٞٔ ‫ٓظلَهش‬ ٝ‫أ‬ ‫ٓـظٔؼش‬ ٌٕٞ‫ط‬ ‫هي‬ ‫ُِظؼز٤ض‬ ١‫ٗوخ‬ ‫ػيس‬ ‫ًٌُي‬ ‫ٗؼظٔي‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 101 ًٖ‫أٓخ‬ ‫ػ٬ع‬ ٝ‫أ‬ ٖ٤ٗ‫ٌٓخ‬ ٝ‫أ‬ ‫ٝحكي‬ ٕ‫رٌٔخ‬ ‫آخ‬ ‫حُظؼز٤ض‬ ٌٕٞ٣ ٝ ‫طؼز٤ض‬ ١‫ٗوخ‬ ‫أٍرغ‬ ٠‫كظ‬ ٝ‫أ‬ H-‫حُٔ٠خػلخص‬: 1-ْ‫حُؼظ‬ ٠ِ‫ػ‬ ‫حَُهٞس‬ ‫حُ٘ٔؾ‬ ‫طٟٞغ‬ ‫ٓٞء‬ 2-: ‫ػ٤٘٤ش‬ ‫ٓ٠خػلخص‬-‫حُٔوِش‬ ‫هِق‬ ‫ِٗف‬ -‫حُٔ٠خػلش‬ ‫حَُإ٣ش‬ ٍ‫آظَٔح‬ -ٖ٤‫حُؼ‬ ٍٝ‫ؿئ‬ -‫حُلـخؽ‬ ‫طلض‬ ‫حُؼٜذ‬ ٕٞ٘‫ط‬ -٠ٔ‫ػ‬ 3-‫كٌ٤ش‬ ‫ؿ٤ٞد‬ ‫اُظٜخد‬ 4-٢ِ‫حُٔل‬ ‫ُِلي‬ ١ٍ‫حُٔ٘وخ‬ ‫حُ٘خطت‬ ‫ٓغ‬ ‫حُٞؿ٘ش‬ ‫اُظٜخم‬ 5-ٕ‫ح٩ٗظخ‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ ‫كساب‬ ‫جودت‬ ‫فراس‬ .‫د‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ ‫كساب‬ ‫جودت‬ ‫فراس‬ .‫د‬
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 102 ‫حَُٔحؿغ‬  Principles of Internal Fixation of the CraniomaxillofacialSkeleton -Trauma and OrthognathicSurgery by AO foundation  Textbook of oral and maxillofacial surgery 2ndedition: S M Balaji  Text book of oral and maxillofacial surgery 3rd edition_neelimaMallik  Contemporary oral and maxillofacial surgery _hupp_ellis_tucker  clinical handbook of oral and maxillofacial surgery_lashkins  Netter’s Atlas version 5.1  Clinical handbook of oral and maxillofacial surgery- Laskins  Textbook of oral and maxillofacial surgery;2nd edition- S.M Balaji  Textbook of oral and maxillofacial surgery;3rd edition- Neelima Mallik  National Center for injury Prevention and control , Annual repost2002  Cerulli G, Carboni A, Mercurio A, etal Soccer – related Caranimaxillo facial / injuries . JcraniofacSurg 2002 :14:627-30  Marshall SW,Muellerfo;KirbyDP,et al Evaluation of Safety balls and Faceguards for Prevention of injuries in Youth baseball ; JAMA 2003;289-74  Exadaktylos A . K ,NMggenspergeretal sports related waxillo facial ewyuties:thefitstwaxillofacialThauwa Database in Switzerland Bry Sport Med 2004 :38:750-753  Tmothy J Rupp , FacialFractures sport wedicine , face and lead Decewber 7-2004  Spectrum of mandebular fractures at atertiary Care dental hospital in Lahore Departwey of and maxillofacial Surgery 2005  Closed treatment of condylar fractures by intermaxillary fixation with thermoforming plates; Haruhiko Terai et al, British Journal, 2004, Pg. 61-63  The risks & benefits of surgery for temporomandibular joint internal derangements; Simon Weinberg et al  Resorbable triangular plate for osteosynthesis of fractures of the condylar neck; Günter Lauer et al; British Journal of Oral and Maxillofacial Surgery 48 (2010) 532–535  Condylar Fracture Repair: Use of the Endoscope to Advance Traditional Treatment Philosophy ;Reid V. Mueller et al, Facial Plast Surg Clin N Am 14 (2006) 1–9  Intraoral approach for treatment of displaced Condylar fractures: case report; valfrido pereira-filho et al; craniomaxillofacial trauma & reconstruction/volume 4, number 2 2011  Mini-retromandibular approach to condylar fractures; Federico BIGLIOLI, Giacomo COLLETTI; Journal of Cranio-Maxillofacial Surgery (2008) 36, 378e383  Renato VALIATI, 2008, The treatment of condylar fractures: to open or not to open? A critical review of this controversy
‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr. firas Kassab Page 103  Transmasseteric Anteroparotid Approach for Mandibular Condylar Fractures-Merits and Demerits; AHMAD MAHROUS MOHAMAD, Egypt, J. Plast. Reconstr. Surg., Vol. 35, No. 2, July: 227-232, 2011  Craniomaxillofac Trauma 3:27, 1997  zygoma-lateral orbital complex fractures. New aspects. Arch  Otolaryngol Head Neck Surg 117:611, 1991  Optimizing the management of orbitozygomatic fractures. Clin Plast Surg 19:149, 1992  Application of endoscope in zygomatic fracture repair. Br J Plast Surg 53:100, 2000  Reduction of zygomatic arch fracture using a towel clip. J Craniofac Surg 10:439, 1999  Stabilisation of the delayed zygomatic arch fracture. Int J Oral Maxillofac Surg 16:445, 1987  Simple fixation method for unstable zygomatic arch fracture using double Kirschner’s  wires. Plast Reconstr Surg 101:1351, 1998  Epistaxis balloon catheter stabilization of zygomatic arch fractures. Ann Otol Rhinol Laryngol105:68, 1996  A method of zygomatic arch stabilization.Br J Oral Maxillofac Surg 32:396, 1994

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Facial fractures كسور عظام الوجه

  • 1.
    ٚ‫حُٞؿ‬ ّ‫ػظخ‬ ًٍٞٔ ّ‫كَح‬.‫ى‬‫ؿٞىص‬‫ًٔخد‬
  • 2.
  • 3.
    ّ‫انٕخ‬ ‫عظاو‬ ‫كغٕس‬ ‫كساب‬‫جودت‬ ‫فراس‬ ّ‫انٕخ‬ ‫عظاو‬ ‫كغٕس‬
  • 4.
    ّ‫انٕخ‬ ‫عظاو‬ ‫كغٕس‬ ‫كساب‬‫جودت‬ ‫فراس‬ ّ‫انٕخ‬ ‫عظاو‬ ‫كغٕس‬1 Copyright© 2017 by Sallab Edition Copyright © 2017 by Sallab, Inc., an affiliate of Sallab Alliance . ‫تأٚح‬ ٔ‫أ‬ ‫شكم‬ ‫تأٚح‬ ّ‫َمه‬ ٔ‫أ‬ ‫انكراب‬ ‫ْزا‬ ٍ‫ي‬ ‫خضء‬ ٘‫أ‬ ‫اَراج‬ ‫إعادج‬ ٍ‫ًٚك‬ ‫ال‬ .‫يسفٕظح‬ ‫انسمٕق‬ ‫خًٛع‬ ٍٚ‫نرخض‬ ‫َظاو‬ ٘‫أ‬ ٔ‫أ‬ ،‫انرغدٛم‬ ،‫انرظٕٚش‬ ‫فٛٓا‬ ‫تًا‬ ،‫ٚذٔٚح‬ ٔ‫أ‬ ‫إنكرشَٔٛح‬ ،‫ٔعٛهح‬،‫اعرعادذٓا‬ ٔ ‫نهًعهٕياخ‬ ٍَٛ‫لٕا‬ ‫زٕل‬ ‫اضافٛح‬ ‫نًعهٕياخ‬ ،ٌ‫اإلر‬ ٗ‫عه‬ ‫انسظٕل‬ ‫كٛفٛح‬ ‫زٕل‬ ‫انرفاطٛم‬ .‫انُاشش‬ ٍ‫ي‬ ٙ‫خط‬ ٌ‫إر‬ ٌٔ‫د‬ ٙ‫ف‬ ‫ذٕخذ‬ ،‫انُشش‬ ‫زمٕق‬ ‫ذشخٛض‬ ‫ٔكانح‬ ٔ ‫انُشش‬ ‫زمٕق‬ ‫كًشكض‬ ‫يُظًاخ‬ ‫يع‬ ‫ذشذٛثاذُا‬ ٔ ‫انُاشش‬ ٌ‫إر‬ ‫ا‬‫نثشٚذ‬:َٙٔ‫اإلنكرش‬Kessab1976@hotmail.com. ‫انُاشش‬ ‫لثم‬ ٍ‫ي‬ ‫انًهكٛح‬ ‫زمٕق‬ ‫تًٕخة‬ ‫يسًٛح‬ ًُّ‫ض‬ ‫انًسرٕاج‬ ‫اإلفشادٚح‬ ‫انًشاسكاخ‬ ٔ ‫انكراب‬ ‫ْزا‬ (‫ُْا‬ ّٛ‫إن‬ ‫اإلشاسج‬ ‫ذدذس‬ ‫لذ‬ ‫يا‬ ‫عذا‬) ‫إشعاساخ‬ ‫ذٕعع‬ ‫انخثشج‬ ٔ ‫اندذٚذ‬ ‫انثسث‬ ٌ‫أل‬ .‫يغرًش‬ ٍ‫تشكم‬ ‫انًدال‬ ‫ْزا‬ ٙ‫ف‬ ‫األفضم‬ ‫انغشٚشٚح‬ ‫انًًاسعح‬ ٔ ‫انًعشفح‬ ‫ٚرغٛش‬ .‫ضشٔسٚح‬ ‫ذظثر‬ ‫لذ‬ ‫انطثٛح‬ ‫انًعاندح‬ ٔ‫أ‬ ،‫انًسرشفح‬ ‫انًًاسعاخ‬ ،‫انثسث‬ ‫طشق‬ ٙ‫ف‬ ‫انرغٛشاخ‬ ٔ ،‫فًُٓا‬ ٔ ‫ذمٛٛى‬ ٙ‫ف‬ ‫انخاطح‬ ‫يعشفرٓى‬ ٔ ‫خثشذٓى‬ ٗ‫عه‬ ً‫ا‬ً‫دائ‬ ‫االعرًاد‬ ٍٛ‫انثازث‬ ٔ ٍٛٚ‫انغشٚش‬ ٍٛ‫انًًاسع‬ ٗ‫عه‬ ‫ٚدة‬ ‫ي‬ ‫ْكزا‬ ‫اعرخذايٓى‬ ٖ‫نذ‬ .‫ُْا‬ ‫يشغٕتح‬ ‫ذداسب‬ ٔ‫أ‬ ،‫عُاطش‬ ،‫طشق‬ ،‫يعهٕياخ‬ ‫أٚح‬ ‫اعرخذاو‬ٌ‫أ‬ ‫ٚدة‬ ‫طشق‬ ٔ‫أ‬ ‫عهٕياخ‬ .‫يُٓى‬ ٍٛ‫انًغؤٔن‬ ٗ‫انًشض‬ ‫فٛٓى‬ ‫تًا‬ ،ٍٚ‫اٜخش‬ ‫عاليح‬ ٔ ‫انشخظٛح‬ ‫عاليرٓى‬ ‫اعرثاسْى‬ ٙ‫ف‬ ‫ٚضعٕا‬ ( ‫انًعطاج‬ ‫انسانٛح‬ ‫انًعهٕياخ‬ ٍ‫ع‬ ‫تانثسث‬ ٌٕ‫انماسئ‬ ‫ُٚظر‬ ،‫يعشف‬ ٙ‫دٔائ‬ ٍ‫يُرح‬ ٔ‫أ‬ ‫دٔاء‬ ٘‫أل‬ ‫االزرشاو‬ ‫يع‬iٍ‫ع‬ ) ( ٔ‫أ‬ ‫انًعشٔضح‬ ‫اإلخشاءاخ‬ii‫ٚرى‬ ‫يُرح‬ ‫كم‬ ‫ُع‬َ‫ظ‬ُ‫ي‬ ‫تٕاعطح‬ )،‫انرشكثٛح‬ ٔ‫أ‬ ‫تٓا‬ ٗ‫انًٕط‬ ‫اندشعح‬ ٍ‫ي‬ ‫نهرأكذ‬ ،ّ‫ذطثٛم‬ ٔ ‫انخاطح‬ ‫خثشذٓى‬ ٗ‫عه‬ ‫االعرًاد‬ ،ٌٕ‫انًًاسع‬ ‫يغؤٔنٛح‬ ‫إَٓا‬ .‫االعرطثاب‬ ‫يضاداخ‬ ٔ ،‫انرطثٛك‬ ‫يذج‬ ٔ ‫طشٚمح‬ ‫خًٛع‬ ‫الذخار‬ ٔ ،‫يشٚض‬ ‫نكم‬ ‫األفضم‬ ‫انعالج‬ ٔ ‫اندشعح‬ ‫يمذاس‬ ‫نرسذٚذ‬ ،‫انرشخٛض‬ ‫نٕضع‬ ،‫تًشضاْى‬ ‫يعشفرٓى‬ .‫انغاليح‬ ‫إخشاءاخ‬ ٗ‫إن‬ٔ‫أ‬ ،ًٍْٛ‫انًغا‬ ٔ ،ٍٛ‫انًؤنف‬ ‫ال‬ ٔ ‫انُاشش‬ ٗ‫عه‬ ‫يغؤٔنٛح‬ ‫أٚح‬ ‫ذمع‬ ‫ال‬ ،ٌَٕ‫انما‬ ّ‫ت‬ ‫ٚغًر‬ ‫زذ‬ ٗ‫ألظ‬ ،‫انًُرداخ‬ ‫يغؤٔنٛح‬ ‫عثٛم‬ ٗ‫عه‬ ‫انًًرهكاخ‬ ٔ‫أ‬ ‫األشخاص‬ ‫ٚظٛة‬ ‫لذ‬ ٘‫انز‬ ‫ضشس‬ ٔ‫ٔ/أ‬ ‫إطاتح‬ ‫أٚح‬ ٍ‫ع‬ ،ٍٚ‫انًسشس‬ ‫أ‬ ،‫ذعهًٛاخ‬ ،‫يُرداخ‬ ٔ ،‫ٔعائم‬ ٍ‫ي‬ ٘‫أ‬ ‫ذشغٛم‬ ٔ‫أ‬ ‫اعرخذاو‬ ٘‫أ‬ ٍ‫ع‬ ٔ‫أ‬ ،‫غٛشْا‬ ٔ‫أ‬ ‫اإلًْال‬‫األفكاس‬ ٔ .‫ُْا‬ ‫انٕاسدج‬ ‫انًٕاد‬ ٙ‫ف‬ ‫انٕاسدج‬ Library of Congress Cataloging-in-Publication Data Kassab Firas Faciale Fractures Firas J. Kassab,.2th ed. Design: Firas Kassab Printed in Syria
  • 5.
    ّ‫انٕخ‬ ‫عظاو‬ ‫كغٕس‬ ‫كساب‬‫جودت‬ ‫فراس‬ َّ‫عهطا‬ ‫عظٛى‬ ٔ ّٓ‫ٔخ‬ ‫تدالل‬ ‫ٚهٛك‬ ‫كًا‬ ‫زًذا‬ ‫هلل‬ ‫انسًذ‬ ّ‫َفغ‬ ٗ‫عه‬ ْٕ ُٗ‫أث‬ ‫كًا‬ ّٛ‫عه‬ ً‫ء‬‫ثُا‬ ٙ‫َسظ‬ ‫ال‬ َّ‫عثسا‬ ٗ‫إن‬ ‫ٓذاج‬ُ‫ي‬ ‫انطثعح‬ ِ‫ْز‬‫انعضٚض‬ ٘‫ٔانذ‬ ‫سٔذ‬ ‫انغانٛح‬ ٙ‫ٔانذذ‬ ٗ‫إن‬ ٙ‫تُاذ‬ ٔ ٙ‫صٔخر‬ ٙ‫أطذلائ‬ ٔ ٙ‫إخٕذ‬ ‫خٕدخ‬ ‫فشاط‬‫كغاب‬ 21-11-2017
  • 6.
    ّ‫انٕخ‬ ‫عظاو‬ ‫كغٕس‬ ‫كساب‬‫جودت‬ ‫فراس‬ ‫يمذيح‬ ‫تغٛطح‬ ‫فكشج‬ ‫إعطاء‬ ‫يع‬ ّ‫انٕخ‬ ‫عظاو‬ ‫ذظٛة‬ ٙ‫انر‬ ‫انكغٕس‬ ‫يدًم‬ ‫انكراب‬ ‫ْزا‬ ٙ‫ف‬ ‫ذُأنُا‬ ٔ ‫انعانًٛح‬ ‫انرظاَٛف‬ ٍ‫ع‬‫انعًم‬ ‫ذفظٛم‬ ٙ‫ف‬ ‫انذخٕل‬ ٌٔ‫د‬ ٔ ‫انعالج‬ ٔ ‫انرشخٛض‬ ٍ‫ع‬ ‫زذٔثا‬ ‫األكثش‬ ‫انكغٕس‬ ‫دساعح‬ ‫زأنُا‬ ‫لذ‬ ٔ ، ٙ‫اندشاز‬ ٔ ٙ‫شخظ‬ ‫خٓذ‬ ْٕ ‫انعًم‬ ‫ْزا‬‫ٔاكثد‬ ‫لذ‬ ٔ ‫انطثاعٛح‬ ‫األخطاء‬ ٍ‫ي‬ ِٕ‫خه‬ ‫خاْذا‬ ‫عًهد‬ ‫لذ‬ ٙ‫ف‬ ٙ‫يشاعهر‬ ‫أسخٕا‬ ٔ ‫انعهًٛح‬ ‫انًماٚٛظ‬ ٔ ‫انًفاْٛى‬ ٍ‫ي‬ ‫انكثٛش‬ ‫انثانثح‬ ‫انطثعح‬ ‫ْزا‬ ٙ‫ف‬ ٘‫أ‬ ‫ٔخٕد‬ ‫زال‬‫أخطاء‬ُٙ‫ي‬ ‫عٕٓا‬ ‫عمطد‬:Kessab1976@hotmail.com ‫انعًم‬ ‫ْزا‬ ‫خالل‬ ٍ‫ي‬ ‫أسخٕا‬‫انطثٛح‬ ‫يُٓرُا‬ ‫ذطٕٚش‬ ٙ‫ف‬ ‫تغٛطح‬ ‫يسأنح‬ ‫لذيد‬ ‫لذ‬ ٌٕ‫أك‬ ٌ‫أ‬ ‫انغايٛح‬ ‫خٕدخ‬ ‫فشاط‬‫كغاب‬ َٙ‫انثا‬ ٍٚ‫ذشش‬2017 ‫طفش‬1431
  • 8.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 1 ّ‫ػظخ‬ ًٍٞٔٚ‫حُٞؿ‬
  • 9.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 2 ٟٞ‫حُٔلظ‬ ‫ٓويٓش‬...........................................................................................................7 ‫طٜٔ٤ي‬...............................................................................................................8 ‫حُظَ٘٣ق‬٢‫حُـَحك‬...............................................................................................10 ٚ٤‫حُظ٘و‬٢‫حُ٘ؼخػ‬...........................................................................................10 ٌَ٤ُٜ‫ح‬٢ٜ‫حُٞؿ‬١ِٞ‫حُؼ‬.........................................................................................11 ٌَ٤ُٜ‫ح‬٢ٜ‫حُٞؿ‬٢ٓٝ٧‫ح‬........................................................................................11 ‫حُلي‬٢ِ‫حُٔل‬....................................................................................................14 ‫اٛخرش‬ًٍّٞٔ‫ػظخ‬ٖ٤ٌ‫حُل‬ٝٚ‫حُٞؿ‬ٝ‫ٓلخِٜٛخ‬..........................................................15 ‫حُٔ٠خػلخص‬........................................................................................................15 ‫حُوطٍٞس‬............................................................................................................15 ‫حُٞهخ٣ش‬..............................................................................................................15 ًٍٞٔ‫حُلي‬٢ِ‫حُٔل‬..........................................................................................17 ‫ٓويٓش‬..............................................................................................................17 ‫حُظٜ٘٤ق‬..........................................................................................................18 ‫أٓزخد‬ًٍٞٔ‫حُلي‬٢ِ‫حُٔل‬................................................................................21 ٝ‫أػَح‬ًٍٞٔ‫حُلي‬٢ِ‫حُٔل‬................................................................................22 ٌَُٔ‫ح‬٢ُ٘ٔ‫ح‬٢‫حُٔ٘و‬.....................................................................................22 ًَٔ‫حُِؤش‬........................................................................................................23 ًٍٞٔ‫حُ٘خطت‬١ٍ‫حُٔ٘وخ‬........................................................................................23 ًٍٞٔ‫حَُأى‬........................................................................................................23 ًٍٞٔ‫حُِحٝ٣ش‬.......................................................................................................23 ًٍْٞٔٔ‫ؿ‬‫حُلي‬................................................................................................23 ًٍٞٔ‫اٍطلخم‬ٖ‫حٌُه‬‫ٝؿخٗذ‬‫ح٩ٍطلخم‬....................................................................24 ٚ‫حُلل‬١َ٣َُٔ‫ح‬..................................................................................................24 ٚ‫حُلل‬‫هخٍؽ‬١ٞٔ‫ك‬..........................................................................................24 ٚ‫حُلل‬َ‫ىحه‬١ٞٔ‫حُل‬.........................................................................................24 ْ‫حُـ‬...........................................................................................................25 ٚ‫حُلل‬٢‫حُ٘ؼخػ‬............................................................................................26 ‫هخٍؽ‬١ٞٔ‫ك‬...................................................................................................26 َ‫ىحه‬ْ‫حُل‬......................................................................................................27 ‫حُٔؼخُـش‬..........................................................................................................27 ‫حُٔؼخُـش‬‫حُزيث٤ش‬..............................................................................................27
  • 10.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 3 ‫ٓؼخُـش‬ًٍٞٔ‫حُلي‬٢ِ‫حُٔل‬١ٝ‫حُلخ‬٠ِ‫ػ‬ٕ‫ح٧ٓ٘خ‬..................................................28 ‫حَُى‬..............................................................................................................28 ‫حُظؼز٤ض‬...........................................................................................................28 ‫أٓخُ٤ذ‬‫حُظؼز٤ض‬..............................................................................................28 ‫طؼز٤ض‬‫ٓؼظٔي‬٠ِ‫ػ‬ٕ‫ح٧ٓ٘خ‬..............................................................................28 ‫حُظؼز٤ض‬َٗ‫حُٔزخ‬٢‫ك‬ْ‫حُؼظ‬...................................................................................30 ‫حُو٤خ١ش‬ٖٟٔ‫حُؼظٔ٤ش‬.....................................................................................31 ‫حُو٤خ١ش‬‫حُيحثَ٣ش‬................................................................................................32 ‫حُٜلخثق‬‫حُؼظٔ٤ش‬.............................................................................................33 ْ٤‫حُيرخر‬‫حُوخٍؿ٤ش‬‫حُٔؼزظش‬.................................................................................34 ‫حُٔوخُذ‬‫حُؼظٔ٤ش‬.............................................................................................35 ‫أٓ٬ى‬َ٘٘٣ًَ................................................................................................35 ٍ‫اهظ٤خ‬‫أِٓٞد‬‫حُظؼز٤ض‬........................................................................................35 ًٍٞٔ‫حُِؤش‬...................................................................................................36 ‫حُظٜ٘٤ق‬...........................................................................................................36 ٚ٤‫حُظ٘و‬......................................................................................................38 ‫حُٔؼخُـش‬.........................................................................................................41 ٍ‫ح٧١لخ‬.........................................................................................................41 ٖ٤‫حُزخُـ‬..........................................................................................................41 َٔ‫حُؼ‬٢‫حُـَحك‬...............................................................................................42 ‫حُظؼز٤ض‬...........................................................................................................46 ّ‫حُطؼخ‬َ‫ٝحُٔٞحث‬..............................................................................................47 ًٍٞٔ‫حُلي‬٢ِ‫حُٔل‬‫ػ٘ي‬ٍ‫ح٧١لخ‬.......................................................................48 ٚ‫حُلل‬١َ٣َُٔ‫ح‬.............................................................................................48 ٚ‫حُلل‬٢‫حُ٘ؼخػ‬............................................................................................48 ‫حُٔؼخُـش‬........................................................................................................48 ًٍٞٔ‫حُلي‬١ِٞ‫حُؼ‬...........................................................................................51 ‫أٓزخد‬ًٍٞٔ‫حُلي‬١ِٞ‫حُؼ‬ٝٚ‫حُٞؿ‬......................................................................51 ‫حُظٜ٘٤ق‬........................................................................................................52 ‫ُٞكٍٞص‬1ٝ‫أ‬ٌَُٔ‫ح‬ْ‫حُؼخث‬..................................................................................53 ‫ُٞكٍٞص‬2ٝ‫أ‬ٌَُٔ‫ح‬٢َُٜٓ‫ح‬................................................................................54 ‫ُٞكٍٞص‬3ٝ‫أ‬ٌٍُٞٔ‫ح‬‫حُٔؼظَٟش‬..........................................................................55 ٝ‫ح٧ػَح‬.........................................................................................................57 ‫حُٔ٠خػلخص‬.....................................................................................................57 ٚ٤‫حُظ٘و‬١َ٣َُٔ‫ح‬.........................................................................................57 ‫حُؼ٬ؽ‬............................................................................................................60
  • 11.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 4 ‫حَُى‬...............................................................................................................61 ‫حُظؼز٤ض‬..........................................................................................................62 ‫طؼز٤ض‬٢ِ‫حُيحه‬................................................................................................62 ‫طؼز٤ض‬٢‫حُوخٍؿ‬...............................................................................................66 ‫ح٧ً٣خص‬‫حَُٔحكوش‬ٝ‫ح٩هظ٬١خص‬.............................................................................68 ًَٔ‫هخع‬‫حُلـخؽ‬.............................................................................................68 ‫حُؼ٬ٓخص‬‫حَُٔ٣َ٣ش‬...........................................................................................69 ‫حُٔؼخُـش‬.......................................................................................................70 َ٤ٛ‫حُظؤ‬.........................................................................................................72 ًٍْٞٔ‫ػظ‬‫ح٧ٗق‬ٝ‫حًَُٔذ‬٢‫ح٧ٗل‬٢ُ‫حُـَرخ‬........................................................73 ‫ٓويٓش‬........................................................................................................73 ‫ح٧ٓزخد‬......................................................................................................74 ‫طٜ٘٤ق‬........................................................................................................74 ٝ‫ح٧ػَح‬......................................................................................................77 ٚ٤‫حُظ٘و‬..................................................................................................78 ‫اهظ٬١خص‬ٌُٔ‫ح‬َ...........................................................................................80 ‫حُؼ٬ؽ‬.........................................................................................................80 َ‫حُٔيحه‬‫حُـَحك٤ش‬.........................................................................................81 َ‫ٓيه‬٢‫هخٍؿ‬..............................................................................................81 َ‫ٓيه‬٢ِ‫ىحه‬...............................................................................................83 ‫حَُى‬ٝ‫حُظؼز٤ض‬...............................................................................................83 ‫اٗو٬ع‬‫ٓآم‬ٖ٤‫حُؼ‬..........................................................................................84 ‫اٛخرش‬‫حُو٘خس‬‫حُيٓؼ٤ش‬......................................................................................85 ‫حُٔ٠خػلخص‬...................................................................................................86 ‫حُ٘وخٛش‬........................................................................................................86 ‫حُؼ٘خ٣ش‬‫حٌُحط٤ش‬..................................................................................................86 ‫حُٞهخ٣ش‬..........................................................................................................87 ًٍْٞٔ‫حُؼظ‬٢٘‫حُٞؿ‬.......................................................................................88 ‫ٓويٓش‬..........................................................................................................88 ‫ح٧ٓزخد‬........................................................................................................89 ‫حُظٜ٘٤ق‬........................................................................................................89 ٝ‫ح٧ػَح‬........................................................................................................91 ٚ‫حُلل‬١َ٣َُٔ‫ح‬ٝٚ٤‫حُظ٘و‬.............................................................................91 ‫حُوٜش‬‫حَُٔ٣َ٣ش‬...............................................................................................91 ٚ‫حُلل‬١َ٣َُٔ‫ح‬.............................................................................................91 ٚ‫حُلل‬٢‫حُ٘ؼخػ‬...........................................................................................92
  • 12.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 5 ‫حُٔ٠خػلخص‬....................................................................................................93 ‫حُؼ٬ؽ‬...........................................................................................................94 ‫حُؼ٬ؽ‬‫حُٔلخكع‬...............................................................................................94 ‫حُؼ٬ؽ‬٢‫حُـَحك‬..............................................................................................95 ‫حَُى‬..............................................................................................................95 ‫حُ٘ن‬٢‫حُـَحك‬..............................................................................................98 ‫حُظؼز٤ض‬.........................................................................................................100 ‫حُٔ٠خػلخص‬....................................................................................................101 ‫حَُٔحؿغ‬........................................................................................................102
  • 13.
  • 14.
  • 15.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 7 ‫اٛيحء‬ ٠ُ‫ا‬٢ُ‫حُـخ‬ ١‫ٝحُي‬ ‫ٍٝف‬ ٢‫ٝحُيط‬‫حُؼِ٣ِس‬ ٢‫ُٝؿظ‬‫حُلز٤زش‬ ٢‫ر٘خط‬‫حُلز٤زخص‬ ٢‫اهٞط‬٢‫أٛيهخث‬ ٝ : ‫ٓويٓش‬ ٕ‫ا‬ًٌٍَٞٔ٤ُٜ‫ح‬٢ٜ‫حُٞؿ‬٢ٛ‫ؿِء‬ٖٓ‫اٛخرخص‬‫ٓ٘طوش‬ٚ‫حُٞؿ‬ٖٝ٤ٌ‫حُل‬َٟٝ‫أه‬ ‫اٛخرخص‬ ‫ٓغ‬ ‫طظَحكن‬‫ٓوظِلش‬‫حُيٍؿخص‬‫ُ٨ٗٔـش‬ ‫حُٔل٤طش‬‫رخُٔ٘طوش‬.ٝ‫ًٌُي‬‫ح٧ؿِحء‬‫حُل٤ٞ٣ش‬َ‫ٓؼ‬ٖ٤‫حُؼ‬ٝ١ٍ‫ٓـخ‬‫حُٜٞحء‬ٝ‫حُـ٤ٞد‬‫حُٔـخٍٝس‬‫ُ٨ٗق‬ٝ‫ًٌُي‬ٕ‫حُِٔخ‬. ‫طظلخٝص‬‫ىٍؿخص‬‫ح٩ٛخرش‬٢‫ك‬ٌٙٛ‫حُٔ٘طوش‬ٖٓ‫ٓـَى‬‫ؿَف‬٢٤ٔ‫ر‬٠ُ‫ا‬‫اٛخرخص‬‫رخُـش‬‫حُوطٍٞس‬َ‫طئػ‬٠ِ‫ػ‬ٌَ٤ُٜ‫ح‬٢ٜ‫حُٞؿ‬َٓ‫رخٌُخ‬ٝ ٝ ُٚٞ‫ك‬ ‫ٓخ‬‫ٜٓ٘خ‬ َٟ‫أه‬ ‫اهظٜخٛخص‬ ٠ُ‫ا‬ ‫طٔظي‬ ‫اٜٗخ‬ ً‫ا‬ ‫ٓليى‬ ٍ‫ٓـخ‬ ٢‫ك‬ ‫كَٜٛخ‬ ٌٖٔ٣ ٫ ٢‫حُظ‬ ٝ ‫حُٔؼويس‬ ‫ح٩ٛخرخص‬ ٖٓ ٢ٛ‫حُـَحكش‬ ‫حُظـٔ٤ِ٤ش‬ ‫حُـَحكش‬ ٝ ‫حُؼ٘ن‬ ‫ؿَحكش‬ ٝ ‫حُؼٜز٤ش‬ ٫‫ا‬ ٌٕٞ٣ ُٖ َ٤‫كخُظير‬ ٍِ‫ٓ٘ؼ‬ ًَٔ ‫ٓ٘خٛيس‬ ‫ٗٔز٤خ‬ ٍ‫حُ٘خى‬ ٖٓ ٚٗ‫أ‬ ٠ُ‫ا‬ ‫ٗظَح‬ َٟٝ‫ح٧ه‬ ‫ح٩هظٜخٛخص‬ ‫ٓغ‬ ‫رخُٔ٘خًٍش‬ ‫ؿَحك٤خ‬ ‫طير٤َٛخ‬ ٝ ‫حُٜٔخرش‬ ‫حُٔ٘طوش‬ ‫كٔذ‬ ٚ‫حُٞؿ‬ ًٍٞٔ ‫رزلغ‬ ‫هٔ٘خ‬ ‫حَُٔ٘ٝع‬ ‫ٌٛح‬ ٢‫ك‬ ‫ٝكوض‬ ‫هي‬ ًٕٞ‫أ‬ ٕ‫أ‬ ‫أٍؿٞح‬ ٝ ٖ٤ٌ‫حُل‬ ٝ ٚ‫حُٞؿ‬ ‫ؿَحكش‬ ٙ‫اهظٜخ‬ ْ‫ُيػ‬ ‫ٓلخُٝش‬ ٖٓ َ‫أًؼ‬ ‫٣ؼيٝح‬ ٫ ‫حٌُظخد‬ ‫ٌٛح‬ ‫ًٔخد‬ ‫ؿٞىص‬ ّ‫كَح‬َ‫ٗٞكٔز‬2016 َ‫ٛل‬1438
  • 16.
  • 17.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 8 : ‫طٜٔ٤ي‬ ٝ ٚ‫حُٞؿ‬ ًٍٞٔ َٔ٘‫ط‬٢ِ٣‫ٓخ‬ ٖ٤ٌ‫حُل‬: *ً‫اىجثه‬ ٌ‫اىؼظ‬ ‫مسىس‬ ‫رٔزذ‬ ‫طليع‬٧‫ح‬ ٜٚ‫حُـز‬ ٠ِ‫ػ‬ ‫ٓزخَٗس‬ ‫هٞ٣ش‬ ‫َٟرش‬‫ٓخٓ٤ش‬ٝ‫أ‬‫كٞم‬( ‫حُلـخؽ‬ٖ٤‫حُؼ‬ َ‫ٓلـ‬)ٝ ،٢‫حُظ‬ْ‫حُؼظ‬ ًَٔ ‫طٔزذ‬ ٧‫ح‬ ٚ‫ؿِث‬ ( ٢ٜ‫حُـز‬ٝ ٢ٓ‫ٓخ‬ٝ ) ٢‫حُوِل‬‫ر‬ ‫حُٜٔخد‬ َ‫٣٘ؼ‬ ً‫س‬‫ػخى‬ٔ٘٠ِ‫ػ‬ َ‫ا‬‫ٓخكٞم‬ ‫حُؼٜذ‬ ‫ٓظيحى‬‫حُلـخؽ‬. *‫مسىس‬: ‫اىحجاج‬ ‫ط‬ٞ‫ر‬ ‫َٟرش‬ ‫رٔزذ‬ ‫ليع‬‫ح‬‫ٓخ١ش‬‫آ‬ُ ‫كخىس‬ َ٤‫ؿ‬ ‫ُش‬‫ِلـخؽ‬‫أ‬ٝ‫أ‬‫ىحس‬‫أ‬٢‫ك‬ ‫حٌَُحص‬ ( َ‫حُٔلـ‬ َ‫ٓيه‬ ٖٓ ‫كـٔخ‬ َ‫ًز‬ٟ‫حَُ٣خ‬‫ش‬ٝ )َ‫٣٘ؼ‬ ‫ػخىس‬ ‫رظ٠خػق‬ ‫حُٜٔخد‬‫حَُإ٣خ‬(Diplopia) *‫االّف‬ ‫مسىس‬: ٧‫ح‬ ٠ِ‫ػ‬ ‫َٟرش‬ ‫رٔزذ‬ ‫طليع‬‫ِٗف‬ ‫٣ٜخكزٜخ‬ ‫ٗق‬ *‫اىىجْح‬ ‫مسىس‬: ‫ٗي٣ي‬ ‫َٟرش‬ ‫رٔزذ‬ ‫طليع‬‫حَُٔكن‬ ْ‫ػظ‬ ‫رٞحٓطش‬ ‫حُٞؿ٘ش‬ ٠ِ‫ػ‬ ٙ‫أ‬‫رٞحٓطش‬ ٝ‫أ‬ٝ ‫ىحس‬ٔ٘‫ٝحُظ‬ ‫حُظ٘٘ؾ‬ ‫طٔزذ‬ ‫هي‬٤‫طلض‬ ‫حُؼٜذ‬ ٢‫ك‬ َ ‫حُلـخؽ‬. *‫اىفل‬ ‫مسىس‬‫اىؼيىي‬: َٝٔ٘‫ط‬: -٠ِ‫أػ‬ َٝ‫ٓٔظؼ‬ ًَٕٔ‫ح٧ٓ٘خ‬ -َُٜٓ‫ح‬ ٌَُٔ‫ح‬٧‫ح‬ ْ‫ػظ‬ َٔ‫ؿ‬ ٚ‫هٔظ‬ ( ٠ِ‫ح٧ػ‬ ‫ُِلي‬ ٢ٝ ‫ٗق‬ٝ ‫ُِـخٗذ‬ ٚ‫٣ظـ‬َ‫ح٧ٓل‬) -ٝ ‫ُِـٔـٔش‬ ّ‫طخ‬ ًَٔٝ )ْٜ٘‫ط‬ ( ٚ‫حُٞؿ‬ٝ ‫حُٞؿ٘ش‬ ًٍٞٔ َٔ٘٣‫حُٔل‬ ٖ٤‫حُؼ‬ َ‫ٓلـ‬ ‫كيٝى‬ٝ ‫ِ٤ش‬ُ‫ح‬ ‫حُلي‬١ِٞ‫ؼ‬ٝ ،‫٣لظخؽ‬ ‫ٌٛح‬ُ‫ا‬٠ ‫ػخُ٤ش‬ ‫هٞس‬,ٝٝ ٖ٤٤ٟ‫حَُ٣خ‬ ‫ػ٘ي‬ ‫ٗخثغ‬ ٌٕٞ٣٫ ‫ٌُٜح‬٢‫ك‬ ‫٣ليع‬ ‫هي‬ ٌُٖ‫(حًُٜٞ٢،حُز‬ َ‫ٓؼ‬ ‫حَُ٣خٟخص‬ ٞ‫رؼ‬ٝ )ٍٞ‫٤ٔز‬‫ٌٛح‬ ٢‫ك‬ ‫ػخىس‬ ٩‫ح‬ ٖٓ ‫حُ٘ٞع‬‫حَُإ٣خ‬ ‫ٓ٠خػلش‬ ‫٣ليع‬ ‫ٛخرش‬(Diplopia)٩‫ح‬ ّ‫ػي‬ ‫ٓغ‬٢‫ك‬ ّ‫ٗظظخ‬‫ا‬‫١زخ‬٧‫ح‬ ‫م‬ٝ ٕ‫ٓ٘خ‬ٔ٘‫حُظ‬٤َ. *‫اى‬ ‫اىفل‬ ‫مسىس‬: ً‫سفي‬ ٩‫ح‬ ّ‫ػي‬ ‫٣٬كع‬٢‫ك‬ ّ‫ٗظظخ‬‫ا‬٧‫ح‬ ‫١زخم‬‫ٓغ‬ ‫حُٜٔخد‬ ‫ػ٘ي‬ ٕ‫ٓ٘خ‬‫أ‬‫حُلي‬ ُْ ٝ ‫طَحًذ‬ ‫ُطَ٣وش‬ َ‫رخُ٘ظ‬‫رؼ٠ٜخ‬ ‫ٓغ‬ ّ‫حُؼظخ‬ ٌٙٛ َ‫طيحه‬‫ك‬‫ح٧ؿِحء‬ ‫رو٤ش‬ ٠ِ‫ػ‬ َ٤‫حُظؤػ‬ ٕٝ‫ى‬ ‫ٜٓ٘خ‬ ‫ؿِء‬ ٌَٔ٘٣ ٕ‫أ‬ ‫حُٜؼذ‬ ٖٓ ٚٗ‫ؤ‬ ‫حُٔـخٍٝس‬ٝ ٚ‫ٍإ٣ظ‬ ‫حُٜؼذ‬ ٖٓ ّ‫ُِؼظخ‬ ‫حُظلظض‬ ‫ٌٛح‬ .ٝ ‫ٓـِوش‬ ً‫ح‬ًٍٞٔ ٚ‫حُٞؿ‬ ٢ٓٝ ‫ٓ٘طوش‬ ًٍٞٔ ٌٕٞ‫ط‬ ‫ٓخ‬ ً‫خ‬‫ؿخُز‬‫ٓظويٓش‬ ‫كخ٫ص‬ ٢‫ك‬ ٠ُ‫ا‬ ٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ ‫٣ظلظض‬ ‫هي‬60ٝ‫أ‬70.ً‫ء‬ِ‫ؿ‬ ًٔ ْ٤ٔ‫طو‬ ٌٖٔ٣:ٖ٤‫ٗٞػ‬ ٠ُ‫ا‬ ‫ػخٓش‬ ٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ ٍٞ 1-ًٍٞٔٝ ّ‫حُؼظخ‬ ٢‫ك‬ ‫طلظض‬ ٕٝ‫ى‬‫حُِ٤٘ش‬ ٝ‫أ‬ ‫حُِٜزش‬ ‫ح٧ٗٔـش‬ ٖٓ ‫أؿِحء‬ ‫كوي‬ ٕٝ‫ى‬ 2-ٝ ّ‫ُِؼظخ‬ ‫طلظض‬ ‫ٓغ‬ ًٍٞٔ‫حُِ٤٘ش‬ ٝ‫أ‬ ‫حُِٜزش‬ ‫ح٧ٗٔـش‬ ٖٓ ‫٧ؿِحء‬ ‫كوي‬ ٍٝ٧‫ح‬ ‫حُ٘ٞع‬ ٖٓ ٢ٛ ٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ ًٍٞٔ ْ‫ٓؼظ‬٢ٜ‫ك‬ ٢ٗ‫حُؼخ‬ ‫حُ٘ٞع‬ ٌٍُٞٔ ‫رخُ٘ٔزش‬ ‫أٓخ‬ .٢‫ك‬ ‫حُٜٞحٍ٣ن‬ ٖٓ ‫اٛخرخص‬ ‫ٗظ٤ـش‬ ً‫خ‬‫ؿخُز‬ ٝ ‫حُٜٔخٗغ‬ ‫اٛخرخص‬ ٝ‫أ‬ ‫حُلَٝد‬٤‫حٌُز‬ ‫ح٧ؿِٜس‬ ‫ك٤ٜخ‬ ّ‫طٔظوي‬ ٢‫حُظ‬ََٜ‫طل‬ ‫ك٤غ‬ ‫حُطَم‬ ‫كٞحىع‬ ‫ٗظ٤ـش‬ ٝ‫أ‬ ‫س‬‫ا‬ْٔ‫ؿ‬ ٖٓ ‫ٓزخَٗس‬ ‫ٛخرش‬ .‫ًز٤َس‬ ‫رَٔػش‬ ‫٣ظلَى‬ ‫كخى‬
  • 18.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 9 ٝ٢‫ك‬ ً‫ء‬‫ٓٞح‬ ٍٝ٧‫ح‬ ْٔ‫حُو‬ ‫ػ٬ؽ‬ ٖ‫ػ‬ ً‫خ‬٣ٌٍ‫ؿ‬ ‫٣وظِق‬ ٌٍُٞٔ‫ح‬ ٖٓ ٢ٗ‫حُؼخ‬ ْٔ‫حُو‬ ‫ػ٬ؽ‬ ٕ٧ ‫ٓخ‬ ً‫خ‬‫ٗٞػ‬ ‫ٓل٤ي‬ ّ‫حُؼخ‬ ْ٤ٔ‫حُظو‬ ‫ٌٛح‬ َ‫٣ؼظز‬ ٍٞ١٢ُٝ٧‫ح‬ ‫حُؼ٬ؽ‬‫أ‬.‫حُز٘خء‬ ‫اػخىس‬ ‫ػِٔ٤ش‬ ٢‫ك‬ ٝ ٢ٜ‫حُ٘و‬ ‫حُؼ٘ق‬ :٢ٛ ‫كيٝػٜخ‬ ‫طَط٤ذ‬ ‫كٔذ‬ ٚ‫حُٞؿ‬ ّ‫ػظخ‬ ٌٍُٞٔ ‫حُٔؼخَٛس‬ ‫ح٧ٓزخد‬ ٕ‫ا‬‫حَُ٣خٟ٤ش‬ ‫ح٩ٛخرخص‬ ,١ٞ‫حُٔو‬ ,‫كٞحىع‬ , ٝ ‫حُطَم‬‫ح‬‫حُٜ٘خػ٤ش‬ ‫حُٔ٘خ١ن‬ ٢‫ك‬ ‫٩ٛخرخص‬. ٝ ‫حُؼخٗ٤ش‬ ‫حُؼخُٔ٤ش‬ ‫حُلَد‬ ‫رؼي‬‫ُٔيس‬30ٚ‫حُٞؿ‬ ‫اٛخرخص‬ ٢‫ك‬ َ‫ح٧ًز‬ ‫حُٔزذ‬ ٢ٛ ‫حُطَم‬ ‫كٞحىع‬ ‫ًخٗض‬ ‫ٓ٘ش‬ٝ ,‫رٔخ‬ ‫طظٔزذ‬ ‫ًخٗض‬ ٚ‫ٗٔزظ‬35ٝ60.ٚ‫حُٞؿ‬ ّ‫ػظخ‬ ًٍٞٔ ٖٓ ‫رخُٔجش‬ َ‫طظؤػ‬ٝ ‫حُٔوظِلش‬ َٓ‫حُؼٞح‬ ‫أٛٔ٤ش‬‫حُظ‬٢ًٞٔ ‫كيٝع‬ ‫ٗٔزش‬ ٠ِ‫ػ‬ َ‫طئػ‬‫حُظخُ٤ش‬ َٓ‫رخُؼٞح‬ ٚ‫حُٞؿ‬ ّ‫ػظخ‬ ٍ: 1-٢‫حُــَحك‬ ‫حُٔٞهغ‬ 2-‫ح٩ؿظٔخػ٤ش‬ ‫حُل٤خس‬ ٢ٔٗ 3-ٝ ٍٞ‫حٌُل‬ٝ ‫حُٔويٍحص‬ٜٗ‫اىٓخ‬ٔ‫خ‬ 4-ٝ ٖ٤ٗ‫هٞح‬ٍَُٝٔ‫ح‬ ّ‫أكٌخ‬ 5-ْٓ‫حُٔٞح‬ ٝ ٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ًٍٞٔ ٚ‫حُٞؿ‬ ٖٓ ٠‫حُٞٓط‬ ‫حُٔ٘طوش‬ ًٍٞٔ َٔ٘‫ط‬ٝ ‫ح٧ٗق‬ ّ‫ػظخ‬ ًٍٞٔ‫هي‬ ‫ريٍٝٛخ‬ ٢‫حُظ‬ًٍٞٔ ‫ٗٔزش‬ ٠ِ‫ػ‬ َ‫طئػ‬ ٖٓ ‫ُحى‬ ‫حَُ٣ل٤ش‬ ‫حُٔ٘خ١ن‬ ٢‫ك‬ ‫ح٧كَحى‬ ٖ٤‫ر‬ ٢ٜ‫حُ٘و‬ ‫حُؼ٘ق‬ ‫ُ٣خىس‬ ً٬‫كٔؼ‬ .‫حُلخ٫ص‬ ٖٓ ٖ٤‫ٓؼ‬ ‫ػيى‬ ‫ىٍحٓش‬ ‫ػ٘ي‬ ‫حٌُِ٤ش‬ ٚ‫حُٞؿ‬ ّ‫ػظخ‬ ٝ ‫ح٧ٗق‬ ّ‫أهٔخ‬ ٢‫ك‬ ‫ُٞكيٛخ‬ ‫ح٧ٗق‬ ّ‫ػظخ‬ ًٍٞٔ ‫طؼخُؾ‬ ‫ٓخ‬ ً‫خ‬‫ؿخُز‬ ‫ر٤٘ٔخ‬ ٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ًٍٞٔ ‫كيٝع‬ ٍ‫ٓؼي‬ٝ ًٕ٧‫ح‬‫حُل٘ـَس‬. ( ٍٝٝ ّ‫هخ‬Rowe)( ٢ِ٤ً ٝKilleyّ‫ػخ‬ ٢‫ك‬ )1968َ٤ِ‫رظل‬ ّ1500‫ٛ٘خى‬ ٕ‫ًٝخ‬ ٚ‫حُٞؿ‬ ّ‫ػظخ‬ ًٍٞٔ ٖٓ ‫كخُش‬501ٌٙٛ ٖٓ ‫كخُش‬ ٝ ٚ‫حُٞؿ‬ ٖٓ ٠‫حُٞٓط‬ ‫حُٔ٘طوش‬ ّ‫ُؼظخ‬ ً‫ح‬ًٍٞٔ ١ٞ‫طل‬ ‫حُلخ٫ص‬128ٝ ٢ِ‫حُٔل‬ ‫حُلي‬ ّ‫ُؼظخ‬ ًٍٞٔ ٠ِ‫ػ‬ َٔ‫ط٘ظ‬ ‫كخُش‬‫حُؼِغ‬ ّ‫ػظخ‬ ٢ٓٝ٧‫ح‬ٕ‫أ‬ ١‫أ‬ ,ٚ‫حُٞؿ‬ ٖٓ629٠ِ‫ػ‬ َٔ‫ط٘ظ‬ ‫ًخٗض‬ ‫حُلخ٫ص‬ ٌٙٛ ٖٓ.ٚ‫حُٞؿ‬ ٖٓ ٠‫حُٞٓط‬ ‫حُٔ٘طوش‬ ّ‫ُؼظخ‬ ًٍٞٔ ( ٕ‫ٛخٍ٣وخ‬ ٝ ٢ِ٤ً ّ‫هخ‬ ‫ًٔخ‬Harriganّ‫ػخ‬ ٢‫ك‬ )1975َ٤ِ‫رظل‬ ّ3324ّ‫ػظخ‬ ٢‫ك‬ ًٍٞٔ ‫رٔزذ‬ ٠‫حُٔٔظ٘ل‬ ٠ُ‫ا‬ ‫أىهِض‬ ‫كخُش‬ ٝ ٚ‫حُٞؿ‬ٝ .‫ح٧ؿِحء‬ ‫ٓظؼيىس‬ ً‫ح‬ًٍٞٔ ‫ٓؼظٜٔخ‬ ‫ًخٗض‬‫ػيىٛخ‬ ‫ٝحُزخُؾ‬ ‫حُلخ٫ص‬ ٌٙٛ ٢‫ك‬ ٌٍُٞٔ‫ح‬ ‫ُـٔ٤غ‬ َ‫رخُ٘ظ‬4317‫ٛ٘خى‬ ٕ‫ًخ‬ ً‫ح‬ًَٔ 594.٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ ‫ٓ٘طوش‬ ٢‫ك‬ ً‫ح‬ًَٔ ( ‫اٗي‬ ٕٝ‫طخ‬ ‫ك٤٘ٔ٤ض‬ ّ‫هخ‬Vincent-Townend( ‫ٗ٤لَى‬ ٝ )Shepherdّ‫ػخ‬ ٢‫ك‬ )1994ٝ ٚ‫حُٞؿ‬ ًٍٞٔ ‫كيٝع‬ ٢ٔٗ َ٤ِ‫رظل‬ ّٖ٤ٌ‫حُل‬ ٝ .‫حٍُٔ٘٘ٞس‬ ‫ح٧رلخع‬ ٖٓ ‫ػيى‬ ٠ِ‫ػ‬ ً‫ح‬‫اػظٔخى‬٢‫ك‬ ٚ‫حُٞؿ‬ ٖٓ ٢ٓٝ٧‫ح‬ ‫حُؼِغ‬ ‫ٓ٘طوش‬ ّ‫ػظخ‬ ًٍٞٔ ‫كيٝع‬ ٍ‫ٓؼي‬ ٕ‫رؤ‬ ‫حُٔلخؿؤس‬ ‫ًخٗض‬ ٤ٗ‫رَ٣طخ‬‫حُلي‬ ٌٍٞٔ‫ر‬ ‫ٓوخٍٗش‬ ٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ًٍٞٔ ‫كيٝع‬ ٍ‫ٓؼي‬ ‫ُ٣خىس‬ ‫رٔزذ‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ّ‫ػظخ‬ ٌٍٞٔ‫ر‬ ‫ٓوخٍٗظٜخ‬ ‫ػ٘ي‬ ‫اٍطلغ‬ ‫هي‬ ‫خ‬ ٖ٤‫ر‬ ‫ٓخ‬ .٢ِ‫حُٔل‬60ٝ70.٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ًٍٞٔ ٢ٛ ٚ‫حُٞؿ‬ ٖٓ ٠‫حُٞٓط‬ ‫حُٔ٘طوش‬ ًٍٞٔ ٖٓ ‫رخُٔجش‬ ٠ِ‫ػ‬ ً‫ح‬َ٤‫ًؼ‬ َ‫أػ‬ ‫هي‬ ً‫خ‬‫ٓخرو‬ ‫حًٌُٔٞس‬ ‫حُٔوظِلش‬ َٓ‫حُؼٞح‬ َ٤‫طؤػ‬ ٢‫ك‬ َ٤‫حُظـ‬ ٕ‫ا‬( ‫رَٝى‬ ّ‫هخ‬ ‫كوي‬ .٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ‫كيٝع‬ ٍ‫ٓؼي‬Brook) ( ‫ٝٝى‬ ٝWoodّ‫ػخ‬ ٢‫ك‬ )1983٢‫ك‬ ‫ػوٞى‬ ‫أٍرؼش‬ ‫كظَس‬ ٠ِ‫ػ‬ ٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ ًٍٞٔ ‫كيٝع‬ ٍ‫ٓؼي‬ ٢ٔٗ ٢‫ك‬ َ٤‫حُظـ‬ ‫ٌٛح‬ ٚ‫رلل‬ ّ ٝ .‫آظَؿخػ٤ش‬ ‫ىٍحٓش‬٢ُ‫رلٞح‬ ٢ٜ‫حُ٘و‬ ‫حُؼ٘ق‬ ‫ُحى‬ ُِٖٓ‫ح‬ ٖٓ ‫حُؼوٞى‬ ٌٙٛ ٍ٬‫ه‬ ٕ‫أ‬ ‫ٝؿيح‬75ٝ %٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ًٍٞٔ ‫أٛزلض‬ ٝ ٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ٖٓ ‫ٗؼز٤ش‬ َ‫أًؼ‬ٝ .‫رزؼ٠ٜخ‬ ‫َٓطزطش‬ ‫كوخثن‬ ٌٙٛ٢ٛ ٢ِ‫حُٔل‬ ‫حُلي‬ ‫ُؤش‬ ْ‫ػظ‬ ًٍٞٔ ٕ‫أ‬ ٖٓ ْ‫حَُؿ‬ ٠ِ‫ػ‬ ‫حُلي‬ ٢‫ك‬ ٢‫كو‬ ‫ٝحكيح‬ ً‫ح‬ًَٔ ‫ٛ٘خى‬ ٌٕٞ٣ ‫ػ٘يٓخ‬ َ‫ح٧ًؼ‬ َ‫طؼظز‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ‫ُحٝ٣ش‬ ‫ٓ٘طوش‬ ًٍٞٔ ٕ‫كب‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ٖ٤‫ر‬ َ‫ح٧ًؼ‬ .٢ِ‫حُٔل‬ ٝ ‫ٗ٤لَى‬ ‫ٝؿي‬ّ‫ػخ‬ ٢‫ك‬ َٕٝ‫آه‬1990٩ ‫طؼَٟٞح‬ ٖ٣ٌُ‫ح‬ ٠َُٟٔ‫ح‬ ٖ٤‫ر‬ ٕ‫أ‬ ّ‫ٛ٘خى‬ ٕ‫ًخ‬ ‫ػخٓش‬ ‫ٛخرخص‬83٢ٜ‫حُٞؿ‬ ٌَ٤ُِٜ ً‫ح‬ًٍٞٔ % ٝ66ّ‫ػخ‬ ‫آظؼخى٣ش‬ ‫ىٍحٓش‬ ٢‫ٝك‬ .ٚ‫حُٞؿ‬ ‫أٗٔـش‬ ٢‫ك‬ ً‫خ‬‫طِٔه‬ %1995( ٕٝ‫ُيح‬ ّDownٝ )‫ىٍحٓش‬ ْ‫ط‬ َٕٝ‫آه‬1088‫طؼَٟٞح‬ ً‫خ‬٠٣َٓ ٝ ٚ‫حُٞؿ‬ ٢‫ك‬ ً‫ح‬ًٍٞٔ ْٜ٣‫ُي‬ ٖ٣ٌُ‫ح‬ ‫ٗٔزش‬ ‫ًخٗض‬ .‫هٞ٣ش‬ ‫٩ٛخرخص‬ٖ٤ٌ‫حُل‬15ْٜ‫ػِؼ‬ ,%ٝ ‫حُلخىع‬ ٕ‫ٌٓخ‬ ٢‫ك‬ ‫ٓخطٞح‬21%‫رؼي‬ ‫ٓخطٞح‬ ٝ .٠‫حُٔٔظ٘ل‬ ُْٜٞ‫ىه‬ٝ ‫ح٩ٛخرش‬ ‫هٞس‬ ٞٛ ً‫خ‬‫ؿخُز‬ ‫حُٞكخس‬ ‫ٓزذ‬ ٕ‫أ‬ ٖٓ ْ‫حَُؿ‬ ٠ِ‫ػ‬ٕ‫كب‬ ‫ٛؼٞرظٜخ‬32‫رٔزذ‬ ْٜ‫ٓٞط‬ ٕ‫ًخ‬ ْٜ٘ٓ % .‫حُٔلظَٟش‬ ‫رخُطَ٣وش‬ ْٜٗ‫اٗؼخ‬ ّ‫ػي‬
  • 19.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 10 ٢‫حُـَحك‬ ‫حُظَ٘٣ق‬: ٝ ٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ ‫ُٔ٘طوش‬ ٢‫حُـَحك‬ ‫حُظَ٘٣ق‬ ٕ‫ا‬‫رٜخ‬ ‫حُٔل٤طش‬ ‫ح٧ٗٔـش‬ٝ ٌٍُٞٔ‫ح‬ ٢ٔٗ ْٜ‫ك‬ ٢‫ك‬ ً‫ح‬‫ؿي‬ ْٜٓ‫أؿِحء‬ ‫اِٗ٣خف‬ ‫١َ٣وش‬ ٝ ‫حٌٍُٔٔٞس‬ ّ‫حُؼظخ‬.‫حُٔ٘طوش‬ ٌٙٛ ٢‫ك‬ ‫ٓؼوي‬ َ٤‫ؿ‬ ّ‫اُظجخ‬ ٠ُ‫ا‬ ٍُٞٛٞ‫ح‬ ٢‫ك‬ ‫حُٜٔٔش‬ َٓ‫حُؼٞح‬ ٌَ٤ُٜ‫ح‬ ْ٤ٔ‫طو‬ ‫١َ٣وش‬ ٕ‫ا‬‫ح‬ٝ ١ِٞ‫ػ‬ ‫ػِغ‬ ٠ُ‫ا‬ ٢ٜ‫ُٞؿ‬ٝ ٢ٓٝ‫أ‬ ‫ػِغ‬ٍ‫ح٩ػظزخ‬ ٖ٤‫رؼ‬ ٌ‫ح٧ه‬ ‫ػ٘ي‬ ‫ٓل٤يس‬ ‫١َ٣وش‬ ٢ٛ ٢ِ‫ٓل‬ ‫ػِغ‬ ٤‫ٓؼ‬ ٌٍُٞٔ ‫حُؼ٬ؽ‬ َ٤ٛ‫طلخ‬‫ك‬ .‫حُٔ٘طوش‬ ٌٙٛ ٢‫ك‬ ‫٘ش‬ٔ‫رٔ٘طوش‬ ً‫ح‬‫ٓليٝى‬ ٌٕٞ٣ ‫كَرٔخ‬ ١ِٞ‫حُؼ‬ ‫حُؼِغ‬ ٢‫ك‬ ًَٔ ‫ٛ٘خى‬ ٕ‫ًخ‬ ‫اًح‬ ً٬‫ؼ‬ ٝ ‫حُؼِ٤خ‬ ‫حُـٔـٔش‬ً‫ء‬ِ‫ؿ‬ ٍٙ‫اػظزخ‬ ٌٖٔ٣‫ح‬ٝ ٚ‫حُٞؿ‬ ‫اٛخرخص‬ ّٖٓ‫ُؼظخ‬ ًٍٞٔ ٠ِ‫ػ‬ َٔ٘٣ ‫ػ٘يٓخ‬ ٖ٤ٌ‫حُل‬ٝ‫حُلـخؽ‬ ‫كٞحف‬ٝ‫ح٧ٗق‬ ّ‫ػظخ‬ ٝ٢ُ‫حُـَرخ‬ ْ‫حُؼظ‬. ٌٖٔ٣ ‫رخُـٔـٔش‬ ٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ ‫ػ٬هش‬ ٕ‫ا‬ٝ ٢ٔ‫ٓز‬ ‫ًٗٔٞؽ‬ ٢‫ك‬ ‫اهظٜخٍٛخ‬‫أٓخٓ٤خص‬ ٝ ‫ح٩ٛخرخص‬ ٢ٔٗ ْٜ‫ك‬ ٠ِ‫ػ‬ ‫٣ٔخػي‬ ١ٌُ‫ح‬ ٝ . ‫حُؼ٬ؽ‬ٍ‫ا١خ‬ ‫ًحص‬ ‫رٍٜٞس‬ ٚ‫ٓوخٍٗظ‬ ٌٖٔ٣ ّ‫ح٧ٓخ‬ ٖٓ ٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ ٠ُ‫ا‬ َ‫رخُ٘ظ‬٢‫ك‬ ٢ٓ‫حُوخ‬ ‫حُـزٜش‬ ْ‫ػظ‬ ٖٓ ٌٕٞٓ ٍ‫ح٩١خ‬ ‫ٌٛح‬ . ٝ ٠ِ‫ح٧ػ‬ٝ ّ‫ػظخ‬ ٖٓ ٖ٤ٌٗٞٓ ٖ٤‫ؿخٗز‬ ُٚ‫كخكش‬ُ‫ح‬‫لـخؽ‬ٝ ‫حُـخٗز٤ش‬.٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ٖٓ ٢‫ح٧كو‬ ٢ِ‫حُٔل‬ ٍ‫ح٩١خ‬ ‫ؿِء‬ ٌٕٞ‫٣ظ‬ ‫ر٤٘ٔخ‬ ٝ ٢ِ‫حُٔل‬ ‫حُلي‬ ّ‫ػظخ‬.‫ٝحكيس‬ ‫ًٌظِش‬ ‫طظلَى‬ ‫ريٍٝٛخ‬ ٢‫حُظ‬ ٝ ٢ِ‫حُٔل‬ ‫حُؼِغ‬ ّ‫ػظخ‬ ٖٓ ‫ٓظؼيىس‬ ّ‫ػظخ‬ ٖٓ ٌٕٞ‫طظ‬ ‫ٓؼويس‬ ‫ٍٛٞس‬ ٠ِ‫ػ‬ ١ٞ‫٣لظ‬ ٍ‫ح٩١خ‬‫حُلـخؽ‬ٝٝ ‫ح٧ٗل٤ش‬ ‫حُـ٤ٞد‬‫ًٔخ‬ .ٕ‫ح٧ٓ٘خ‬ ٌٙٛ ٢‫طـط‬ ٢‫ح٧ٗل‬ ٌَ٤ُٜ‫ح‬ ‫ؿ٠َٝف‬ َ‫ٓؼ‬ ‫حُِ٤٘ش‬ ‫ح٧ٗٔـش‬ ٕ‫أ‬.‫حٍُٜٞس‬ ‫ٌٓٞٗخص‬ ٌَٔ‫ُظ‬ ‫حُٔ٘طوش‬ ٕ‫ا‬ٌُٙٛ‫ح‬‫ٔوخٍرش‬ٍ‫ح٩١خ‬ ‫اٛ٬ف‬ ْ‫ك٤ظ‬ .ٖ٤‫ٓؼ‬ ‫رظَط٤ذ‬ ٌٕٞ٣ ٕ‫أ‬ ‫٣ـذ‬ ‫اٛ٬كٜخ‬ ٕ‫كب‬ ٍ‫ح٩١خ‬ ‫ًحص‬ ‫حٍُٜٞس‬ ٌَٔ‫ط‬ ‫طو٤ِ٘خ‬ ‫كبًح‬ ‫ٓل٤يس‬ ‫ػِٔ٤ش‬ ٝ ‫حُٔلظٞ٣خص‬ َ٤ٛ‫طلخ‬ ‫ر٘خء‬ ‫اػخىس‬ ْ‫٣ظ‬ ْ‫ػ‬ ً٫ٝ‫أ‬‫ٍُِٜٞس‬ ٢‫حُٞحه‬ ‫حُِؿخؽ‬ ٍ‫آظزيح‬ ْ‫٣ظ‬ ً‫ح‬َ٤‫أه‬ٝ ٚ‫حُٞؿ‬ ‫اٛخرخص‬ ‫ػ٬ؽ‬ ٕ‫ا‬ .‫ح‬ْ‫ر٘ل‬ ْ‫٣ظ‬ ٖ٤ٌ‫ُل‬ ٝ ‫حُطَ٣وش‬‫حُظَط٤ذ‬ ْ‫ر٘ل‬. ٢‫حُ٘ؼخػ‬ ٚ٤‫حُظ٘و‬: ‫ح٩ٗخٍس‬ ٖٓ ‫٫ري‬‫ح‬ ٞ‫ُزؼ‬‫كظخص‬ ٬ُٔ: ‫ٗؼخػ٤خ‬ ‫حُٞؿٜ٤ش‬ ‫ح٧ً٣خص‬ ٚ٤‫ط٘و‬ ٚ٤‫طٞؿ‬ ٝ ْٜ‫ُل‬ ‫أ‬‫وال‬: *٩‫ح‬ َ‫هز‬ ‫٣ـذ‬، ‫حُ٘ؼخػ٤ش‬ ‫حُٔلَىحص‬ ٠ِ‫ػ‬ ‫١٬ع‬‫أ‬٢٤‫ٗل‬ ٕ‫ػِٔخ‬٤‫حُظَ٘٣ل‬ ‫رخُٔ٘خ١ن‬ٝ ‫ٗؼخػ٤خ‬ ‫حُٔيٍٝٓش‬ ‫ش‬ٌَُٔ‫ح‬ ١ٞ‫روط‬‫أ‬ٝ ‫ٓ٘خ١ن‬‫حُولل٤ش‬ ‫حُٞؿٜ٤ش‬ ‫حُ٠ؼق‬. *ُٔ‫ح‬ ٠‫حُطزو‬ َ٣ٜٞ‫حُظ‬ ‫ٗطزن‬ ‫هخٛش‬ ٚ‫حُٞؿ‬ ًٍٞٔ ٠َٟٓ ٢‫ك‬ٝ ٍٟٞ‫ل‬‫ٓلٍٞ٣ش‬ ‫ٓوخ١غ‬ ٖ‫ػ‬ ‫ػزخٍس‬ ٞٛ‫أ‬ٝ ‫١زو٤ش‬ ٝ‫ا‬‫ؿزٜ٤ش‬ ‫ًِ٤ِ٤ش‬ ٛٝ٢‫ر٤ٜ٘خ‬ َٜ‫٣ل‬ ‫حَُٝط٤٘٤ش‬ ‫حُٔوخ١غ‬3–5ٝ ْٓ‫ٍرٔخ‬‫أ‬ٝ ، َ‫ه‬٣٧‫ح‬ ُِٕٞ‫ح‬ ٍ‫ي‬ٝ ، ‫حُؼظ٤ٔش‬ ‫حُٔخىس‬ ٠ِ‫ػ‬ ٞ٤‫ر‬‫ح‬٧‫ح‬ ُِٕٞ٠ِ‫ػ‬ ‫ٓٞى‬ ‫حُ٘لٔ٤ش‬ ‫حُٔخىس‬‫أ‬‫حَُهٞس‬ ‫حُ٘ٔؾ‬ ٝ. ‫ًؼخكخ‬ ‫٣َ٣٘خ‬ ‫ًٔخ‬ِٚ‫ريحه‬ ‫حُٜٞحء‬ ‫ٓغ‬ ٠ٌ‫حُل‬ ‫حُـ٤ذ‬ ‫ص‬‫أ‬‫ح‬ َ‫ريحه‬ ٝ‫ُلـخؽ‬‫أ‬ٍٞٓ‫ٗخ‬ ‫ٗظ٤ـش‬ ‫حُولق‬ ٌٖٝٝٔ٣‫ا‬‫حُٔوخ١غ‬ ٌٙٛ ٍ‫ٍٓخ‬‫ا‬٠ُ ٝ ‫ُ٘خ‬ ‫ُ٤ـٜٔٔخ‬ َ‫حٌُٔز٤ٞط‬ٝ ‫ٓـٔٔخ‬ ‫ٓ٘ظَح‬ ‫٣ؼط٤٘خ‬ٝ ‫حُـَحكش‬ َ‫هز‬ ٚ‫حُٞؿ‬ َ‫ط٘خظ‬ ‫ُ٘خ‬ ْ٤‫٣و‬ ‫ٌٛح‬‫حُـَحك٤ش‬ ‫رؼي‬ ٚ‫ٟٝؼ‬ٝ‫أ‬ٟ‫ٓٔخإ‬ ْٛ ُ‫ح‬ ‫ٌٛح‬٧‫ح‬ ٠‫حُؼ٬ػ‬ ٍٟٞ‫حُٔل‬ ٠‫حُطزو‬ َ٣ٜٞ‫ظ‬‫رؼ‬‫ٌُٔ٤ش‬ ٞ٣َُٔ‫ح‬ َٝ‫طؼ‬ ٢ٛ ْٔ‫حُٔـ‬ ‫خى‬‫أ‬‫ح٫ٗؼش‬ ٖٓ َ‫ًز‬. ‫ثاٍّا‬: *٠ٔ٤١‫حُٔـ٘خ‬ ٖ٤َُٗ‫ح‬ٍُٚٝ‫ى‬‫أ‬ٝ ‫حُِٔٓ٘ش‬ َُٟٝٞ‫ح‬ ٢‫ك‬ َ‫ًز‬‫حُلخىس‬ ‫ُ٤ٔض‬. ٝ٧‫ح‬ ٚ٤‫ك‬ ‫٣ظ٠ق‬ٌَ٘‫ر‬ ‫حُـ٠َٝك٤ش‬ ّ‫هٔخ‬‫أ‬ٖٓ َ‫ًز‬CTٝ٠ٌ‫حُل‬ َٜ‫حُٔل‬ ٢‫ك‬ َٙ‫حُو‬ ‫هخٛش‬. *ٕ‫حَُٔٗخ‬ َ٠‫٣ل‬٠ِ‫ػ‬C Tٝ ، ‫حُؼ٠٬ص‬ ٙٞ٘‫ط‬ ‫ٓؼَكش‬ ٢‫ك‬ٝ ‫حُلـخؽ‬ َ‫ىحه‬ ‫حُِ٘ف‬ ‫طلي٣ي‬ٝ ‫حُٔٔلخم‬ ‫طلض‬٩‫ح‬ٝ ‫ٜٗزخرخص‬‫طلي٣ي‬ ٧‫ح‬٧‫ح‬ ّ‫ؿٔخ‬‫حُٔؼيٗ٤ش‬ َ٤‫ؿ‬ ‫ؿ٘ز٤ش‬‫أ‬ًٔ ‫طلي٣يٛخ‬ ْ‫ك٤ظ‬ ‫حُٔؼيٗ٤ش‬ ‫ٓخ‬‫خ‬٢‫ك‬C T *َ٠‫٣ل‬MRI٢‫ك‬‫أ‬‫ػخٓش‬ ٕ‫حُِٔخ‬ ٝ‫َٓح‬ٝ٧‫ح‬ّ‫ٍٝح‬ُٝ‫ح‬‫ظ٘ٞٛخص‬.
  • 20.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 11 ‫ثاىثا‬: ‫٣ل٤ي‬ٕ‫حَُٔٗخ‬٢‫ك‬ٝ ‫حُلخىس‬ ‫حُلخ٫ص‬ٝ َُٟٝٞ‫ح‬ٝ ٚ‫حُٞؿ‬ ًٍٞٔٝ ٖ٤ٌ‫حُل‬ٝ ، ‫حُؼظٔ٤ش‬ ‫حُظوَرخص‬٢‫ك‬‫أ‬ٝ ْ‫حُؼظ‬ ٝ‫َٓح‬٠‫حُؼ٘خر‬ ‫حُـٞف‬، ٝٝ ‫حُظٌ٘ٔخص‬ ‫كخ٫ص‬ ٢‫ك‬ ‫٣ل٤ي‬ٝ ‫حُِٔٓ٘ش‬ ‫حُلخ٫ص‬٩‫ح‬ٝ ‫ٜٗزخرخص‬‫آ‬ٝ ٠‫حُٜيؿ‬ ٠ٌ‫حُل‬ َٜ‫حُٔل‬ ‫كخص‬ٞ٣َُٔ‫ح‬ َٝ‫٣ؼ‬ ٫ َ٣ٜٞ‫حُظ‬ ‫ٌٛح‬ ٧‫ٗؼش‬,ٝ َٜٓ‫ٓؼِٞٓخص‬ ‫ػيس‬ ٠‫٣ؼط‬. ًَٝ ٠ِ‫ػ‬ٝ ، ٍٟٞ‫حُٔل‬ ٠‫حُطزو‬ َ٣ٜٞ‫كخُظ‬ ٍ‫كخ‬‫حُلخ٫ص‬ ٞ‫رؼ‬ ٢‫ك‬ ٕ٬ٓ‫ٓظٌخ‬ ، ٕ‫حَُٔٗخ‬. ‫ساتؼا‬: ٩‫ح‬ ‫٣ـذ‬‫ٗخٍس‬‫ا‬٠ُDENTAL SCANٝ‫ططز٤و‬ٚ‫خط‬٢‫ك‬ ‫هخٛش‬٢‫ك‬ ‫٣ل٤ي‬ ٜٞ‫ك‬ ٖ٤ٌ‫ٝحُل‬ ْ‫حُل‬ ‫ؿَحكش‬‫أ‬٧‫ح‬ ‫ه٤خٓخص‬ ٌ‫ه‬‫حُٔ٘خٓزش‬ ًٖ‫ٓخ‬ ٝ ٠ُ٘ٔ‫ح‬ ‫ٍُِِع‬ٝ ْ‫حُؼظ‬ ‫ٓٔخًش‬٧‫ح‬٧‫ح‬ ًٖ‫ٓخ‬ٝ ‫حُلي‬ َُ٘٘ ‫ٗٔذ‬‫ا‬٬ٛ‫حُلي‬ ٢‫ك‬ ‫هخٛش‬ َُٝ‫حُز‬ ‫ف‬‫ح‬‫ُِٔ٘خ١ن‬ َٝ‫حُظؼ‬ ٕٝ‫ى‬ ٢ِ‫ُٔل‬ ٣َ٘‫حُظ‬‫ل‬‫٤ش‬٧‫ح‬ ٝ‫ػٜخد‬٧‫ح‬ ٝ‫ٝػ٤ش‬.‫ٍإ٣ش‬ ٖٓ ‫٣ٌٔ٘٘خ‬ ‫ًٔخ‬‫أ‬ٝ ٚ‫حُٞؿ‬ ٢‫ك‬ ْ‫حُؼظ‬ ّ‫هٔخ‬‫ر‬ ٖ٤ٌ‫حُل‬‫ؤر‬‫حُؼ٬ػش‬ ‫ؼخىٛخ‬ًٝ ‫ٓـٔٔش‬ ‫ـٔـٔش‬ ٝ َ‫حٌُٔز٤ٞط‬ ٠ِ‫ػ‬ ‫حُـٜخص‬ ٌَ‫ر‬ ‫طيٝ٣َٛخ‬ ٌٖٔ٣ٝ ‫ريهش‬ ٌَُٔ‫ح‬ ‫ٓٞهغ‬ ‫طلي٣ي‬ ٠ُ‫رخُظخ‬٩‫ح‬ ‫طلي٣ي‬ُ‫ح‬ َ‫ىحه‬ ٙ‫ٗؤخ‬٤‫ـ‬‫ٞد‬ٝ‫ُحٝ٣ش‬ ًٍٞٔ ٝ ‫حُلي‬ٝ ‫حُلـخؽ‬‫ػ‬ َ٠‫طل‬٢‫حُظ‬ َ‫ٝٝط‬ ‫رٟٞؼ٤ش‬ ‫حُـ٤ٞد‬ ‫ٍٛٞس‬ ٖ‫أ‬٠‫طؼط‬ ٫ ‫ٛزلض‬‫ا‬ٝ ‫ٓليٝىس‬ ‫ٓؼِٞٓخص‬ ٫٠ُ‫رخُظخ‬‫أ‬٩‫رخ‬ ‫ٛزق‬ٕ‫ٌٓخ‬ ‫ً٘ق‬‫أ‬ّ‫ٍٝح‬‫ػخىس‬ ‫طٌ٘ق‬ ٫ ٢‫حُظ‬ ٠ٌ‫حُل‬ ‫حُـ٤ذ‬‫ا‬‫ٓظ‬ ٌَ٘‫ر‬ ٫‫ؤ‬‫رؼي‬ َ‫ه‬‫ا‬ٝ ‫طوَد‬ ‫كيحع‬‫ا‬َ٤‫ًز‬ ٠ٔ‫ػظ‬ ٙ‫ٓظٜخ‬. ١ِٞ‫حُؼ‬ ٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ ‫حُؼِغ‬ ٕ‫ا‬ٝ ‫حُـزٜش‬ ْ‫ػظ‬ ٖ‫ػ‬ ‫ػزخٍس‬ ٞٛ ٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ ٖٓ ١ِٞ‫حُؼ‬‫ط‬ ٢‫حُظ‬ٌٖٓ ١ِٞ‫حُؼ‬ ‫حُـِء‬ ٕٞ‫كٞحف‬‫حُلـخؽ‬ٝٚ‫ٓطل‬١ِٞ‫حُؼ‬. ‫رِحٝ٣ش‬ ‫حُوِق‬ ٠ُ‫ا‬ ‫حُـٔـٔش‬ ‫هخػيس‬ ‫طٔظي‬45ْ‫حُؼظ‬ ‫ٓغ‬ ‫حُـزٜش‬ ْ‫ػظ‬ ‫ك٤ٜخ‬ ٌِ‫٣َط‬ ٢‫حُظ‬ ‫حُٔ٘طوش‬ ٢‫ك‬ َ‫ح٧ٓل‬ ٠ُ‫ا‬ ً‫خ‬‫طوَ٣ز‬ ‫ىٍؿش‬ ١‫حُٞطي‬ٝ ٚ‫حُٞؿ‬ ٖٓ ٢ٓٝ٧‫ح‬ ‫حُـِء‬ ٕ‫ا‬ .‫ٌٓٞٗخ‬٠٘‫حُٔ٘ل‬ ‫ٌٛح‬ ٠ِ‫ػ‬ ٌِ‫طَط‬ ٚ‫ط‬ٝ ,٠ُ‫ا‬ ٢ُ‫حُـَرخ‬ ْ‫ُِؼظ‬ ‫حُظخرغ‬ ١ٞ‫حُٜٔل‬ ْ‫حُؼظ‬ ‫٣ٔظي‬ ٝ ‫حُٔن‬ ‫ٓلخ٣خ‬ ْٓ٬٣ ٠‫كظ‬ ٠ِ‫ح٧ػ‬ُْ٘‫ح‬ ‫أػٜخد‬ َٔ‫ط‬ ٚ٘ٓٝ ‫حُـزٜش‬ ْ‫ػظ‬ ٕ‫ا‬ .ٝ ْٔ‫حُـ‬ُ‫ح‬ ‫حُـ٘خف‬َ٤‫ٌز‬ُٝ‫ح‬ ‫حُـ٘خف‬َ٤‫ٜـ‬ْ‫ُِؼظ‬ ٌٍُِٞٔ َٝ‫طظؼ‬ ٫ ً‫خ‬‫ؿخُز‬ ١‫حُٞطي‬‫رٞحٓطش‬ ‫ًز٤َس‬ ‫ريٍؿش‬ ٕٞ٤ٔ‫ٓل‬ ْٛ ‫حُلو٤وش‬ ٢‫ك‬ .ٚ‫حُٞؿ‬ ٖٓ ٢ٓٝ٧‫ح‬ ‫ُِـِء‬ ‫حُٞٓخى٣ش‬ ‫حُوخٛ٤ش‬ ‫حُٜيٓخص‬ ‫هٞس‬ ٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ ٖٓ ٢ٓٝ٧‫ح‬ ‫حُؼِغ‬ ّ‫ػظخ‬ ٚ‫طٔظ‬ ‫ك٤غ‬ٝ‫ح‬ ٠ُ‫ا‬ ‫حُوٞس‬ ٌٙٛ َ‫ط٘و‬ ٕ‫أ‬ َ‫هز‬ ٌَٔ‫طظ‬.َٟ‫ح٧ه‬ ّ‫ُؼظخ‬ ‫طليع‬ ‫ػ٘يٓخ‬ُ‫ح‬ٌٍٞٔ٢‫ك‬ُ‫ح‬ٝ ‫طليع‬ ‫ٜٓٔش‬ ً‫خ‬‫ػٞحهز‬ ‫ٛ٘خى‬ ٕ‫كب‬ ٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ ‫ٓ٘طوش‬ ٖٓ ‫حُولل٤ش‬ ‫ٌٔٞٗخص‬٢ٛ: 1-‫حُٔن‬ َٝ‫٣ظؼ‬ ‫ٍرٔخ‬‫ٓزخَٗس‬ ‫ُٜيٓش‬, 2-‫حٌٍُٔٔٞس‬ ‫حُٔ٘طوش‬ ٢‫ك‬ ً٬‫ٓؼ‬ ‫ُِِ٘٣ق‬ ‫ٗظ٤ـش‬ ‫ٓزخَٗس‬ َ٤‫حُـ‬ ‫ح٩ٛخرخص‬ َ‫ُوط‬ ً‫خ‬َٟ‫ٓؼ‬ ‫حُٔن‬ ٌٕٞ٣ ‫ٍرٔخ‬, 3-ٖٓ ٢‫حُوِل‬ ٍ‫حُـيح‬ ٌَُٔ‫ح‬ َٔ٘٣ ‫ٍرٔخ‬‫ٓطق‬ ٝ‫أ‬ ‫حُـزٜ٤ش‬ ‫حُٜٞحث٤ش‬ ‫حُـ٤ٞد‬ٓ‫و‬‫ِش‬ٝ ١ٞ‫حُٜٔل‬ ْ‫حُؼظ‬ ٝ‫أ‬ ٖ٤‫حُؼ‬‫ٍرٔخ‬ ‫ريٍٝٛخ‬ ٢‫حُظ‬ ٝ‫أ‬ ‫حُيٓخؿ٤ش‬ ‫حُـخك٤ش‬ ّ٧‫ح‬ ٢‫ك‬ ‫رظِٔم‬ ‫طٜخكذ‬٢‫حُ٘وخػ‬ َ‫حُٔخث‬ ٢‫ك‬ ‫طَٔد‬ 4-ٝ ‫ح٩ِٗ٣خف‬.٢‫حُطز٤ؼ‬ ‫ُٟٞؼٜخ‬ ٌٍُٞٔ‫ح‬ ‫اػخىس‬ ‫ٓغ‬ ٍٝ‫٣ظؼخ‬ ‫هي‬ ‫حُوِق‬ ٠ُ‫ا‬ ‫هخٛش‬ ٢ٓٝ٧‫ح‬ ٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ ٖٓ َّٞٓٓ ٢‫ه‬ ٠ِ‫ح٧ػ‬ ٢‫ك‬ ‫٣ليٛخ‬ ٢‫حُظ‬ ‫حُٔ٘طوش‬ ٚٗ‫رؤ‬ ٢ٓٝ٧‫ح‬ ٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ ‫طؼَ٣ق‬ ٌٖٔ٣ً‫ح‬ٍَٝٓ ٢٘‫حُٞؿ‬ ٢ٜ‫حُـز‬ ٍُ‫حُي‬ ‫ٓ٘طوش‬ ‫ر‬ٝ ٢‫ح٧ٗل‬ ٢ٜ‫حُـز‬ ٍُ‫خُي‬‫ح‬ ٍُ‫حُي‬ُ‫ح‬ ٢ٜ‫ُـز‬٢ٌ‫ل‬َ‫ح٥ه‬ ‫حُـخٗذ‬ ٢‫ك‬ ٢٘‫حُٞؿ‬ ٢ٜ‫حُـز‬ ٍُ‫حُي‬ ٠ُ‫ا‬.ٟٝٞ‫ٓٔظ‬ َ‫ح٧ٓل‬ ٖٓ ‫٣ليٛخ‬ ْ‫ػظ‬ ٖٓ ‫ٌٓٞٗش‬ ‫حُٔلِ٤ش‬ ٙ‫كيٝى‬ ٌٕٞ‫كظ‬ ٕ‫أٓ٘خ‬ ٕٝ‫ري‬ ٞ٣َُٔ‫ح‬ ٕ‫ًخ‬ ‫اًح‬ ٝ .ٕ‫أٓ٘خ‬ ‫ٛ٘خى‬ ٕ‫ًخ‬ ‫اًح‬ ١ِٞ‫حُؼ‬ ‫حُلي‬ ٢‫ك‬ ٕ‫ُ٨ٓ٘خ‬ ‫ح٩١زخم‬ ١ِٞ‫حُؼ‬ ‫ُِلي‬ ‫حُيٍى‬ٝ .٠ُ‫ا‬ ‫حُوِق‬ ٠ُ‫ا‬ ٢ٓٝ٧‫ح‬ ٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ ‫٣ٔظي‬ٝ ١‫حُٞطي‬ ْ‫ُِؼظ‬ ‫حُـ٘خك٤ش‬ ‫حُٜلخثق‬ ‫ٓ٘طوش‬‫ٓخ‬ ً‫خ‬‫ؿخُز‬ ٢‫حُظ‬ .‫حُوٞ٣ش‬ ‫ح٩ٛخرخص‬ ٢‫ك‬ ٌَٔ‫ط‬
  • 21.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 12 ٌٕٞ‫طظ‬٢ٓٝ٧‫ح‬ ٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ ‫ٓ٘طوش‬‫حُظخُ٤ش‬ ّ‫حُؼظخ‬ ٖٓ -2ْ‫حُؼظ‬ ٖٓ٢ٌ‫حُل‬ -2٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ٖٓ -2٢‫حُٜيؿ‬ ْ‫ُِؼظ‬ ٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ‫ٗظٞءحص‬ ٖٓ -2‫حُل٘ي‬ ْ‫ػظ‬ ٖٓ -2‫ح٧ٗق‬ ْ‫ػظ‬ ٖٓ -2ٖٓ٢‫حُيٓؼ‬ ْ‫حُؼظ‬ -ْ‫ػظ‬‫حُٔ٤ٌؼش‬ -ٝ ٢ُ‫حُـَرخ‬ ْ‫حُؼظ‬‫حُوَ٣٘خص‬‫رٜخ‬ ‫حُٔظِٜش‬ -2ٖٓ‫حُوَ٣٘خص‬‫حُٔلِ٤ش‬ -١‫حُٞطي‬ ْ‫ُِؼظ‬ ‫حُـ٘خك٤ش‬ ‫حُٜلخثق‬ )*ٚ‫حُٞؿ‬ ٢ٓٝ ‫ُٔ٘طوش‬ ٢ٔ‫حُؼظ‬ ٌَ٤ُِٜ ‫حُل٤ِ٣خث٤ش‬ ‫حُٜلخص‬ 1-ٝ ٌَ٤ٛ ٌٕٞ‫٣ظ‬ٝ ّ‫حُؼظخ‬ ٖٓ ‫ػيى‬ ٖٓ ٢ٔ‫حُؼظ‬ ٚ‫حُٞؿ‬ ٢ًٓ‫ح‬ٍ‫ٗخى‬ ٢ٛ‫ٓ٘لَىس‬ ٌٍُٞٔ َٝ‫طظؼ‬ ‫ٓخ‬ 2-ٝ ‫حًَُٔذ‬ ‫حُز٘خء‬ٝ َ‫ح٧ٓل‬ ٖٓ ‫حُٔ٠ؾ‬ ٟٞ‫ه‬ َٔ‫طل‬ ٠ِ‫ػ‬ ‫حُويٍس‬ ُٚ َ‫٣ـؼ‬ ٌَ٤ُٜ‫ح‬ ‫ٌُٜح‬ ْ‫حُٔ٘ظ‬ٞ‫رؼ‬ ٢‫ك‬ ‫حُلٔخ٣ش‬ َ‫٣ٞك‬ ‫ًٌُي‬ .ٖ٤‫حُؼ‬ ‫هخٛش‬ ‫حُٔـخٍٝس‬ ‫حُل٤ٞ٣ش‬ ‫ُ٨ؿِحء‬ ‫حُٔ٘خ١ن‬ ٢‫حُِل‬ ‫حُلي‬ ‫ُـ٤ٞد‬ ٢‫حُوخٍؿ‬ ٍ‫حُـيح‬ ‫ٓ٘طوش‬ ٢‫ك‬ ‫حُلي‬ ْ‫ػظ‬ ٖٓ ‫ؿِء‬ ‫اُحُش‬ ْ‫ط‬ ُٕٞ‫أ‬ َٟ٤ٖٓٓ ٌٕٞ‫٣ظ‬ ٚ‫حُٞؿ‬ ٢ٓٝ ٌَ٤ٛ ّ‫ػظخ‬ ٝ ‫ٓظظخرؼش‬ ّ‫ػظخ‬‫حُـٔـٔش‬ ّ‫ػظخ‬ ٠ُ‫ا‬ ‫ح٧ٓخٓ٤ش‬ ٕ‫ح٧ٓ٘خ‬ ٖٓ ٠ِ‫ح٧ػ‬ ٠ُ‫ا‬ ‫ٓظـٜش‬ ‫ىحػٔش‬ٝ .ٌٙٛ ٠ِ‫ػ‬ ّ‫حُطؼخ‬ ‫ٓ٠ؾ‬ ‫هٞس‬ ‫طظُٞع‬ ٝ ‫ح٧ٗق‬ ٍٞ‫ك‬ ‫حُٜ٘ش‬ ‫حُٔ٘طوش‬.‫حُـٔـٔش‬ ‫هخع‬ ٠ُ‫ا‬ ‫ُ٨ٗق‬ ‫حُٔـخٍٝس‬ ‫حُـ٤ٞد‬ 3-َ‫ح٧ٓل‬ ٖٓ ٟٞ‫ه‬ َٔ‫طل‬ ٌٚ٘ٔ٣ ‫حُز٘خء‬ ٖٓ ‫حُ٘ٞع‬ ‫ٌٛح‬،ٌُٖ‫اطـخٛخص‬ ٖٓ ٟٞ‫ه‬ ١‫أ‬ ‫ٗظ٤ـش‬ ‫رُٜٔٞش‬ ٌَٔ‫طظ‬ ‫حُز٘خء‬ ‫ٌٛح‬ ّ‫ػظخ‬ .َٟ‫أه‬ ّ‫ػخ‬ ٢‫ك‬1975( ْٛ‫ٗخ‬ َٟ‫أؿ‬ ّNahumٝ ٚ‫حُٞؿ‬ ٢ٓٝ ٌَ٤ٛ ًٍٞٔ ٠ِ‫ػ‬ ‫طـخٍد‬ )٢‫ك‬ ًَٔ ‫٩كيحع‬ ‫حُ٬ُٓش‬ ‫حُوٞس‬ ٍ‫ٓويح‬ ٕ‫أ‬ ‫ٝؿي‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ّ‫ػظخ‬ ٌَُٔ ‫حُ٬ُٓش‬ ‫حُوٞس‬ ٍ‫ٓويح‬ ‫ػِغ‬ ٝ‫أ‬ ْٔ‫ه‬ ٞٛ ٚ‫حُٞؿ‬ ٢ٓٝ ٌَ٤ٛ‫ًِٜخ‬ ٚ‫حُٞؿ‬ ّ‫ػظخ‬ ٕ‫ا‬ .‫ٟؼ٤ق‬ َٔ‫طل‬ ‫ُي٣ٜخ‬ ‫حُ٠خؿطش‬ ٟٞ‫ُِو‬ُ‫ح‬ ‫حُلي‬ ‫ر٤٘ٔخ‬ ,٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ّٞ‫ه‬ ‫طِ٤ٜخ‬ ٌَُِٔ ‫ح٧ٟؼق‬ ‫ٓوخٝٓظٜخ‬ ‫ُٜخ‬ ‫ح٧ٗق‬ ّ‫ػظخ‬ ٕ‫أ‬ ‫ًٔخ‬ .١ِٞ‫ؼ‬‫كٔخٓ٤ش‬ ُٚ ( ‫ح٧كو٤ش‬ ‫ُ٪ٛخرخص‬ ‫رخُـش‬Huelke AndCompton, 1983.) 4-ٔ‫ر‬ ٌَٔ‫طظ‬ ّ‫حُؼظخ‬ ٌٙٛ ٕ‫كب‬ ٚ‫حُٞؿ‬ ٢ٓٝ ٌَ٤ٛ ّ‫ػظخ‬ ‫رٜخ‬ ِ٤ٔ‫طظ‬ ٢‫حُظ‬ ‫حُٜ٘خٗش‬ ‫ٛلش‬ ‫رٔذ‬ٝ ‫ُٜٞش‬‫ٝحه٤ش‬ ‫ًٞٓخىس‬ َٔ‫طؼ‬ ‫ٟٓٞٞع‬ ‫حُؼوخد‬ ‫ػٞى‬ ‫رٜ٘يٝم‬ ‫حُٟٞغ‬ ‫ٌٛح‬ ٚ٤‫ط٘ز‬ ٌٖٔ٣ .٢‫حُـخٗز‬ ٢ٓ‫ح٧ٓخ‬ ٙ‫ح٩طـخ‬ ٖٓ ٝ‫أ‬ ّ‫ح٧ٓخ‬ ٖٓ ‫ح٩ٛخرخص‬ ٢‫ك‬ ‫هخٛش‬ ‫ُِولق‬ ٝ ‫طلض‬٩‫ح‬ ٌٙٛ .‫أٓلِٜخ‬ ٢ِ‫حُٔل‬ ‫حُلي‬ َُٝ‫ر‬ ٖ‫ػ‬ ‫ٝطوظِق‬ ‫حُٔن‬ ١ٞ‫طل‬ ٢‫حُظ‬ ‫حُِٜزش‬ ‫حُٔ٘طوش‬ ّ‫أٓخ‬ً‫ح‬‫ؿي‬ ‫ٜٓٔش‬ ‫حُل٤ِ٣خث٤ش‬ ‫هظ٬كخص‬ ‫حُل٤خس‬ ٢‫ك‬ّ‫حَُأ‬ ‫اٛخرخص‬ ‫رؼي‬. ‫حُٞكخس‬ ‫طٔزذ‬ ‫هي‬ ٝ‫أ‬ ‫حُٔن‬ ٢‫ك‬ ‫هط٤َس‬ ٍ‫أَٟح‬ ‫٩كيحع‬ ‫ًخك٤ش‬ ٌٕٞ‫ط‬ ‫هي‬ ‫حُولق‬ ‫ٓ٘طوش‬ ٠ِ‫ػ‬ ‫حُٔزخَٗس‬ ‫حُٜيٓش‬ْ‫ٝر٘ل‬ ‫حُٜيٓش‬ ْ‫ٗل‬ . ْ‫ٓ٤ظ‬ ٚ‫حُٞؿ‬ ‫ٓ٘ظٜق‬ ٌَ٤ٛ ٠ُ‫ا‬ ‫ٝؿٜض‬ ‫ٓخ‬ ‫اًح‬ ‫حُوٞس‬‫ا‬ٝ ‫ٓظٜخٜٛخ‬ٚ٤‫ٝػ‬ ‫حُٜٔخد‬ ‫٣لوي‬ ٫ ‫ٍرٔخ‬ َ‫ر‬ ٍ‫ح٧َٟح‬ ْ‫ٗل‬ ٠ُ‫ا‬ ١‫طئى‬ ٫ ‫ٍرٔخ‬ ٓ‫حُٜي‬ ٌٙٛ ‫رٔزذ‬ٝ ٚ‫حُٞؿ‬ ّ‫ػظخ‬ ‫ٓ٘طوش‬ ٢‫ك‬ ً‫ح‬ٍ‫ىٓخ‬ ‫طٔزذ‬ ‫ٌُٜ٘خ‬ ,‫ش‬١‫حُٔظٜي‬ ٞٛ ٢ِ‫حُٔل‬ ‫حُلي‬ ٕ‫ًخ‬ ‫اًح‬ .‫رٜخ‬ ‫حُٔل٤طش‬ ‫ح٧ٗٔـش‬ ‫ٛلش‬ ٕ‫كب‬ ‫حُٜيٓش‬ ٌُٜٙ‫ا‬ٝ َ‫طو‬ ‫حُٜيٓخص‬ ٙ‫ٓظٜخ‬.‫حُٔ٬ًٔش‬ ‫ٍ٣خٟش‬ ٢‫ك‬ ‫حُوخٟ٤ش‬ ‫حُ٠َرش‬ ٢‫ك‬ ‫٣ليع‬ ‫ُٔخ‬ ‫ٓ٘خرٜش‬ ‫حُٔن‬ ‫اٛخرش‬ ٌٕٞ‫ط‬ )*٩‫ح‬‫حُـٔـٔش‬ ‫هخػيس‬ ‫ٓغ‬ ١‫ٍطزخ‬ -ّ‫ػظخ‬ ‫اُحُش‬ ْ‫ط‬ ‫اًح‬ٝ ٢ٜ‫حُـز‬ ْ‫حُؼظ‬ ٕ‫أ‬ ‫ٍإ٣ش‬ ٌٖٔ٣ ‫حُـٔـٔش‬ ٖٓ ٚ‫حُٞؿ‬ ٢ٓٝ ٌَ٤ٛ٠ُ‫ا‬ ٚ‫٣ظـ‬ ٠٘‫ٓ٘ل‬ ٕ‫٣ٌٞٗخ‬ ١‫حُٞطي‬ ْ‫حُؼظ‬ ‫ٓويحٍٛخ‬ ‫رِحٝ٣ش‬ ‫حُوِق‬ ٠ُ‫ٝا‬ َ‫ح٧ٓل‬45. ‫حُؼِٞ٣ش‬ ٕ‫ح٧ٓ٘خ‬ ‫ا١زخم‬ ٢‫ه‬ ‫ٓغ‬ ‫ىٍؿش‬
  • 22.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 13 -ٝ ‫ُِـٔـٔش‬ ‫حُوٞ٣ش‬ ‫رخُوخػيس‬ ٚ‫حُٞؿ‬ ٢ٓٝ ٌَ٤ٛ ّ‫ػظخ‬ ٌِ‫طَط‬ّ‫حُؼظخ‬ ٌٙٛ ٕ‫كب‬ ًَٔ ‫كيٝع‬ ‫ػ٘ي‬ٖ‫ػ‬ َٜ‫ط٘ل‬ ‫هي‬ٕ‫ا‬ .‫حُولق‬ ‫هخػيس‬ ٍ‫ٓويح‬‫ا‬ٝ ٢٤ٔ‫ر‬ ‫حُوِق‬ ٠ُ‫ا‬ ّ‫حُؼظخ‬ ٌٙٛ ‫ِٗ٣خف‬١ِٞ‫حُؼ‬ ‫حُلي‬ ٢‫ك‬ ‫حُوِل٤ش‬ ّ‫ح٧َٟح‬ ٕ‫كب‬ ‫حُـٔـٔش‬ ‫هخػيس‬ ٢‫ك‬ ٠٘‫حُٔ٘ل‬ ‫رٞؿٞى‬ ٌُٖ ‫ٓلظٞكش‬ ‫أٓخٓ٤ش‬ ‫ػ٠ش‬ ‫ػٜ٘خ‬ ‫٣٘ظؾ‬ ‫ٓٔخ‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ٢‫ك‬ ‫حُوِل٤ش‬ ّ‫ح٧َٟح‬ ‫ٓغ‬ ٢‫١ز٤ؼ‬ َ٤‫ؿ‬ ‫ٟٝغ‬ ٢‫ك‬ ‫ططزن‬,ٕ‫ح٧ك٤خ‬ ٞ‫رؼ‬ ٢‫ك‬ ٩‫ح‬ ٌٕٞ٣٤ُ ً‫خ‬٤‫ًخك‬ ‫ِٗ٣خف‬‫ا‬ ‫ٔزذ‬‫ٓظ‬ٝ ٚ‫حُٞؿ‬ ٢‫ك‬ ‫طخُش‬ٌٔ٣ ‫حُلخ٫ص‬ ٞ‫رؼ‬ ٢‫ك‬ٝ ٞ‫حَُه‬ ‫حُل٘ي‬ ‫٣يكغ‬ ٕ‫أ‬ ٖ‫ر‬ ٕ‫حُِٔخ‬‫ب‬ٝ ‫حُوِق‬ ٙ‫طـخ‬‫٣ظٔززخ‬ ‫حُٜٞحث٤ش‬ ١ٍ‫ُِٔـخ‬ ‫اػخهش‬ ٢‫ك‬٣ .ٝ ‫حَُهٞس‬ ‫ُ٨ٗٔـش‬ ٍّٞ‫رظ‬ ‫ٌٛح‬ ‫ٜخكذ‬‫ا‬‫حُيٓٞ٣ش‬ ‫رخُوؼَس‬ ‫ح٧ٗق‬ ‫كظلخص‬ ‫ٗٔيحى‬٠ِ‫ػ‬ ٚٗ‫أ‬ ًٌَ‫ط‬ ‫٣ـذ‬ . ‫حُٜٞحث٤ش‬ ١ٍ‫ُِٔـخ‬ ‫حُل٤ِ٣خث٤ش‬ ‫ح٩ػخهش‬ ٕ‫أ‬ ٖٓ ْ‫حَُؿ‬٠‫ٝ٣زو‬ ‫ٌٛح‬ ٝٞ‫٣ؼ‬ ٕ‫أ‬ ‫٣ٔظط٤غ‬ ٢‫حُٞػ‬ ‫كخهي‬ َ٤‫ؿ‬ ‫حُٜٔخد‬ ٕ‫كب‬ ,‫حُل٤خس‬ ‫طٜيى‬ ‫هي‬ .‫حُل٤خس‬ ‫ه٤ي‬ ٠ِ‫ػ‬ٕ‫ا‬َ‫حُوط‬٢‫حُلو٤و‬١ٌُ‫ح‬‫٣ٜيى‬‫حُل٤خس‬‫٣ظٞحؿي‬‫ػ٘ي‬‫كيٝع‬‫اٛخرش‬ّ‫َُِأ‬‫ٜٓخكزش‬ٝ‫ربٗولخ‬٢‫ك‬ٟٞ‫ٓٔظ‬٢‫حُٞػ‬ ٟ‫ُي‬‫حُٜٔخد‬.٢‫ك‬ٌٙٛ‫حُلخُش‬‫ٓ٤وظ٘ن‬ٞ٣َُٔ‫ح‬‫ا‬‫ًح‬ُْْ‫٣ظ‬ٚ‫ٟٝؼ‬٠ِ‫ػ‬ٚ‫ؿخٗز‬ٝ‫أ‬٢‫ك‬‫ٟٝغ‬‫ح٩ٌٗزخد‬(‫حُٟٞغ‬٢٘‫حُزط‬)‫ُِٔلخكظش‬ ٠ِ‫ػ‬١ٍ‫حُٔـخ‬‫حُٜٞحث٤ش‬‫ٓلظٞكش‬. )*‫هٞس‬ ‫ُ٣خىس‬ ٠ِ‫ػ‬ َٔ‫طؼ‬ ٢‫حُظ‬ ٝ ‫حُلٔخ٣ش‬ ‫ريػخٓخص‬ ‫ًٌُي‬ ‫طؼَف‬ ٢‫حُظ‬ ٝ ‫حُؼظٔ٤ش‬ ‫رخُيػخٓخص‬ ٠ٔٔ٣ ‫ٓخ‬ ٠ِ‫ػ‬ ٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ ١ٞ‫٣ل‬ . ٢ٜ‫حُٞؿ‬ ٌَ٤ُٜ‫ح‬ : ‫حُيػخٓخص‬ ٌٙٛ ٖٓ ٖ٤‫ٗٞػ‬ َٜ‫ٗل‬ ٕ‫أ‬ ‫ٗٔظط٤غ‬ 1)‫ىػخٓخص‬‫ػٔٞى٣ش‬ -٢‫أٗل‬٢ٜ‫ؿز‬ -ٝ٢٘‫ؿ‬٢ٜ‫ؿز‬ -٢٘‫حُٞؿ‬ٌ‫حُل‬٢٢٘‫حُٞك‬٢ٔٗ٩‫ٝح‬ -٢‫ؿ٘خك‬٢ٌ‫ك‬١ِٞ‫ػ‬ 2)‫ىػخٓخص‬‫أكو٤ش‬ -ُ‫ح‬‫لخكش‬ُ‫ح‬‫لـخؿ٤ش‬‫حُؼِٞ٣ش‬ -ُ‫ح‬‫لخكش‬ُ‫ح‬‫لـخؿ٤ش‬‫حُٔلِ٤ش‬ -‫هزش‬‫حُل٘ي‬ -‫حُٞؿ٘٤ش‬ ‫حُلخكش‬
  • 23.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 14 )*ًَ ٠ُ‫ا‬ َ‫حُ٘ظ‬ ‫ػ٘ي‬ ‫ٓظؼيىس‬ ٌٕٞ‫ط‬ ‫ٓخ‬ ً‫خ‬‫ؿخُز‬ ٚ‫حُٞؿ‬ ٢ٓٝ ٌَ٤ٛ ًٍٞٔ .‫كيس‬ ٠ِ‫ػ‬ ‫ػظٔش‬ ٝ ٚ‫حُٞؿ‬ ٢‫ك‬ ‫حُ٠ؼ٤لش‬ ١ٞ‫حُوط‬ ‫٣ظزغ‬ ّ‫حُؼظخ‬ ٌٙٛ ٢‫ك‬ ٌٍُٞٔ‫ح‬ ٢ٔٗ ٕ‫ا‬ ( ٖ٣ٍ‫ؿخ‬ ‫ٝٛلٜخ‬ ٢‫حُظ‬Guerinّ‫ػخ‬ )1866ٝ ّ٤ُ( ‫لٍٞص‬Le Fortّ‫ػخ‬ ) 1901.ّ ٛ ًٍٞٔ ‫ُٞٛق‬ ‫حُٔٔظويٓش‬ ‫حٌُِٔخص‬‫حُٔؼَٝكش‬ ٚ‫حُٞؿ‬ ٢ٓٝ ٌَ٤ ٌٍٞٔ‫ر‬٤ٍُٞ‫ل‬‫ص‬ْ‫ٍه‬1ْٝ‫ٍه‬2ْٝ‫ٍه‬3ٌَُٔ‫ح‬ ٟٞ‫ٓٔظ‬ ٠ُ‫ا‬ َ٤٘‫ط‬ ٝ ‫حُـٔـٔش‬ ‫ُوخػيس‬ ‫رخُ٘ٔزش‬ٖٓ ‫ٓ٘ظوش‬ ٢ٛ‫حُظوِ٤ي٣ش‬ ‫ح٧ٍٝحم‬ ٌٙٛ ‫حٍُٔ٘٘ٞس‬. ‫ػظخ‬ ٢‫ك‬ ً‫خ‬‫طلظظ‬ ‫حُوط٤َس‬ ‫ح٩ٛخرش‬ ‫طٔزذ‬‫كخُش‬ ٢‫ك‬ ‫حُٔطل٤ش‬ ٚ‫حُٞؿ‬ ّ ٤ُ ًٍٞٔٝ .‫حُظوِ٤ي٣ش‬ ‫لٍٞص‬ٝ ‫ح٧ٗق‬ ّ‫ػظخ‬ َ‫طظؤػ‬‫ٝأ٣٠خ‬ ٢ُ‫حُـَرخ‬ ْ‫حُؼظ‬ ‫حُلي‬ ْ‫ػظ‬ ٖٓ ٢ٓ‫ح٧ٓخ‬ ‫حُـِء‬٢ِ‫حُٔل‬ٝ‫٣ؼَف‬ ‫ٓخ‬ ‫طلظظٜخ‬ ‫٣ٔزذ‬ ( ٢٘‫حُٜل‬ ٚ‫حُٞؿ‬ ٙٞ٘‫رظ‬Dish Face٤‫ك‬ )ً‫خ‬‫ٗخطـ‬ ٙٞ٘‫حُظ‬ ‫ٌٛح‬ ٌٕٞ٣ ٫ ‫غ‬ ٖ‫ػ‬‫ا‬. ‫حُوِق‬ ٠ُ‫ا‬ ّ‫حُؼظخ‬ ٌٙٛ ‫ِٗ٣خف‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ٢ٓٞ‫حُٔظ‬ ٚٔٔ‫ه‬ ٌ‫٣ؤه‬ ‫ٓلَى‬ ْ‫ػظ‬ ٢ِ‫حُٔل‬ ‫حُلي‬"ٝ َّ‫حُل‬ َ‫ٗؼ‬ ٌَٗ "ْ٤ٔ‫حُـ‬ٚ‫طظـ‬‫رٟٞغ‬ ٠ِ‫ح٧ػ‬ ٞ‫ٗل‬ "ٕ‫"حُ٘ؼزظخ‬ ٙ‫ٜٗخ٣ظخ‬ ٝ ْ٤ٔ‫حُـ‬ ‫ٓغ‬ ‫ُحٝ٣ش‬ ٕ٬ٌ٘٤‫ك‬ ً‫خ‬‫طوَ٣ز‬ ٢ُٞ‫ٗخه‬ٝ ،‫حُوخػي٣ش‬ ‫حُٔلِ٤ش‬ ٚ‫كخكظ‬ ٖٓ ‫أٍم‬ ْ‫حُؼظ‬ ‫ٌُٜح‬ ‫حُٔ٘و٤ش‬ ‫حُؼِٞ٣ش‬ ‫حُلخكش‬ ٌٕٞ‫ط‬ ٝ ،‫حٌُه٘٤ش‬ ‫رخُ٘خٓوش‬ َ‫رخ٧ٓل‬ ٢ٜ‫ط٘ظ‬ ٢٘‫حٌُه‬ ‫ح٩ٍطلخم‬ ٢ٛ ‫هِ٘ػش‬ ٢ٓٞ‫حُٔظ‬ ٢‫حُو‬ ٠ِ‫ػ‬ ٢‫حُوخٍؿ‬ ٚ‫ٓطل‬ ٠ِ‫ػ‬ َٜ‫٣ظ‬ٖٓ ‫٣٘٘ؤ‬ ُ‫ح‬‫َُِأى‬ ‫ح٧ٓخٓ٤ش‬ ‫حُلخكش‬ ٠‫كظ‬ ‫ُ٤ٔظي‬ َٛ‫حُظخ‬ ‫حُٔ٘لَف‬ ٢‫حُو‬ ‫حٌُه٘٤ش‬ ‫٘خٓوش‬ٕ‫حٌُه٘٤خ‬ ٕ‫حُؼوزخ‬ ٢‫حُوخٍؿ‬ ‫حُٔطق‬ ٠ِ‫ػ‬ ‫ٗ٘خٛي‬ ‫ًٔخ‬ ، ً‫خ‬٠٣‫أ‬. ‫ٗظٞء‬ ‫أٍرؼش‬ ٢ٓٞ‫حُٔظ‬ ٢‫حُو‬ ‫ٓ٘طوش‬ ٢‫ك‬ ٚ٤ِ‫ػ‬ َٜ‫ك٤ظ‬ ٖ١‫حُزخ‬ ٚ‫حُٞؿ‬ ‫أٓخ‬‫حٌُه٘٤ش‬ ‫حُ٘ظٞءحص‬ ٠‫طيػ‬ ‫ٛـ٤َس‬ ‫حص‬‫ا‬‫ػِ٤ٜٔخ‬ ٌِ‫طَط‬ ٕ‫ػِٞ٣خ‬ ٕ‫ػ٘خ‬ ُِٔ‫ح‬ ‫حٌُه٘٤ش‬ ‫حُؼ٠ِش‬ٝ ‫خٗ٤ش‬‫ا‬‫حُ٬ٓ٤ش‬ ‫حٌُه٘٤ش‬ ‫حُؼ٠ِش‬ ‫ػِ٤ٜٔخ‬ ٌِ‫طَط‬ ٕ‫ٓلِ٤خ‬ ٕ‫ػ٘خ‬ٝ ،‫حُٔ٘لَف‬ ٢‫حُو‬ ‫حٌُه٘٤ش‬ ‫حُ٘ظٞءحص‬ ٖٓ ‫٣٘٘ؤ‬ ٝ ،ٌْ٤‫ٓز‬ ‫ٗٞى‬ ٢‫ك‬ ‫حُؼخُؼش‬ ٠‫حَُك‬ ‫هِق‬ ٢ٜ‫٣٘ظ‬ ١ٌُ‫ح‬ ٖ١‫حُزخ‬ٝ ،‫حُ٬ٓ٤ش‬ ‫حُ٠َٓ٤ش‬ ‫حُؼ٠ِش‬ ٚ٤ِ‫ػ‬ ٌِ‫طَط‬٢‫حُو‬ ‫ٌٛح‬ ٠ِ‫أػ‬ ٢‫ك‬ ٝ ٕ‫حُِٔخ‬ ‫طلض‬ ‫حُللَس‬ ‫طٞؿي‬.ٕ‫حُِٔخ‬ ‫طلض‬ ‫حُـيس‬ ‫ك٤ٜخ‬ ٌٖٔ‫ط‬‫ك٤غ‬ ‫حُلٌ٤ش‬ ‫طلض‬ ‫حُللَس‬ ‫كظٞؿي‬ ٖ١‫حُزخ‬ ‫حُٔ٘لَف‬ ٢‫حُو‬ َ‫أٓل‬ ‫أٓخ‬ ‫طل‬ ‫حُـيس‬ ٌٖٔ‫ط‬٩‫ح‬ ‫٣ٞؿي‬ ‫ٜٓ٘خ‬ ّ‫ح٧ٓخ‬ ٠ُ‫ا‬ ،‫حُلي‬ ‫ض‬ٖ٤٘٤‫حُزط‬ ‫ًحص‬ ‫ُِؼ٠ِش‬ ٢ٓ‫ح٧ٓخ‬ ُ‫ٍطٌخ‬. ُ٘‫ح‬ ٢ٜ‫ط٘ظ‬‫ؼ‬ٖ٣‫ر٘ظٞأ‬ ‫حُٜخػيس‬ ‫ش‬,ٝ ١ٍ‫حُٔ٘وخ‬ ‫حُ٘ظٞء‬ ٠‫٣يػ‬ ٢ٓ‫أٓخ‬ٝ ٢‫هِل‬٢ٔ‫حُِو‬ ‫رخُ٘ظٞء‬ ٠‫٣يػ‬ٌَ٘٣ ٜٞ‫ك‬ ١ٍ‫حُٔ٘وخ‬ ‫حُ٘ظٞء‬ ‫أٓخ‬ ، ‫ا‬‫حُٜيؿ٤ش‬ ‫ُِؼ٠ِش‬ ً‫ح‬ُ‫ٍطٌخ‬ٝ ،‫حُؼ٘ن‬ ٢ٛ ‫ٟ٤وش‬ ‫روطؼش‬ ‫حَُأى‬ ‫ٓغ‬ َٜ‫ك٤ظ‬ ٢ٔ‫حُِو‬ ‫حُ٘ظٞء‬ ‫ر٤٘ٔخ‬ ،ٝ َ‫ٓوؼ‬ ٢ٔٗ٧‫ح‬ ‫ؿٜش‬ٚ٤ِ‫ػ‬ ٌِ‫طَط‬ ٝ ‫حُٞك٘٤ش‬ ‫حُـ٘خك٤ش‬ ‫حُؼ٠ِش‬ٝ ‫ؿِ٤ظش‬ ‫حُٞك٘٤ش‬ ٚ‫كخكظ‬َٜ‫ُِٔل‬ ‫حُلٌ٤ش‬ ‫حُؼٌحٍ٣ش‬ ٝ‫أ‬ ‫حُٞك٘٤ش‬ ‫حُـخٗز٤ش‬ ‫ح٧ٍرطش‬ ‫ػِ٤ٜخ‬ ٌِ‫طَط‬.
  • 24.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 15 ‫ا‬ًٍٞٔ ‫ٛخرش‬ٝ ٖ٤ٌ‫حُل‬ ّ‫ػظخ‬ٝ ٚ‫حُٞؿ‬‫ٓلخِٜٛخ‬ ٧‫ح‬ ٌٕٞ‫ط‬ ٚ‫حُٞؿ‬ ّ‫ػظخ‬ ًٍٞٔ ‫ػ٘ي‬ٝ ٌَُٔ‫ح‬ ‫رٔ٘طوش‬ ‫ؿخُزخ‬ ٚ‫َٓطزط‬ ٝ‫ػَح‬ٝ ٚ‫ٗيط‬‫أ‬‫ٜٛٔخ‬: : ‫َٓ٣َ٣خ‬ * -ٝ ‫ح٩ٛخرش‬ ٕ‫ٌٓخ‬ ُْٔ ‫ػ٘ي‬ ُْ‫أ‬‫ح٩ٛخرش‬ ٕ‫ٌٓخ‬ ٢‫ك‬ ‫كخى‬ ُْ‫أ‬, -‫ك‬‫ط‬ ٢‫ك‬ ٚ‫حُٜؼٞر‬ َ‫ٓؼ‬ ٚ‫حُٞظ٤ل‬ ٕ‫ويح‬٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ‫ػ٘ي‬ ‫حُلي‬ ‫لَ٣ي‬‫ا‬‫ٟخكش‬‫ا‬٧‫ح‬ ٠ُُْ, -ٚ‫حُ٘ل‬ ٢‫ك‬ ٍ‫هي‬ ‫٣ليع‬ ‫هي‬, -ٝ ٕ‫ح٧ٓ٘خ‬ ‫طلَى‬ ‫ٓغ‬ ُْ٧‫ح‬ ‫٣ليع‬ٝ ّ‫طخ‬ ٌَ٘‫ر‬ ‫ا١زخهٜخ‬ ‫آٌخٗ٤ش‬ ّ‫ػي‬٧‫ح‬٩‫ح‬ ‫ػ٘ي‬ ‫حُ٘ي٣ي‬ ُِْٗ ، ‫١زخم‬ّ‫ػي‬ ‫ٓغ‬ ْ‫حُل‬ َ‫ىحه‬ ‫ف‬ ‫كظلش‬ ‫آٌخٗ٤ش‬ْ‫حُل‬, -٧‫ح‬ٝ ُْ٧‫ح‬ ٍّٞ‫ط‬‫ٗٔـ‬١ِٞ‫حُؼ‬ ‫حُلي‬ ًٍٞٔ ‫ػ٘ي‬ ٚ‫حُٔل٤ط‬ ٚ‫أ‬ٔ‫حُـٔـ‬ ‫هخػيس‬ ٝ, ‫ش‬ -ٌَُٔ‫ح‬ ٕ‫ًخ‬ ‫اًح‬ ‫ٝحٟق‬ ٙٞ٘‫ط‬ٝ ً٬ٓ‫ًخ‬ٝ ‫ٌٓخٜٗخ‬ ٖٓ ‫طلًَض‬ ‫حٌٍُٔٔٞس‬ ّ‫حُؼظخ‬ ‫أؿِحء‬ٙٞ٘‫ط‬ّ‫ػظخ‬ ًَٔ ‫ػ٘ي‬ ٚ‫حُٞؿ‬ ٢‫ك‬‫حُلـخؽ‬ ٝ٧‫ح‬ ّ‫ػظخ‬ٝ ٍّٞ‫حُظ‬ ٖ‫ػ‬ ٬٠‫ك‬ ‫ٗق‬ٝ ‫حٌُيٓخص‬‫حُِ٘ف‬. *‫حُٔ٠خػلخص‬ -‫حُِ٘ف‬ ‫ٗيس‬ ‫رٔزذ‬ ٚٓ‫حُٜي‬, -‫ا‬ٖ٤‫حُؼ‬ ‫ٛخرش‬ٝ‫أ‬ ‫حُوَ٣زش‬ ‫ح٧ػٜخد‬ ٝ‫أ‬ ‫ح٧ٗق‬ ,ٝ ‫ح٧ٍرطش‬ ( ٚ‫حُٔل٤ط‬ ‫حُظَحً٤ذ‬ٍ‫ح٧ٝطخ‬ٝ‫حُٔل‬ ‫ح٧ٗٔـش‬ ٝ‫أ‬ ‫حُيٓٞ٣ش‬ ‫ح٧ٝػ٤ش‬)‫٤طش‬, -ْ‫حُظ٘ل‬ ٢‫ك‬ ‫اػخهش‬, -ٝ‫ٓخ‬ ‫ٓ٠خػلخص‬ َٜ‫طل‬ ‫هي‬‫حُ٘ي٣ي‬ ‫ًخُِ٘ف‬ ٚ‫حُـَحك‬ ‫رؼي‬‫أ‬‫حُظِٞع‬ ‫ٗظ٤ـش‬ ٝ‫أ‬‫ك‬ ‫ٓٞص‬ ٝ‫حُظ‬ ‫هطغ‬ ‫رٔزذ‬ ّ‫حُؼظخ‬ ‫ه٬٣خ‬ ٢. ‫حُيٓٞ٣ش‬ ‫َٝ٣ش‬ *ٍٙٞ‫حُوط‬: ‫ا‬ٝ ‫حُظـٌ٣ش‬ ‫ٟؼق‬ ٕ٤ُٔ‫حٌُخ‬ ٚ‫ٗو‬ ‫هخٛش‬٢‫ك‬ ‫ٓٔخػيح‬ ٬ٓ‫ػخ‬ ‫٣ؼي‬ ّٞ٩‫ح‬ ‫ُٜٓٞش‬ٌٍُٞٔ‫رخ‬ ٚ‫ٛخر‬ ٝ ٖ٤‫حُظيه‬ ‫ٓغ‬ ‫حُوطٍٞس‬ ‫طِىحى‬ َ٣‫حُظوي‬ ٝ‫أ‬ ‫حُـَحكش‬ ‫كخُش‬ ٢‫ك‬ ‫ًٌُي‬‫ا‬ٝ , ‫ُِؼ٠٬ص‬ ‫حَُٔه٤ش‬ ‫ح٧ىٝ٣ش‬ ( َ‫ٓؼ‬ ‫ح٧ىٝ٣ش‬ ٞ‫رؼ‬ ٍ‫ٓظؼٔخ‬ ‫حُٜٔيثش‬ ‫ح٧ىٝ٣ش‬ٝ ,ٝ ٢‫حُ٠ـ‬ ‫أىٝ٣ش‬ٝ ‫حُٔ٘ٞٓخص‬ٝ ‫حٌُٔٔ٘خص‬ٝ ٖ٤ُٞٔٗ٧‫ح‬. )ِٕٝ٤‫حٌٍُٞط‬ *٣‫حُٞهخ‬: ‫ش‬ +‫ا‬ٚ‫حُٞؿ‬ ‫ُلٔخ٣ش‬ ٚ٤‫ٝهخث‬ ّ‫ُُٞح‬ ‫ٍطيحء‬ٝ٩‫ح‬ ٖٓ ْ‫حُل‬ٝ ٟٚ‫حَُ٣خ‬ ٢‫ك‬ ٚ‫ٛخر‬٩‫ح‬٤ٗ‫رخُوٞح‬ ّ‫ُظِح‬ٖ، +‫ا‬ّ‫ٓظويح‬‫أ‬‫كِٓش‬‫ػِٔخ‬ ‫حُٔ٤خٍص‬ ‫ه٤خىس‬ ‫ػ٘ي‬ ‫حُٔوخػي‬‫أ‬ُٜٞ‫ح‬ ‫حُٞٓخثي‬ ٕ‫ُ٤ٔض‬ ‫حُٔ٤خٍحص‬ ٢‫ك‬ ٙ‫حُٔٞؿٞى‬ ٚ٤‫حث‬‫آ‬٢‫ك‬ ‫طٔخٓخ‬ ٚ٘ٓ‫ا‬‫ٛخرخص‬ ٚ‫حُٞؿ‬,‫٣ـذ‬ ‫ًٔخ‬‫ا‬‫حُو‬ ‫ٍطيحء‬٣ٍ‫حُ٘خ‬ ‫حُيٍحؿخص‬ ‫ه٤خىس‬ ‫ػ٘ي‬ ‫ًٞحص‬‫ش‬, +٢‫ك‬ ٖ٤ٌ‫ٝحُل‬ ٚ‫حُٞؿ‬ ‫اٛخرخص‬ ٖٓ ‫حُٞهخ٣ش‬ ‫ً٤ل٤ش‬‫ح‬ٟ‫َُ٣خ‬‫ش‬ ‫ا‬ٕ‫ا‬‫حُٞح‬ ّ‫ٓظويح‬١‫حُ٘٘خ‬ ‫ُ٘ٞع‬ ‫حُٔ٘خٓزش‬ ‫ه٤خص‬‫٣ٔظط٤غ‬‫أ‬٩‫ح‬ ‫ٗٔذ‬ ٖٓ َِ‫٣و‬ ٕ٧‫ح‬ ٢‫ك‬ ‫ٛخرخص‬ٝ ‫ُؼخد‬٩‫ح‬ ‫ًحص‬ ً‫ش‬ٛ‫هخ‬‫ح‬ ‫كظٌخى‬َٗ‫ُٔزخ‬ ٖ٤‫حُ٬ػز‬ ٖ٤‫ر‬‫أ‬ّ‫حُظٜخى‬ ٝ‫أ‬٠ُ‫ح‬ ‫طلظخؽ‬ ٢‫حُظ‬ ‫ح٫ُؼخد‬ ٝ‫هٞس‬‫ػخُ٤ش‬،ٝ‫ُٞهخ٣ش‬ٝ ٖ٤ٌ‫حُل‬٧‫ح‬ٕ‫ٓ٘خ‬‫أ‬ٝ ‫ٓ٬ثٔش‬ ‫ٝحه٤خص‬ ‫هظَكض‬َ‫ٓؼ‬ ‫ىه٤وش‬ ٢‫ٝحه‬(Custom mouthgard)ٝ٩‫ح‬ ٖٓ ٢‫حُٞحه‬ ‫ٌٛح‬ َِ‫٣و‬ ‫هي‬‫حُيٓخؿ٤ش‬ ‫ٍطـخؿخص‬‫ا‬ٚ‫ٟخك‬‫ا‬٧‫ح‬ ‫ٝهخ٣ش‬ ٠ُ٩‫ح‬ ٖٓ ٕ‫ٓ٘خ‬٧‫ح‬ ٢‫ك‬ ‫ٛخرخص‬‫ُؼخد‬ ‫حَُ٣خٟ٤ش‬،ٝ‫ى‬ ‫هي‬‫ٍَٟٝس‬ ٠ِ‫ػ‬ ٚ٤ٗ‫حُٔ٤يح‬ ‫حُظـخٍد‬ ‫ُض‬‫ا‬‫ػ٘ي‬ ْ‫حُل‬ ٢‫ٝحه‬ ‫ٍطيحء‬‫أ‬ٝ ‫حُٔ٘خُ٫ص‬ ‫ُؼخد‬‫حُ٠َرخص‬ ‫ك٤ٜخ‬ ٌٕٞ‫ط‬ ٢‫حُظ‬‫أ‬٩‫ح‬ ٝ‫كظٌخى‬ ٝ٩‫ح‬‫حُليٝع‬ ٌٖٔٓ َٗ‫حُٔزخ‬ ّ‫ٛطيح‬. ‫حُـٔؼ٤ش‬ ‫أٛيٍص‬ ‫ٝهي‬‫حُؼخُٔ٤ش‬‫ٍَٟٝس‬ ٍٞ‫ك‬ ‫طؼِ٤ٔخص‬ ٕ‫ح٧ٓ٘خ‬ ‫ُطذ‬‫ا‬ٍ٥‫ح‬ ‫ح٧ُؼخد‬ ٢‫ك‬ ٕ‫ح٧ٓ٘خ‬ ٢‫ٝحه‬ ‫طيحء‬ٚ٤‫ط‬:٧‫ح‬‫ًَٝرخط٤ي‬‫ًَس‬ ، ُِٔ‫ح‬‫ش‬‫حُٔ٬ًٔش‬ ،،٢ًُٜٞ‫ح‬،، ّ‫حُوي‬ ‫ًَس‬‫حُـٔ٘خٓظي‬،‫حُ٤ي‬ ‫ًَس‬ٖ٤‫حُٔظُِـ‬ ،،‫حُوظخُ٤ش‬ ٕٞ٘‫حُل‬،ُ‫ح‬٢‫ًَز‬،‫حَُٓخ٣ش‬،‫حُٔظ٬ص‬، ٧‫ح‬ٕ‫ٌٓٞح‬،ٍ‫ح٧ػوخ‬ ‫ٍكغ‬،‫ح‬‫ُٜٔخٍػ‬‫ش‬،‫حُطخثَس‬ ‫ًَس‬،ٍٝٞ‫حُز٤ٔز‬...... +‫أ‬ْ‫حُل‬ ‫ٝحه٤خص‬ ‫ٗٞحع‬: -‫حُـخِٛس‬ ‫حُٞحه٤ش‬(Stock Mouth Guard)‫حٍُٜٞس‬ (1، ٖ٤ٌ‫حُل‬ ١ٞ‫طل‬ ٕ‫أ‬ ‫طٔظط٤غ‬ ‫ٝحكيس‬ ‫ٓطخ١٤ش‬ ‫هطؼش‬ ٖ‫ػ‬ ‫ػزخٍس‬ : )
  • 25.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 16 -‫طًَ٤زش‬‫هخٛش‬Mouth Formed boil and bite‫حٍُٜٞس‬ (2: )ْ‫حُل‬ ٌَٗ ٌ‫طؤه‬ ‫هخٛش‬ ‫طًَ٤زش‬ ٌٙٛ‫أ‬‫حُٔخء‬ ٢‫ك‬ ‫طٟٞغ‬ ( ْ‫حُل‬ ‫ٛ٤جش‬ ٝ ٍ‫حُلخ‬‫ط‬ ٢ٌُ ْ‫حُل‬ ٢‫ك‬ ‫طٟٞغ‬ ْ‫ػ‬‫ؤ‬) ٌِٚٗ ٌ‫ه‬ٝ ْ‫حُل‬ ٢‫ك‬ ‫طؼزض‬ ‫ك٤غ‬٧ ٚ‫رَٔػ‬ ‫طوَؽ‬ْ‫حُٔ٬ث‬ ٌَُ٘‫ح‬ ٌ‫ه‬ Custom Made –‫(حٍُٜٞس‬3)٧‫ح‬ ‫١ز٤ذ‬ َ‫هز‬ ٖٓ ‫طٜ٘غ‬ ‫ٝحه٤ش‬‫ك٤غ‬ ٕ‫ٓ٘خ‬ٝ ٚ‫١زؼ‬ ٌ‫طئه‬‫١َ٣ن‬ ٖ‫ػ‬ ٌَٔ‫ط‬ٝ ، َ‫حُٔوظز‬ٌٙٛ ‫طؼي‬ ٧‫ح‬ ٚ٤‫حُٞحه‬‫رو٤ش‬ ٖٓ َ٠‫ك‬‫أ‬ٝ ٢ٟ‫حَُ٣خ‬ ‫ٍحكش‬ ‫ك٤غ‬ ٖٓ ‫حُٞحه٤خص‬ ‫ٗٞحع‬ٝ ٖ٤‫ٓ٘ظ‬ ‫ُٔيس‬ ٠‫طزو‬‫ًخك٤ش‬ ‫ٝهخ٣ش‬ َ‫طٞك‬ ‫حُٞهض‬ ْ‫ر٘ل‬ +ْ‫حُل‬ ‫ٝحه٤خص‬ ْ٤٤‫طو‬: ٚ‫حُٞؿ‬ ٝ ‫ا‬‫حُـٔؼ٤ش‬ ‫طٞٛ٤خص‬ ٠ِ‫ػ‬ ً‫ح‬‫ػظٔخى‬‫حُؼخُٔ٤ش‬٧‫ح‬ ‫٧١زخء‬٠ِ‫ػ‬ ‫أًيص‬ ٕ‫ٓ٘خ‬‫أ‬٠‫أك‬ ٕ‫٣ـذ‬ ً‫ح‬َ٤‫طؤػ‬ َ‫ٝح٧ًؼ‬ ‫حُٞحه٤خص‬ َ‫أ‬ٌٕٞ‫ط‬ ٕ: -، ‫َٓٗش‬ ‫َٓ٣لش‬ -٫ًَ‫طظؤ‬ -‫أ‬ٝ ْ‫حُل‬ ٢‫ك‬ ‫ػخرظش‬ ٌٕٞ‫ط‬ ٕ‫حُظ٘ظ٤ق‬ ‫ِٜٓش‬ -٫ٌِْ‫حُظ‬ ٠ِ‫ػ‬ َ‫طئػ‬‫أ‬ْ‫حُظ٘ل‬ ٝ -‫أ‬١‫أ‬ ‫ىحثٔ٤ش‬ ٌٕٞ‫ط‬ ٕ‫أ‬ِٚ٣ٞ١ ‫ُلظَس‬ ّٝ‫طي‬ ٕ. ٞ٣ ٝ‫ر‬ ٢ٛ‫ب‬٥‫ح‬ ‫حُٞحه٤خص‬ ٖ٤ٟ‫حَُ٣خ‬ ‫ٍطيحء‬ٚ٤‫ط‬ٍٚٓ‫حُٔٔخ‬ ٚ‫حُِؼز‬ ‫ٗٞع‬ ‫كٔذ‬ -ّ‫حُوي‬ ‫ًَس‬(ٝ ٚ‫ٝؿ‬ ٢‫ٝحه‬ ‫ٓغ‬ ًٙٞ‫ه‬ٕ‫حٓ٘خ‬ ٢‫ٝحه‬) -‫حُٔ٬ًٔش‬(ْ‫حُظ٘ل‬ ‫٫٣ؼ٤ن‬ ‫رل٤غ‬ ٙ‫هخ‬ ٌَ٘‫ر‬ ْٜٔٓ ٕ‫حٓ٘خ‬ ٢‫ٝحه‬) -ٚ‫حُٜٔخٍػ‬(ًٙٞ‫ه‬–ٚ‫ٝؿ‬ ٢‫ٝحه‬) -ٍٞ‫حُز٤ِر‬(ًٙٞ‫ه‬–ٚ‫ٝؿ‬ ٢‫ٝحه‬) -ًٙٞ‫رو‬ َٜ‫ٓظ‬ ٚ‫ٝؿ‬ ٢‫ٝحه‬ ( ‫حُـِ٤ي‬ ٢ًٞٛ) -٢ًُٜٞ‫ح‬(ٕ‫حٓ٘خ‬ ٢‫ٝحه‬) -‫ًَس‬‫ح٫َٓ٣ٌ٤ش‬ ّ‫حُوي‬(Soccer)(ًٙٞ‫ه‬ ‫ٓغ‬ ٢‫ٝحه‬) 123
  • 26.
  • 27.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 17 ًٔٞ٠ِ‫حُٔل‬ ‫حُلي‬ ٍ A-:‫ٓويٓش‬ ٝ ْٔ‫حُـ‬ ّ‫ػظخ‬ ًٍٞٔ ٢‫ك‬ ً‫ح‬َٗ‫ػخ‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ‫طٜ٘ق‬ٚ‫حُٞؿ‬ ّ‫ػظخ‬ ًٍٞٔ ٢‫ك‬ ‫ح٧ٗق‬ ْ‫ػظ‬ ‫رؼي‬ ً‫خ‬٤ٗ‫ػخ‬ٝ‫ًُي‬ ‫٣ؼٞى‬: ٠ُ‫ا‬ 1-‫ٓٞهغ‬٢ِ‫حُٔل‬ ‫حُلي‬. 2-‫ٝحُؼ٘ن‬ ٚ‫حُٞؿ‬ ّ‫ػظخ‬ ٖ٤‫ر‬ َُٙٝ‫ر‬. 3-‫ا‬ٚ‫ٗل٘خث‬ٕ‫حُلٜخ‬ ‫ُلٌٝس‬ ٚ‫حُٔ٘خر‬ ٌِٚٗ ٝ. ٝ ٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ٍ‫طزي‬ ٢‫ك‬ ً‫ح‬َ٤‫ًز‬ ً‫ح‬ٍٝ‫ى‬ ‫حُؼ٠٬ص‬ ‫طِؼذ‬ٝ ‫حُلي‬ ‫٣ئى٣ٜخ‬ ٢‫حُظ‬ ‫حُلًَخص‬ ْٛ‫أ‬ ًٌَٗ ‫ٓٞف‬ ٢ِ٣ ‫ك٤ٔخ‬‫حُؼ٠٬ص‬ ‫ػٜ٘خ‬ ‫حُٔٔئُٝش‬: 1 -‫حَُحكؼش‬ ‫حُؼ٠٬ص‬ ‫طئى٣ٜخ‬ ّ‫ح٧ٓخ‬ ٞ‫ٗل‬ ‫طويٓ٤ش‬ ‫كًَش‬.ٕٝ‫حُٔخٟـظخ‬ ٕ‫حُؼ٠ِظخ‬ ‫أٜٛٔخ‬. 2 -‫كًَش‬ٝ ٠ِ‫ح٧ػ‬ ٞ‫ٗل‬ ‫اؿ٬م‬ٝ ‫حَُحكؼش‬ ‫حُؼ٠٬ص‬ ‫طئى٣ٜخ‬٢ٛ: ٬٠‫حُؼ‬: ‫ص‬-ُ‫ح‬‫ـ٘خك٤ش‬٧‫ح‬‫ٗٔ٤ش‬,ُ‫ح‬‫ٜيؿ٤ش‬. -‫حُٞك٘٤ش‬ ‫حُـ٘خك٤ش‬ ‫حُؼ٠ِش‬. 3 -ٝ َ‫ح٧ٓل‬ ٞ‫ٗل‬ ‫كظق‬ ‫كًَش‬ٝ ‫حُوخك٠ش‬ ‫حُؼ٠٬ص‬ ‫طئى٣ٜخ‬‫أٜٛٔخ‬: -ٖ٤٘‫حُزط‬ ‫ًحص‬
  • 28.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 18 ‫حُ٬ٓ٤ش‬ ‫حٌُه٘٤ش‬ ‫ـ‬ ‫ح٧ٓخٓ٤ش‬ ‫حُ٠َٓ٤ش‬ ‫ـ‬ B-‫حُظٜ٘٤ق‬: ٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ‫طٜ٘٤ق‬ ٌٖٔ٣٠ُ‫ا‬: ‫أ‬٢ٔ‫حُؼظ‬ ‫حُٜيع‬ .Greenstick Fracture:ٖٝٞٛ‫ػ‬ ‫ػزخٍس‬ًَّٔ‫طخ‬ َ٤‫ؿ‬ٌٖٔ٣ ‫ٓخ‬ ‫ؿخُزخ‬ ٝ‫حُِ٤٘ش‬ ٍ‫ح٧١لخ‬ ّ‫ػظخ‬ ٢‫ك‬ ٚ‫ٜٓخىكظ‬ )َ٤‫حُ٘ظ‬ ٖٜ‫حُـ‬ ًَٔ(ٖ٤‫حُزخُـ‬ ّ‫ػظخ‬ ٢‫ك‬ ٚ‫ٜٓخىكظ‬ ٌٖٔ٣ ‫ًٔخ‬ ، ْٜٓ‫ػظخ‬ ٢‫ك‬ ٌِْ‫حُظ‬ ٚ‫ُ٘و‬ ‫ٗظ٤ـش‬ٕ‫ًخ‬ ٍ‫كخ‬ ٢‫ك‬١‫حُٔئى‬ ‫حُٔزذ‬ ‫ًخف‬ َ٤‫ؿ‬ ٌَُٔ‫ح‬ ‫ُليٝع‬. ‫د‬٢ٔٔ‫حُو‬ ٌَُٔ‫ح‬ .Partial F.ْ‫حُؼظ‬ ٖٓ ‫ؿِء‬ ٍ‫اٗلٜخ‬ ٖ‫ػ‬ ‫ػزخٍس‬ ٞٛ ٝ :) ٢‫ٓ٘و‬ ٌٕٞ٣ ‫ؿخُزخ‬ (‫ح٧ٓخ‬ ‫حُؼظٔ٤ش‬ ‫حُوطؼش‬ ٖ‫ػ‬ٓ‫٤ش‬ ‫كيٝع‬ ٕٝ‫ى‬ّ‫طخ‬ ٍ‫اطٜخ‬ ‫اٗوطخع‬. ‫ح٧ه٤َس‬ ٢‫ك‬ ‫ص‬ّ‫حُظخ‬ ٌَُٔ‫ح‬ .Completely F.‫حُؼظٔ٤ش‬ ‫حُوطؼش‬ ٢‫ك‬ ّ‫طخ‬ ٍ‫اطٜخ‬ ‫اٗوطخع‬ ٞٛ ٝ :. 1-‫اىنسش‬ ‫ىْىع‬ ً‫ا‬‫وفق‬ ‫اىراٍح‬ ‫اىنسىس‬ ‫ذصٍْف‬: ٢٤ٔ‫حُز‬ ٌَُٔ‫ح‬ .‫أ‬Simple F. :٢ُٓٞ‫ح‬ ٝ‫أ‬ ١ٞٔ‫حُل‬ ٢ُٓٞ‫ح‬ ‫ٓغ‬ َٜ‫ٓظ‬ َ٤‫ؿ‬ ٌَُٔ‫ح‬ ٌٕٞ٣ ‫ك٤غ‬.٢‫حُوخٍؿ‬ ٢‫ك‬٢‫ُِطز٤ؼ‬ ‫ٓٔخ٣َس‬ ‫حُلي‬ ‫ٝكيٝى‬ ْ‫حُؼظ‬ ٢‫هطؼظ‬ ٖ٤‫ر‬ ‫طَحًذ‬ ‫٣ٞؿي‬ ٫ ٢٤ٔ‫حُز‬ ٌَُٔ‫ح‬ ‫حًَُٔذ‬ ٌَُٔ‫ح‬ .‫د‬Compound F. :َٜٝ‫٣ظ‬ ٚ٤‫ك‬ٌَُٔ‫ح‬ ٢‫ه‬٢‫ك‬ ‫ؿَف‬ ‫رٞحٓطش‬ ٢‫حُوخٍؿ‬ ٢ُٓٞ‫ح‬ ٝ‫أ‬ ١ٞٔ‫حُل‬ ٢ُٓٞ‫ح‬ ‫ٓغ‬ ‫حُـِي‬ ٝ‫أ‬ ‫حُلٔٞ٣ش‬ ‫حُٔوخ١٤ش‬. ‫ؽ‬-‫حُٔظلظض‬ ٌَُٔ‫ح‬Comminuted F.. ‫حُ٘ظخ٣خ‬ ٖٓ ‫ػيى‬ ١ٞ‫٣ل‬ ١ٌُ‫ح‬ ٝ : ‫ى‬-٢َُٟٔ‫ح‬ ٌَُٔ‫ح‬Pathological F.:ٍ َ‫أه‬ ‫ػ٘ي‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ًَٔ ‫٣ليع‬ ٕ‫أ‬ ٌٖٔ٣٢َٟٓ ‫رٔزذ‬ ‫ٓ٠ؼق‬ ْ‫ُؼظ‬ ‫٣ليع‬ ٝ َٓ‫ؼ‬‫ا‬ٝ ْ‫ػظ‬ ‫ُظٜخد‬٢‫ٗو‬،ّ‫أٍٝح‬،‫ػخٓش‬ ٝ‫أَٓح‬،ّ‫أً٤خ‬ ٙ-‫حُٔوظِطش‬ ٌٍُٞٔ‫ح‬Compound Comminuted Fractures: 2-‫اىنسش‬ ُ‫ىَنا‬ ً‫ا‬‫وفق‬ ‫اىراٍح‬ ‫اىنسىس‬ ‫ذصٍْف‬: ٝ ‫حُؼ٬ٓخص‬ ٕ٧ ‫ُ٨ً٣ش‬ ٢‫حُظَ٘٣ل‬ ٕ‫حٌُٔخ‬ ٠ِ‫ػ‬ ‫٣ؼظٔي‬ ‫ػِٔ٤ش‬ ‫٧ٓزخد‬ ٌٍُِٞٔ ‫طٜ٘٤ق‬ َ٠‫أك‬ ٕ‫ا‬‫ػخثيس‬ ‫ٝحُٔؼخُـش‬ ٝ‫ح٧ػَح‬ٕ‫ٌُٔخ‬ ٝ ٌَُٔ‫ح‬٢ُ‫ًخُظخ‬ ٢ٛ: ٢‫ٓ٘و‬ ٢٘ٓ .‫أ‬Dental – Alveolar F.ٝ‫كيٝػٜخ‬ ‫ٗٔزش‬ ‫طزِؾ‬3.1% ٢ٔ‫ُو‬ .‫د‬Condylar F. .ٝ‫كيٝػٜخ‬ ‫ٗٔزش‬ ‫طزِؾ‬29.1% ١ٍ‫ٓ٘وخ‬ .‫ؽ‬Coronoid F. .ٝ‫كيٝػٜخ‬ ‫ٗٔزش‬ ‫طزِؾ‬1.3% ‫حَُأى‬ .‫ى‬Ramus F. .ٝ‫كيٝػٜخ‬ ‫ٗٔزش‬ ‫طزِؾ‬1.7% ّ‫حُِحٝ٣ش‬ .Angle F. .ٝ‫كيٝػٜخ‬ ‫ٗٔزش‬ ‫طزِؾ‬24.5% ْٙٔ‫حُـ‬ .Body F. .ٝ‫كيٝػٜخ‬ ‫ٗٔزش‬ ‫طزِؾ‬16% ٝ.ٝ ٖ‫حٌُه‬‫ا‬ٖ‫حٌُه‬ ‫ٍطلخم‬Symplysis F. .ٝ‫كيٝػٜخ‬ ‫ٗٔزش‬ ‫طزِؾ‬22%
  • 29.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 19 ‫حُظَط٤ذ‬ ْ‫ٗل‬ ٠ِ‫ػ‬ ‫طظلن‬ ‫ٌُٜ٘خ‬ ٝ ‫حَُٔحؿغ‬ ‫كٔذ‬ ‫ِٔذ‬ُ٘‫ح‬ ٌٙٛ ‫طوظِق‬ 3-‫اىنسش‬ ‫ىسثة‬ ً‫ا‬‫وفق‬ ‫اىراٍح‬ ‫اىنسىس‬ ‫ذصٍْف‬: :ٌَُٔ‫ح‬ ‫ٓزذ‬ ٌٕٞ٣‫آخ‬‫ٛيٓش‬‫ٓزخَٗس‬ٝ‫أ‬‫ٓزخَٗس‬ َ٤‫ؿ‬ ‫ٛيٓش‬‫رٔزذ‬ ٝ‫أ‬‫حُِحثي‬ ٢ِ٠‫حُؼ‬ ِٚ‫حُظو‬. ٝ٠ُ‫ا‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ‫طٜ٘ق‬ ٢ُ‫رخُظخ‬: .‫أ‬‫حُـخٗذ‬ ‫ٝك٤ي‬ ًَٔUnilateral F . .‫د‬‫حُـخٗذ‬ ٢‫ػ٘خث‬ ًَٔBilateral F. .‫ؽ‬‫ٓظؼيى‬ ًَٔMultiple F. .‫ى‬‫ٓظلظض‬ ًَٔComminuted F. َٝ٤‫طؤػ‬ َٜ‫٣ظ‬ ‫ٛ٘خ‬ ٖٓ‫ا‬ٝ ٙ‫طـخ‬‫حُٜيٓش‬ ‫ٗٞع‬‫حُٔزخَٗس‬ ‫كخُٜيٓش‬ ،‫هي‬ٕ‫ٌٓخ‬ ٢‫ك‬ ‫ٓزخَٗس‬ َ٤‫ؿ‬ ٟٞ‫ه‬ ‫طُٞي‬ِ‫حُٔل‬ ‫حُلي‬ ٖٓ َ‫آه‬ٌٙٛ . ٢ ٟٞ‫حُو‬ُ‫ح‬‫ًخك‬ ‫حُٔزخَٗس‬ َ٤‫ـ‬‫٤ش‬ًَٔ ‫٩كيحع‬ٕ‫ػخ‬. ‫ػخُغ‬ ٝ‫أ‬ ٝ‫حُٔخرن‬ ‫حُظٜ٘٤ق‬ َٜ‫ظ‬ ‫حُٞؿٜش‬ ٌُٜٙ ‫ٗظ٤ـش‬. 1-‫حُـخٗذ‬ ‫ٝك٤ي‬ ٌَُٔ‫ح‬: 2-ٌَُٔ‫ح‬‫حُـخٗذ‬ ٢‫ػ٘خث‬: 3-ٌَُٔ‫ح‬:‫حُٔظؼيى‬ٝ ‫حُٔزخَٗس‬ ‫حُٜيٓش‬ ‫أِٓٞد‬ ْ‫ر٘ل‬ٝ ‫حُٔزخَٗس‬ َ٤‫ؿ‬‫ٓزخَٗس‬ ‫ٛيٓش‬ ٞٛ ً‫خ‬‫ٗ٤ٞػ‬ َ‫ح٧ًؼ‬ ‫حُٔظؼيى‬ ٌَُٔ‫ح‬ ‫حُٔظ‬ ‫حُٔ٘طوش‬ ٠ِ‫ػ‬ ١ٞ‫حُٔو‬ ‫ٗظ٤ـش‬٢‫ك‬ ًَٔ ‫ػٜ٘خ‬ ‫٣٘ظؾ‬ ٖ‫حٌُه‬ ٖٓ ‫ٞٓطش‬‫ا‬ٝ )‫ٓزخَٗس‬ ‫حٌُهٖ(ٛيٓش‬ ‫ٍطلخم‬ٖ٤‫حُِؤظ‬ ٬ً ٢‫ك‬ ًَٔ َ٤‫ؿ‬ ‫(ٛيٓش‬‫ٓزخَٗس‬.) 4-‫حُٔظلظض‬ ٌَُٔ‫ح‬:
  • 30.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 20 4-‫إ‬ ‫حسة‬ ‫اىنسش‬ ‫ذصٍْف‬‫اىنسش‬ ‫خظ‬ ٓ‫ذجا‬: ‫ٓٔظلزش‬ ًٍٞٔ : ٠ُ‫ا‬ ٌَُٔ‫ح‬ ٢‫ُو‬ ً‫خ‬‫طزؼ‬ ٌٍُٞٔ‫ح‬ ‫طٜ٘ق‬ٟٞ‫ه‬ ‫ًخٗض‬ ٍ‫كخ‬ ٢‫ك‬ ( ) ٌَُٔ‫ح‬ ٢‫ه‬ ٖٓ َ٤‫طـ‬ ٫ ‫حُؼ٠٬ص‬َٝ٤‫ؿ‬ ًٍٞٔ‫ٓٔظلزش‬‫ٗي‬ ٟٞ‫ه‬ ‫ًخٗض‬ ٍ‫كخ‬ ٢‫ك‬ ( ) ٌَُٔ‫ح‬ ٢‫ه‬ ٢‫ك‬ َ٤‫طـ‬ ٠ُ‫ا‬ ١‫طئى‬ ‫حُؼ٠٬ص‬. ١‫حُؼٔٞى‬ ٙ‫ح٩طـخ‬ ٢‫ك‬ *(A): ٢‫ح٧كو‬ ٙ‫ح٩طـخ‬ ٢‫ك‬ *(B): ٢‫حُلَحؿ‬ ٙ‫ح٩طـخ‬ ٢‫ك‬ *(C): ‫ح٩ُظٞحء‬ : 5-‫حسة‬‫اىنسش‬ ‫خظ‬ ‫ذثذه‬: ٌَُٝٔ‫ح‬ ٢‫ه‬ ٙ‫اطـخ‬ ‫ٓغ‬ ٢ِ٠‫حُؼ‬ ‫حُ٘ي‬ ٟٞ‫ه‬ ٙ‫اطـخ‬ ٠ِ‫ػ‬ ‫٣ؼظٔي‬ ( ‫حُؼظٔ٤ش‬ ‫ح٩ٓظَٔحٍ٣ش‬ ٢‫ك‬ َ٤٤٤‫طـ‬ ‫٣ليص‬ : ‫ٓٔظلذ‬ َ٤‫ؿ‬ *Aٌَُٔ‫ح‬ ٢‫ُو‬ ‫ٓٞحُ٣ش‬ ‫حُ٘ي‬ ٟٞ‫ه‬ ٕ‫أ‬ ‫ك٤غ‬ ) ( ٌَُٔ‫ح‬ ٢‫ه‬ ٢‫ك‬ ‫طَحًذ‬ ‫٣ليع‬ ٫ : ‫ٓٔظلذ‬ *B)ٌَُٔ‫ح‬ ٢‫ُو‬ ‫ٓؼخًٔش‬ ‫حُلخُش‬ ٌٙٛ ٢‫ك‬ ‫حُ٘ي‬ ٟٞ‫ه‬
  • 31.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 21 6-‫وجىد‬ ‫حسة‬ ‫اىنسش‬ ‫ذصٍْف‬ُ‫األسْا‬: ٝ ٚ‫اُحُظ‬ ‫٣ـذ‬ ٌَُٔ‫ح‬ ٢‫ه‬ ٢‫ك‬ ٖٓ ًٌَْ‫رل‬ ٕ‫اٗظخ‬ ٍ‫ٜٓي‬ ٕ‫ح٧ٓ٘خ‬ ٕ٧ ‫ًُي‬‫رٔزذ‬ ‫طٔٞص‬ ‫هي‬ ٢‫حُِز‬ ‫حُ٘ٔ٤ؾ‬ ًٕٞ‫ا‬‫حُظَٝ٣ش‬ ‫ٗوطخع‬ ‫ُليٝع‬ ‫٣ئٛذ‬ ‫ٓٔخ‬‫ا‬ٝ ْ‫ػظ‬ ‫ُظٜخد‬٢‫ٗو‬. ٝ٩‫ح‬ ‫٣ـذ‬ ٌُٖٙ‫ٗظزخ‬٠ِ‫ػ‬ ‫ُ٪روخء‬ٍ‫كخ‬ ٢‫ك‬ ُٖٔ‫ح‬‫ا‬ ‫حُلخؿش‬ٚ٤ُٝ ‫حُظؼز٤ض‬ ٢‫ك‬‫حُ٘لخء‬ ‫َٓحهزش‬‫ًٔخ‬٠ِ‫ػ‬ َٟ‫حُؼ‬ ‫ٟٝغ‬ ّ‫ػي‬ ‫٣ـذ‬ ٌَُٔ‫ح‬ ٢‫رو‬ ٍُٞٔ٘ٔ‫ح‬ ُٖٔ‫ح‬. ُ‫ح‬ ‫ح٩ٓظطزخرخص‬ *‫وطؼ٤ش‬: ٌَُٔ‫ح‬ ٢‫ه‬ ٖٓ ٕ‫ح٧ٓ٘خ‬ ‫٩ُحُش‬ . ٌٍ‫حُـ‬ َٔ٘٣ ٢ٗ٫ٞ١ ًَٔ .‫أ‬ ‫ا‬ .‫د‬‫ٗو٬ع‬ّ‫طخ‬ٖٓ ُٖٔ‫ح‬ٚ‫ٓ٘و‬. .‫ؽ‬‫ٝؿٞى‬‫ا‬١ًٍٝ ٍٞ‫ك‬ ‫ُظٜخد‬. .‫ى‬ٌَُٔ‫ح‬ ٢‫ه‬ ٕ‫اٗظخ‬. ٙ.ُٖٔ‫ح‬ ٍٞ‫ك‬ ‫طٞحؽ‬. ٝ. ‫حُؼ٬ؿ٤ش‬ ‫حُوطش‬ ‫اػخهش‬ . *٩‫ح‬ ‫أٓخ‬‫٩ُحُش‬ ‫حُ٘ٔز٤ش‬ ‫ٓظطزخرخص‬٢ٜ‫ك‬ ٌَُٔ‫ح‬ ٢‫ه‬ ٖٓ ٕ‫ح٧ٓ٘خ‬: .‫أ‬‫حُٜ٘خ٣ش‬ ٢‫ك‬ ‫ُِوِغ‬ ُٚ‫ٓآ‬ ٢‫ٝظ٤ل‬ َ٤‫ؿ‬ ٖٓ. .‫د‬ّ‫ٓظوي‬ َ‫ٗو‬. .‫ؽ‬ّ‫ٓظوي‬ ١ٞ‫ُؼ‬ َٝٓ. .‫ى‬ٝ ‫ك٤ٜخ‬ ‫ٌٓ٘ٞى‬ ٕ‫أٓ٘خ‬‫حُ٘لخء‬ ‫رؼي‬ ‫ػٜ٘خ‬ ٞ٣ٞ‫حُظؼ‬ ٌٖٔ٣. ٙ.َ٤‫ؿ‬ ًَٔ ٢‫ك‬ ‫ُٓ٘ٔٞش‬ ٕ‫أٓ٘خ‬ٖٓ َ‫أًؼ‬ ‫ٓؼخُؾ‬3‫ح٧ً٣ش‬ ‫رؼي‬ ّ‫أ٣خ‬. *٢ٜ‫ك‬ ٌَُٔ‫ح‬ ٢‫ه‬ ٢‫ك‬ ٖٓ ‫اروخء‬ ‫ػ٘ي‬ ‫ططز٤وٜخ‬ ‫٣ـذ‬ ٢‫حُظ‬ ‫ح٩ؿَحءحص‬ ‫أٓخ‬: .‫أ‬‫ًٍٝ٣ش‬ ‫ٍٛٞس‬. .‫د‬ٌَُٔ‫ح‬ ‫كيٝع‬ ‫ػ٘ي‬ ً‫خ‬٣ُ‫ؿٜخ‬ ‫حُل٤ٞ٣ش‬ ‫رخُٜخىحص‬ ‫ٓؼخُـش‬. .‫ؽ‬‫كًَظٜخ‬ ‫ػ٘ي‬ ٕ‫ح٧ٓ٘خ‬ ‫طؼز٤ض‬. .‫ى‬ً ‫اًح‬ ‫ُٜخ‬ ‫حُِز٤ش‬ ‫حُٔؼخُـش‬ِ٘‫حُِذ‬ ‫ق‬. ٙ.ٕ‫ربٗظخ‬ ٌَُٔ‫ح‬ ‫أٛخد‬ ‫اًح‬ ُِٖٔ َٗ‫ٓزخ‬ ‫هِغ‬. ٝ.ٝ ‫ٓ٘ش‬ ‫ُٔيس‬ ‫َٓحهزش‬‫حُل٤ٞ٣ش‬ ٕ‫كويح‬ ٍ‫كخ‬ ٢‫ك‬ ‫حُِز٤ش‬ ‫حُٔؼخُـش‬. C-٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ‫أٓزخد‬: ٠ُ‫ا‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ‫أٓزخد‬ ْ٤ٔ‫طو‬ ٌٖٔ٣: 1-‫حُوخٍؿ٤ش‬ َُٟٝٞ‫ح‬:َٝٔ٘‫ط‬ *َ٤ُٔ‫ح‬ ‫كٞحىع‬. *‫ٓ٘خؿَحص‬. *‫َٓطلؼش‬ ًٖ‫أٓخ‬ ٖٓ ١ٞ‫حُٔو‬. *َٔ‫حُؼ‬ ‫١ٞحٍة‬. *‫حُٔلِ٤ش‬ ‫حُؼخُؼش‬ ٠‫حَُك‬ ‫هِغ‬ ‫ػ٘ي‬.
  • 32.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 22 2-‫حَُٟٔ٤ش‬ ٌٍُٞٔ‫ح‬:َٝٔ٘‫ط‬ *ُ‫ا‬ٝ ْ‫حُؼظ‬ ‫ظٜخد‬٢‫حُ٘و‬. *ٝ ‫حُِٔ٤ٔش‬ ّ‫ح٧ٍٝح‬‫حُوز٤ؼش‬. *ّ‫ح٧ً٤خ‬. *٢‫حُ٘ؼخػ‬ ٢ٔ‫حُؼظ‬ ‫حُظوَد‬. 3-‫حُؼخٓش‬ ٝ‫ح٧َٓح‬:َٝٔ٘‫ط‬ *ّ‫حُؼظخ‬ ٖ٤ِ‫ط‬. *٢‫حُ٘٤وٞه‬ ْ‫حُؼظ‬ ‫ٛ٘خٗش‬. *٢‫حُؼٜز‬ ُ‫حُـٜخ‬ ٝ‫أَٓح‬. *‫حُٔؼيٗ٤ش‬ ‫حُظٔٔٔخص‬. D-‫حُلي‬ ًٍٞٔ ٝ‫أػَح‬٢ِ‫حُٔل‬: )*٢ِ٣ ‫رٔخ‬ ٝ‫ح٧ػَح‬ ٚ٤‫طِو‬ ٌٖٔ٣: 1-‫ٝؿٞى‬‫هٜش‬ٝ ‫هي٣ٔش‬ ‫أً٣ش‬٢َٟٓ ًَٔ َ٤ُ‫ى‬ ٢ٛ ٝ‫ح٧ػَح‬ ٍٜٞ‫ظ‬. 2-٢ٔ‫ػظ‬ َ٤‫طـ‬ ٠ُ‫ا‬ ‫ػخثي‬ ‫ا١زخم‬ ‫ٓٞء‬. 3-ٝ ‫١ز٤ؼ٤ش‬ َ٤‫ؿ‬ ‫كًَش‬‫كًَش‬‫ػيس‬ٕ‫ح٧ٓ٘خ‬‫ٝحكيس‬ ‫ًٌظِش‬. 4-ْ‫حُـ‬ ٝ‫أ‬ ‫حُلًَش‬ ‫ػ٘ي‬ ُْ٧‫ح‬. 5-‫حُٞظ٤ل٤ش‬ ‫حُلًَش‬ ٝ‫أ‬ ْ‫حُـ‬ ‫ػ٘ي‬ ‫حُلَهؼش‬. 6-‫حُٔ٠ؾ‬ ٠ِ‫ػ‬ ‫حُويٍس‬ ّ‫ػي‬. 7-ُِٟ. 8-ٌَُٔ‫ح‬ ٕ‫ٌٓخ‬ ٢‫ك‬ ‫حُِؼش‬ ‫طِٔم‬. 9-‫ه‬ٝ ٍ‫ي‬٢‫ك‬ ‫هخٛش‬ٝ ‫حُِؼش‬٢ٓٞ‫حُٔظ‬ ٢‫حُو‬ ٠‫كظ‬ ‫حُ٘لش‬‫ًُي‬ ٝ٢ِ‫حُٔل‬ ٢ُ٘ٔ‫ح‬ ‫حُؼٜذ‬ ًٟ‫٣ئ‬ ‫ػ٘يٓخ‬. 10-ُ‫ح‬ ٝ‫أ‬ ‫حُِؼش‬ ٠ِ‫ػ‬ ‫ًيٓخص‬٘‫ـ‬ً‫خ‬٣ِ٤ِٛ‫ى‬ ٝ‫أ‬ ً‫خ‬٤ٗ‫ُٔخ‬ ٢١‫حُٔوخ‬ ‫خء‬. 11-ٝ ‫حُِؼخد‬ ٕ٬٤ٓٞ٣َُٔ‫ح‬ ْ‫ُ٘ل‬ ‫ٍحثلش‬. )*‫طوظِق‬ٝ ‫حُؼ٬ٓخص‬٢ِ‫حُٔل‬ ‫حُلي‬ ًَٔ ‫ُٔٞهغ‬ ‫رخُ٘ٔزش‬ ٝ‫ح٧ػَح‬: ‫أ‬-ٌَُٔ‫ح‬:٢‫حُٔ٘و‬ ٢ُ٘ٔ‫ح‬‫٣ليع‬ ٕ‫أ‬ ٌٖٔ٣ٗ‫ا‬ٝ ٢‫ٓ٘و‬ ًَٔ ‫ٓغ‬ ٕ‫ُ٨ٓ٘خ‬ ًَٔ ٝ‫أ‬ ٢‫ؿِث‬ ‫و٬ع‬ٕ‫أ‬ ٌٖٔ٣ٌٕٞ‫ط‬‫ٓغ‬ ٝ‫أ‬ ‫ٓلَىس‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ٢‫ك‬ ٌَُِٔ َ‫آه‬ ‫ٗٞع‬. 1-ٕ‫ح٧ٓ٘خ‬ ‫أً٣ش‬: ‫حُلـَس‬ ٍٝ‫طظ٘خ‬ ‫هي‬ ًٍٞٔ ‫طليع‬ ٕ‫أ‬ ٌٖٔ٤‫ك‬ ٕ‫ح٧ٓ٘خ‬ ٕ‫ط٤ـخ‬ ‫أً٣ش‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ٠ِ‫ػ‬ َُِٝ ‫حُظخُ٤ش‬ ً‫خ‬‫ٗ٤ٞػ‬ ‫ح٧ً٣خص‬ َ‫أًؼ‬٫ ٝ‫أ‬ ‫حُِز٤ش‬ ‫طظ٘خُٜٝخ‬ٝ ،ٝ ، ‫ُِ٘لش‬ ‫حَُهٞس‬ ‫حُ٘ٔؾ‬ ٍَ٠‫طظ‬ ٕ‫أ‬ ٌٖٔ٣ٕ‫أ‬ ٌٖٔ٣َُ‫ط٘ـ‬. ‫حُ٘لش‬ ٖٟٔ ‫حٌٍُٔٔٞس‬ ٕ‫ح٧ٓ٘خ‬ ٕ‫ط٤ـخ‬ ‫ليع‬‫ط‬ ٕ‫أ‬ ٌٖٔ٣ٕ‫ح٧ٓ٘خ‬ ٌٍٝ‫ؿ‬ ًٍٞٔ‫ط‬.‫حُِؼش‬ ٟٞ‫ٓٔظ‬ ‫طلض‬ ‫لظض‬ ٩‫ح‬ٕ‫ح٧ٓ٘خ‬ ٌٙٛ ٕ‫ط٤ـخ‬ ‫رلًَش‬ ‫٣٬كع‬ ٕ‫أ‬ ٌٖٔ٣ ٕ‫أٓ٘خ‬ ‫ػيس‬ ٝ‫أ‬ ُٖٔ ٢‫حُـِث‬ ‫ٗو٬ع‬. 2-ُ‫ح‬ ٌَُٔ‫ح‬٢‫ٔ٘و‬: ٝ ‫ؿَف‬ ‫ٓ٬كظش‬ ٌٖٔ٣‫حُٔلِ٤ش‬ ‫حُ٘لش‬ ٠ِ‫ػ‬ ‫ًيٓش‬,ٝ ‫حُِؼش‬ ٢‫ك‬ ‫ؿَٝف‬ٝ ‫ًيٓخص‬ٌٕٞ‫ط‬ ٕ‫أ‬ ٌٖٔ٣ ٢‫حُظ‬ ٕ‫ح٧ٓ٘خ‬ ‫ٓ٘ن‬ ٢‫ك‬ ٙٞ٘‫ط‬ ‫ٌٍٓٔٞس‬ ٝ‫أ‬ ‫ٓوِٞػش‬ ٝ‫أ‬ ‫ٓلوٞىس‬.
  • 33.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 23 ٝ ٕ‫ح٧ٓ٘خ‬ ‫كًَش‬ ٚ‫ٗلل‬ٝ ‫ك٤ٞ٣ظٜخ‬ ٚ‫ٗلل‬ٖٟٔ ٕ‫ُ٨ٓ٘خ‬ ‫حُٔـٌ٣ش‬ ِّ‫حُل‬ ‫هطغ‬ ٠ُ‫ا‬ ١‫طئى‬ ‫حُٔ٘ن‬ ًَٔ ٠ُ‫ا‬ ‫أىص‬ ٢‫حُظ‬ ‫حُوٞس‬ ً‫خ‬‫ؿخُز‬ ‫حُوطؼش‬‫حُٔ٘و٤ش‬. ‫د‬-‫حُِؤش‬ ًَٔ: ٝ ً‫خ‬‫ٗ٤ٞػ‬ َ‫ح٧ًؼ‬ ٞٛ‫٣ٜ٘ق‬ ٕ‫أ‬ ٌٖٔ٣ًَٔ ٠ُ‫ا‬‫حُٔللظش‬ ‫هخٍؽ‬ ٝ‫أ‬ ‫حُٔللظش‬ ٖٟٔ،‫حُـخٗذ‬ ٢‫ػ٘خث‬ ٝ‫أ‬ ‫حُـخٗذ‬ ١‫أكخى‬. ٝ ً‫خ‬‫كيٝػ‬ َ‫ح٧ًؼ‬ ٢ٛ ‫حُٔللظش‬ ‫هخٍؽ‬ ٌٍُٞٔ‫ح‬ ‫أٓخ‬ ‫ٗخىٍس‬ ‫حُٔللظش‬ ٖٟٔ ٌٍُٞٔ‫ح‬‫ػ٘ن‬ ‫ٓ٘طوش‬ ٢‫ك‬ ‫هخٛش‬‫حُِؤش‬,١‫٣ئى‬ ‫هي‬ٌَُٔ‫ح‬ ‫حُٔللظش‬ ‫هخٍؽ‬٠ُ‫ا‬َ٤٤‫طـ‬‫حُِؤش‬ ٕ‫ٌٓخ‬ ٢‫ك‬ ‫طظَحًذ‬ ٕ‫أ‬ ٌٖٔ٣‫حُٔلِ٤ش‬ ‫حُ٘ظ٤ش‬ ٠ِ‫ػ‬ ‫حُؼِٞ٣ش‬ ‫حُ٘ظ٤ش‬‫حَُأى‬ ()ً‫خ‬٤ٗ‫ُٔخ‬ ٝ‫أ‬ ً‫خ‬٣ِ٤ِٛ‫ى‬ ‫طِ٘حف‬ ٕ‫أ‬ ٌٖٔ٣ ‫ًٔخ‬ٝ‫أ‬ ٢‫َٓطز‬ ٌٕٞ٣ ١ٌُ‫ح‬ ٝ ٖ‫ػ‬ ‫ٗخطؾ‬‫حُِؤش‬ ‫ػ٘ن‬ ٠ِ‫ػ‬ ‫طظؼزض‬ ٢‫حُظ‬ ‫حُٞك٘٤ش‬ ‫حُؼ٠ِش‬ َ‫ؿ‬. 1-‫حُـخٗذ‬ ‫حُٞك٤ي‬ ٌَُٔ‫ح‬: +ٚ‫حُلل‬ٝ ٢‫حُٜيؿ‬ ٢ٌ‫حُل‬ َٜ‫حُٔل‬ ‫ٓ٘طوش‬ ‫كٞم‬ ‫اٗظزخؽ‬ ً‫خ‬‫ؿخُز‬ ‫ٛ٘خى‬ :١ٞٔ‫حُل‬ ‫هخٍؽ‬‫حُـخٗذ‬ ٢‫ك‬ ًٕ٧‫ح‬ ٖٓ ‫ِٗف‬ ‫٣ليع‬ ٕ‫أ‬ ٌٖٔ٣ ‫حُٜٔخد‬. ٝ َ‫ح٧ٓل‬ ٞ‫ٗل‬ ‫حُِؤش‬ ‫٣يكغ‬ ٕ‫أ‬ ٌٖٔ٣ ‫حُؼِٞ٣ش‬ ‫حُ٘ظ٤ش‬ ٍٞ‫ك‬ ١ٞٓ‫حُي‬ ٍُّٞ‫ح‬‫حُٔٔغ‬ َٟ‫ٓـ‬ َ‫أٓل‬ ‫حُوِق‬ ٝ َٛ‫حُظخ‬ٝ ‫حُـخٗذ‬ ْ‫ٗل‬ ٠ِ‫ػ‬ ٢‫حُـ٘خث‬ ‫حُ٘خطت‬ َ‫أٓل‬ ٢‫كو‬ ‫حُـِي‬ ٠ِ‫ػ‬ ‫ًيٓخص‬ ‫ٗ٘ٞء‬ ‫٣ٔزذ‬ ‫ٌٛح‬ٌٙٛ ‫طؼَف‬ ‫ك٤غ‬ ‫حُـٔـٔش‬ ‫هخػيس‬ ٌٍٞٔ‫ر‬ ‫طليع‬ ‫ٗلٜٔخ‬ ‫حُؼ٬ٓش‬(َ‫رخط‬ ‫رؼ٬ٓش‬. ) ‫أٓخ‬ً٫ٝ‫أ‬ ٜٞ‫ك‬ ْ‫حُـ‬ُ‫حُِؤش‬ ‫ظلي٣ي‬‫حُٜٔخرش‬ٝ‫ا‬‫حَُأى‬ ‫ٓغ‬ ‫حُِؤش‬ ‫ػ٘ن‬ ٍ‫ٓظَٔح‬. +ٚ‫حُلل‬َ‫ىحه‬١ٞٔ‫حُل‬:ُ‫ح‬ ٢‫ك‬ َٜ‫ه‬ ٠ُ‫ا‬ ١‫٣ئى‬ ‫حُِؤش‬ ٕ‫ٌٓخ‬ َ٤‫طـ‬ ٝ‫أ‬ ‫ح٩ِٗ٣خف‬‫ٓٔخ‬ ‫حُـخٗذ‬ ْ‫ٗل‬ ٖٓ ‫َأى‬ ‫ا‬ ٠ُ‫ا‬ ١‫٣ئى‬٢‫كو‬ ‫ح٧ٍكخء‬ ٠ِ‫ػ‬ ‫ح٩١زخم‬ ‫٣ٜزق‬ ٝ ‫حُٜٔخد‬ ‫حُـخٗذ‬ ٞ‫ٗل‬ ‫حُلي‬ ‫ِٗ٣خف‬‫ٓغ‬ٕ‫ح٧ٓ٘خ‬ ْٓ٬‫ط‬ ّ‫ػي‬ ‫ح٧ٓخٓ٤ش‬ 2-ُ ‫حُـخٗذ‬ ٢‫ػ٘خث‬ ٌَُٔ‫ح‬ِٖ٤‫ِؤظ‬: +٢ٛ ْ‫حُل‬ ‫هخٍؽ‬ ‫حُؼ٬ٓخص‬ٝ ‫حُـخٗذ‬ ١‫ح٧كخى‬ ٌَُٔ‫ح‬ ٢‫ك‬ ‫ٗلٜٔخ‬٠ِ‫ػ‬ ٌُٖ.ٖ٤‫حُطَك‬ +‫ك‬ ْ‫حُل‬ َ‫ىحه‬ ‫أٓخ‬٬ًٍٞٔ ‫كيٝع‬ ‫ػ٘ي‬ ‫ح٩١زخم‬ ٢‫ك‬ َ٤‫طـ‬ ١‫أ‬ ‫ٗ٬كع‬‫٣ليع‬ ٫ ‫ػ٘يٓخ‬ ٝ‫أ‬ ‫حُٔللظش‬ َ‫ىحه‬‫ا‬ٝ ، ‫ُِ٘ظخ٣خ‬ ‫ِٗ٣خف‬٢‫ك‬ ِٞ‫حُؼ‬ ‫حُ٘ظ٤ش‬ ٢‫ك‬ ٍ‫طزي‬ ‫كيٝع‬ ٍ‫كخ‬‫أٓخٓ٤ش‬ ‫ٓلظٞكش‬ ‫ػ٠ش‬ ‫ك٤ليع‬ ‫٣ش‬‫ٓغ‬ٝ ُْ‫أ‬ٝ ْ‫حُل‬ ‫ُلظق‬ ‫طلي٣ي‬ٝ ‫ح٩ؿ٬م‬‫حُـخٗز٤ش‬ ‫حُلًَخص‬. ‫ؽ‬-١ٍ‫حُٔ٘وخ‬ ‫حُ٘خطت‬ ًٍٞٔ: ‫ر‬ ٠ِ‫ُ٨ػ‬ ‫حُ٘ظ٤ش‬ َ‫طـ‬‫ب‬ٝ ، ‫حُٜيؿ٤ش‬ ‫حُؼ٠ِش‬ ‫رٞحٓطش‬ ‫حُٜيؿ٤ش‬ ‫طلض‬ ‫حُللَس‬ ٙ‫طـخ‬ٝ ً‫خ‬٣َ٣َٓ ٌَُٔ‫ح‬ ‫ٌٛح‬ ٚ٤‫ط٘و‬ ‫حُٜؼذ‬ ٌُٖٖٓ ‫حُٔ٘طوش‬ ٢‫ك‬ ‫ًيٓخص‬ ‫ٓ٘خٛيس‬ ٌٖٔ٣ ْ‫حُل‬ ‫هخٍؽ‬ٝٝ ُْ‫أ‬ ‫ٝٛ٘خى‬ ‫حُٔ٘طوش‬ ‫كٞم‬ ْ‫رخُـ‬ ‫١َحٝس‬٢ِ‫حُٔل‬ ‫حُلي‬ ‫كًَش‬ ٢‫ك‬ ‫طليى‬ ‫ح٩ؿ٬م‬ ‫ػ٘ي‬ ‫هخٛش‬. ‫ى‬-‫حَُأى‬ ًٍٞٔ: ٝ ‫ٗخىٍس‬ ‫َُِأى‬ ‫طليع‬ ٢‫حُظ‬ ٌٍُٞٔ‫ح‬‫ٜٓ٘خ‬ ‫ٗ٬كع‬ٖ٤ٌِٗ: 1-‫َُِأى‬ ‫ٓلَى‬ ًَٔ. 2-‫َُِأى‬ ‫ٓظلظض‬ ًَٔ. ٝ ‫ٗ٬كع‬‫ؿٞى‬‫ا‬ٝ ‫ٗظزخؽ‬ٝ ،‫ًيٓخص‬‫ر‬ْ‫خُـ‬ُْ‫أ‬ ‫ٓغ‬ ‫حَُأى‬ ‫كٞم‬ ‫١َحٝس‬ ّ‫اكٔخ‬ ٢‫٣ؼط‬٢ِ‫حُٔل‬ ‫حُلي‬ ‫كًَخص‬ ‫أػ٘خء‬. ّ-‫حُِحٝ٣ش‬ ًٍٞٔ: ‫٣٘خٛي‬‫ا‬ٝ ‫حُلي‬ ‫ُحٝ٣ش‬ ٢‫ك‬ ٙٞ٘‫ط‬ ‫ٓغ‬ ‫ٗظزخؽ‬ْ‫رخُـ‬ ٍ‫هي‬ ‫كيٝع‬ ٌٖٔ٣‫ٓغ‬‫حُلي‬ ‫ُحٝ٣ش‬ ‫ػ٘ي‬ ‫رخُطَحٝس‬ ّ‫اكٔخ‬. ٙ-ًٍٞٔ‫ؿ‬( ‫حُلي‬ ْٔٝ ‫ح٧ٍكخء‬ ‫ٓ٘طوش‬‫حُ٠ٞحكي‬): ٝ ٝ‫ح٧ػَح‬ٗ ٢ٛ ‫حُؼ٬ٓخص‬‫حُِحٝ٣ش‬ ًٍٞٔ ٢‫ك‬ ‫لٜٔخ‬ٝ .‫٣ليع‬ ‫هي‬‫ا‬‫ِٗ٣خف‬‫ٓٔظلذ‬ ‫ٟٝغ‬ (ٝ )‫ٓٔظلذ‬ َ٤‫ؿ‬ ‫ٟٝغ‬ ٝ‫أ‬َ٤‫رظؤػ‬ ‫ًُي‬
  • 34.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 24 ٝ ‫حُلي‬ ْٔ‫رـ‬ ‫حُٔظِٜش‬ ‫حُؼ٠٬ص‬‫ػ٘ي‬ٛ‫حُلخ٫ص‬ ٌٙٛ ٢‫ك‬ َ٣ِ‫ؿ‬ ‫ِٗف‬ ‫٣ليع‬ ‫خ‬‫حُلٌ٤ش‬ ‫حُٞػخث٤ش‬ ‫حُلِٓش‬ ‫اٗوطخع‬ ‫اكظٔخُ٤ش‬ ‫رٔزذ‬ ‫حُٔلِ٤ش‬. ٝ-ًٍٞٔ‫ا‬ٝ ٖ‫حٌُه‬ ‫ٍطلخم‬٩‫ح‬ ‫ؿخٗذ‬‫ٍطلخم‬: ٢‫ػ٘خث‬ ٝ‫أ‬ ‫حُـخٗذ‬ ‫ٝك٤ي‬ ‫حُِؤش‬ ‫ػ٘ن‬ ًٍٞٔ ‫ٓغ‬ ٌٍُٞٔ‫ح‬ ٌٙٛ ‫طظَحكن‬ ‫ٓخ‬ ً‫خ‬‫ؿخُز‬‫حُـخٗذ‬.ّ‫ح٩كٔخ‬ ٢ٛ ‫ظٍٜٞٛخ‬ َٔ‫حُٔلظ‬ ‫حُؼ٬ٓخص‬ ٝ ْ‫حُـ‬ ‫ػ٘ي‬ ‫رخُطَحٝس‬ُ ‫ِٗف‬٢ٗ‫ٔخ‬ٕ‫حُِٔخ‬ ‫طلض‬ ‫ًيٓش‬ ٝ.ٍٝ‫كخ‬ ٢‫ك‬‫حُـخٗذ‬ ٢‫ػ٘خث‬ ٌَُٔ‫ح‬ ٕ‫ًخ‬َ‫كٔ٤ظؤػ‬٩‫ح‬٢ٗ‫حُِٔخ‬ ٍ‫طٜخ‬ ٖ‫حٌُه‬ ‫ُٔ٘طوش‬ٕ‫ًخ‬ ٍ‫كخ‬ ٢‫كل‬ٝ َ‫ٓ٤ظؤػ‬ ٢ٔ‫حُظ٘ل‬ َٟ‫حُٔـ‬ ٕ‫كب‬ ‫ٝحع‬ َ٤‫ؿ‬ ٞ٣َُٔ‫ح‬‫ػٞح‬ َٜ‫ٓظظ‬ٍٝ‫ا‬‫هظ٘خه٤ش‬،ًٕٞ ٍ‫كخ‬ ٢‫ك‬ ‫أٓخ‬ ٝ ‫ٓؼخم‬ َ٤‫ؿ‬ ٢ٔ‫حُظ٘ل‬ َٟ‫حُٔـ‬ ‫اروخء‬ ‫٣ٔظط٤غ‬ ٚٗ‫كب‬ ً‫خ‬٤‫ٝحػ‬ ٞ٣َُٔ‫ح‬ٝ ٌِْ‫حُظ‬ ‫٣ٔظط٤غ‬‫حُؼٜذ‬ ًٟ‫طؤ‬ ‫اًح‬ ٫‫ا‬ ْ‫حُل‬ ٕ‫كويح‬ َٜ‫٣ل‬ ٫ ٝ‫أ‬ ٢٘‫حٌُه‬‫حُؼوزش‬‫حٌُه٘٤ش‬. E-ٚ‫حُلل‬١َ٣َُٔ‫ح‬: )**ٞ٣َٓ ًَٓٝ ٚ‫حُٞؿ‬ ٢‫ك‬ ‫ٍٟ٤ش‬ ‫رـَٝف‬ ‫ٜخد‬ٚ٤ٌ‫ك‬ ‫أكي‬ ٢‫ك‬ ًَٔ ‫رٞؿٞى‬ ‫٣٘ي‬ ٕ‫أ‬ ‫٣ـذ‬ ّ‫حَُأ‬.ٕٝ‫أ‬ ‫٣ـذ‬ ‫ٗ٢ء‬ ًَ َ‫هز‬ ٌُٖ ‫ك‬ ٞ٣َُٔ‫ح‬ ٚ‫٣لل‬‫اٛخرخص‬ ٍٜٞ‫ك‬ ّ‫ػي‬ ٖٓ ‫ُِظؤًي‬ ً‫ح‬‫ؿ٤ي‬ ً‫خ‬ٜ‫ل‬َٟ‫أه‬َ‫أًؼ‬‫أٛٔ٤ش‬‫حُٜٔخد‬ ‫ك٤خس‬ ٠ِ‫ػ‬ ‫هطَح‬ َ‫أًؼ‬ ٝ‫(حُؼٜز٤ش‬ٝ)‫حُِ٘ك٤ش‬ ‫ك‬ٌٌَُٜٙٔ‫ح‬ ‫ٓؼخُـش‬ َ‫هز‬ ‫ؿ٤ي‬ ٌَ٘‫ر‬ ‫طؼخُؾ‬ ٕ‫أ‬ ‫٣ـذ‬ َٟ‫ح٧ه‬ ‫ح٩ٛخرخص‬. ٞ٣َُِٔ ‫حُؼخٓش‬ ‫حُلخُش‬ ٚ‫كل‬ ٖٔ٠‫٣ظ‬: 1-١َ‫حُظل‬١‫أ‬ ‫ٝؿٞى‬ ٖ‫ػ‬‫هلل٤ش‬ ‫اٛخرخص‬. 2-ْ‫حُظ٘ل‬ َٟ‫ٓـ‬ ٚ‫كل‬: -ٞ٣َُٔ‫ح‬ ‫ػ٘ي‬ ٢‫١ز٤ؼ‬ ْ‫حُظ٘ل‬ ٕ‫أ‬ ٖٓ ‫حُظؤًي‬ ٖٓ ‫ري‬ ٫ -ٝ ‫حٌٍُٔٔٞس‬ ٕ‫ح٧ٓ٘خ‬ ‫هطغ‬ ٖ‫ػ‬ ْ‫حُل‬ ٢‫ك‬ ‫حُزلغ‬ ‫٣ـذ‬ٝ ‫حُٔوِٞػش‬ ٕ‫ح٧ٓ٘خ‬ٝ ‫حٌٍُٔٔٞس‬ ٕ‫حُظ٤ـخ‬ ٝ‫أ‬ ‫حُل٘ٞحص‬‫ٓغ‬ ‫ٓطخروظٜخ‬ ٝ ٍ‫كخ‬ ٢‫ك‬ ‫حٌٍُٔٔٞس‬ ‫ح٧ؿِحء‬‫ٍٛٞس‬ ‫اؿَحء‬ ‫ك٤ـذ‬ ‫حُوطغ‬ ٌٙٛ ٠ِ‫ػ‬ ٍٞ‫حُؼؼ‬ ّ‫ػي‬ ‫ػ٘ي‬ ‫أٓخ‬ ،‫ؿٞىٛخ‬‫هي‬ ‫ًخٗض‬ ‫اًح‬ ‫ك٤ٔخ‬ ‫ُٔؼَكش‬ ٍ‫ُِٜي‬ ‫أ‬ٞ٣َُٔ‫ح‬ َ‫هز‬ ٖٓ ‫ٓظ٘٘وض‬٩‫حُٔؼ‬ ‫ؿَحء‬‫حُ٬ُٓش‬ ‫ح٩ٓؼخك٤ش‬ ‫خُـش‬. 3-‫حُِ٘ف‬: ٝ ، َ٤‫هط‬ ‫ِٗف‬ ‫٣ليع‬ ٫ ً‫خ‬‫ؿخُز‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ٢‫ك‬‫ا‬‫حُ٘ٔؾ‬ ‫طِٔم‬ ‫رٔزذ‬ ‫٣ليع‬ ‫ٓخ‬ ً‫خ‬‫ؿخُز‬ ّ‫حُي‬ ٖٓ ‫ٓؼظزَس‬ ‫ًٔ٤ش‬ ٚ‫ٗو‬ ٕ ٝ ‫حَُهٞس‬ِ٤٤ٔ‫ط‬ ‫٣ـذ‬ ‫ػ٘يٛخ‬ٖٛ‫ػ‬ ‫خ‬ٝ ‫حُٞؿٜ٤ش‬ ‫ح٧ٝػ٤ش‬ َ‫ٓؼ‬ ‫حُ٘خُكش‬ ٢‫حُ٘و‬١‫ُظوخ‬ ‫ٗٔؾ‬ ٢‫رِٔو‬ ‫ُوطٜخ‬. 4-‫حُٜيٓش‬: ٢‫حُظ‬ ٝ. ٠ُٝ٧‫ح‬ ‫حُيٍؿش‬ ٖٓ ‫ح٩ٓؼخك٤ش‬ ‫حُلخ٫ص‬ ٖٓ َ‫طؼظز‬ )**ٚ‫رلل‬ ‫رؼيٛخ‬ ‫ٗزيأ‬‫ًحطٜخ‬ ‫رلي‬ ‫ح٩ٛخرش‬ٖٝ٤ٌ‫حُل‬ ًٍٞٔ ٖ‫ػ‬ ١َ‫حُظل‬. ‫أ‬-ٚ‫حُلل‬١ٞٔ‫حُل‬ ‫هخٍؽ‬: ‫ىح‬ ‫رٔخء‬ ‫رِطق‬ ٞ٣َُٔ‫ح‬ ٚ‫ٝؿ‬ ‫٣٘ظق‬ ً٫ٝ‫أ‬ٝ َ‫حُٔظوؼ‬ ّ‫حُي‬ ‫٩ُحُش‬ ٕ‫هٔخ‬ ‫روطؼش‬ ٝ‫أ‬ ‫كت‬..‫حُن‬ ‫حُطَ٣ن‬ ‫أٝٓخم‬‫ؿَٝف‬ ْ٤٤‫طو‬ ٖٓ ٌٖٔ‫ُ٘ظ‬ ‫ٝحٌُيٓخص‬ ‫حَُهٞس‬ ‫حُ٘ٔؾ‬ٝ ‫ًيٓخص‬ ‫ٛ٘خى‬ ٌٕٞ٣ ‫ٓخ‬ ً‫خ‬‫ؿخُز‬ ً‫ا‬‫ا‬ٌٖٔ٣ ‫ًٔخ‬ ٌَُٔ‫ح‬ ٕ‫ٌٓخ‬ ‫كٞم‬ ‫ٗظزخؽ‬ُٔ٘‫ٝح‬ ‫حُـِي‬ ٢‫ك‬ ‫رظِٔم‬ ‫٣ظَحكن‬ ٕ‫أ‬‫ؾ‬ ٞ‫حَُه‬‫س‬ٖ‫ػ‬ ‫ٗخطـش‬ ‫هخٛش‬ ‫ٍحثلش‬ ٢‫٣ؼط‬ ًَٔ ‫ٝؿٞى‬ ٍ‫كخ‬ ٢‫ك‬ ْ‫حُل‬ ٕ‫أ‬ ‫ًٔخ‬ .ٝ ‫حُ٘خُف‬ ْ‫حُل‬ ٖ٤‫ر‬ َٛ‫حُلخ‬ ‫حُِٔ٣ؾ‬‫حُِؼخد‬. ‫د‬-ٚ‫حُلل‬١ٞٔ‫حُل‬ َ‫ىحه‬: *ٝ ‫حُيٓٞ٣ش‬ ‫ٝحُؼِوخص‬ ّ‫حُطؼخ‬ ‫ك٠٬ص‬ ٍ‫طِح‬ ْ‫ػ‬ ،‫َٓحص‬ ‫ػيس‬ َُٜٔ‫رخ‬ ْ‫حُل‬ َٜ‫ٗط‬ ٖ٤‫حُ٘لظ‬ ‫ارؼخى‬ ‫رؼي‬‫ح٧ؿ٘٤ش‬ٝ ‫حُِٔٔهش‬١‫أ‬ ٍ‫٣ِح‬ ْ‫حُل‬ ٖٓ ‫رِطق‬ ٢٘‫حُٔو‬ ْ‫حُؼظ‬ ٝ‫أ‬ ٕ‫ح٧ٓ٘خ‬ ٖٓ ‫حٌٍُٔٔٞس‬ ‫ح٧ؿِحء‬ ٍ‫طِح‬ ‫ًٔخ‬ ٢‫ِٓو‬ ٠ِ‫ػ‬ َٔ‫٣ل‬ ٕ‫ر٘خ‬ ‫ٓظـٔغ‬ ّ‫ى‬. *‫حُٔ٘٤ش‬ ّٞ‫حُو‬ ٚ‫كل‬: ٝ ٕ‫ح٧ٓ٘خ‬ ٚ‫ٗلل‬ٝ ٌٍٞٔٓ ‫ؿِء‬ ١‫أ‬ َ٣ِٗ‫ٗ٢ء‬ ًَ َ‫هز‬ ٢١‫حُٔوخ‬ ‫حُـ٘خء‬ ٚ‫كل‬ ٖٓ ‫ري‬ ٫ ٞ٣َُٔ‫ح‬ ‫ػ٘ي‬ ٕ‫ح٧ٓ٘خ‬ ٕ‫كويح‬ ‫كخُش‬ ٢‫ك‬
  • 35.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 25 ٤‫ك‬ ‫طِٔم‬ ١‫كؤ‬‫حًَُٔزش‬ ٌٍُٞٔ‫ح‬ ٢‫ك‬ ‫(هخٛش‬ ًَٔ ‫ٝؿٞى‬ ٠ِ‫ػ‬ ٍ‫٣ي‬ ‫هي‬ ٚ‫حُٜخػيس‬ ‫حُ٘ؼزش‬ ًٍٞٔ ٢‫ك‬ ‫ًٔخ‬ ‫حُٔـِوش‬ ٌٍُٞٔ‫ح‬ ٢‫ك‬ ‫أٓخ‬ ) ‫ًيٓش‬ ‫ك٤٘خٛي‬ ‫حُزٔ٤طش‬ ٌٍُٞٔ‫ح‬ ٝ‫أ‬ٝ‫أ‬١ٞٓ‫ى‬ ٍّٝ‫أ‬ٝ‫ا‬ٝ ‫ٍُهخم‬٠ُ‫ا‬ ‫حُِـٞء‬ ٖٓ ‫ري‬ ٫ ‫حُلخُش‬ ٌٙٛ ٢‫ك‬ٚ‫حُلل‬ْ‫حُـ‬ ‫رطَ٣وش‬،ٕ‫أ‬ ً‫ا‬ ٠ُ‫رخ‬ ٢٘‫٣ؼ‬ ٫ ‫حُيِٛ٤ِ٣ش‬ ‫حُـٜش‬ ٠ِ‫ػ‬ ‫حٌُيٓش‬ ‫ٝؿٞى‬‫ٝؿٞى‬ ‫ٍَٝس‬ ٝ‫أ‬ ‫ًيٓش‬ ‫ٝؿٞى‬ ‫أٓخ‬ ًَٔ‫ا‬ُ‫ح‬ ٢‫ك‬ ‫ٍُهخم‬ً‫خ‬‫كـخُز‬ ‫حُِٔخٗ٤ش‬ ‫ـٜش‬ ‫ٝؿٞى‬ ٢٘‫٣ؼ‬ًَٔ. ‫ٝحٟق‬ ٙٞ٘‫ط‬ ً‫خ‬ٗ‫أك٤خ‬ ‫ك٘٘خٛي‬ ٚٔ‫ك‬ ‫٣لظق‬ ٕ‫أ‬ ٞ٣َُٔ‫ح‬ ٖٓ ‫ٗطِذ‬ ٖ٤‫هطؼظ‬ ٠ُ‫ا‬ ‫ٓ٘ؤٔش‬ ّٞ‫حُو‬ ٌٕٞ‫ط‬ ً‫ا‬ ‫حُٔ٘٤ش‬ ّٞ‫حُو‬ ٢‫ك‬ ‫ا‬ ‫ٗٔزش‬ ‫حُٞحكيس‬ ٍ‫طظزي‬ٝ َٟ‫ح٧ه‬ ٠ٌُٕٞ٣ ‫هي‬ ٙٞ٘‫حُظ‬ ‫ٌٛح‬ ‫ر‬‫ب‬ٝ ٢ٗ‫ُٔخ‬ ١ِ٤ِٛ‫ى‬ ٝ‫أ‬ ٢٘‫ٝك‬ ٢ٔٗ‫أ‬ ٝ‫أ‬ ٢‫طخؿ‬ ١ٌٍ‫ؿ‬ ٙ‫طـخ‬ ٖٓ ‫ٓـٔٞػش‬ َٟٗ ً‫ا‬ ٢‫حُظخؿ‬ ١ٌٍ‫حُـ‬ ٍ‫حُظزي‬ ٞٛ ً‫خ‬‫ٟٝٞك‬ َ‫ح٧ًؼ‬ ٝ ‫َٓطلؼش‬ ٕ‫ح٧ٓ٘خ‬‫ٓ٘ول٠ش‬ َٟ‫ح٧ه‬‫ٌٛح‬ ٕ‫ا‬ .ٝ ٙٞ٘‫حُظ‬ ٩‫ح‬‫رخ٩ٛخرش‬ ٚ٤‫ط٘و‬ ‫رٟٞغ‬ ‫٣ٔٔق‬ ‫حُٔ٘٤ش‬ ّٞ‫حُو‬ ٢‫ك‬ ‫ٗلَحف‬ ‫رخ‬ٌَُٔ. ٝ٢‫ك‬ ‫ٓٞء‬ ‫ٗ٬كع‬ ٚٔ‫ك‬ ‫اؿ٬م‬ ٞ٣َُٔ‫ح‬ ٖٓ ‫ٗطِذ‬ ‫ػ٘يٓخ‬ ٝ ‫ح٫١زخم‬َ‫طوِو‬ ‫٣٘خٛي‬ ‫ًٔخ‬ ‫رؼ٠ٜخ‬ ‫ٓغ‬ ٕ‫ح٧ٓ٘خ‬ َٜ‫طٔل‬ ّ‫ػي‬ ٌَُِٔ ‫حُٔـخٍٝس‬ ٕ‫ح٧ٓ٘خ‬ٝ‫أك‬ٚٔ‫ك‬ ‫كظق‬ ٞ٣َُٔ‫ح‬ ٌٍَ٣ ٖ٤‫ك‬ ً‫خ‬ٗ‫٤خ‬ ٝ‫ا‬ٖ‫ػ‬ ٕ‫ح٧ٓ٘خ‬ ‫طظزخػي‬ ٚ‫ؿ٬ه‬ٝ ‫طظوخٍد‬ ْ‫ػ‬ ‫رؼ٠ٜخ‬‫طَطلغ‬ ً‫خ‬ٗ‫أك٤خ‬ ‫ا‬ٝ ‫كيحٛخ‬ٞ‫ط٘ول‬َٟ‫ح٧ه‬ٝ .‫ا‬‫كيع‬ ‫ًح‬‫حُ٘ظخ٣خ‬ ٕ‫ٌٓخ‬ ٢‫ك‬ َ٤‫طـ‬ ٝ ‫رؼ٠ٜخ‬ ‫ٓغ‬ ‫ح٧ٓخٓ٤ش‬ ٚٗ‫أٓ٘خ‬ ‫اؿ٬م‬ ٖٓ ٞ٣َُٔ‫ح‬ ٌٖٔ‫٣ظ‬ ٫ ً‫خ‬‫ٓلظٞك‬ ْ‫حُل‬ ٠‫٣زو‬.‫حُلًَش‬ ٢‫ك‬ ‫طليى‬ ٝ‫أ‬ ُْ‫أ‬ ‫ٝؿٞى‬ ‫ٗ٬كع‬ ‫ًٔخ‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ‫رلًَخص‬ ٞ٣َُٔ‫ح‬ ّ‫ه٤خ‬ ‫ػ٘ي‬. ‫ؽ‬-ْ‫حُـ‬: *‫رـخ٣ش‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ٢‫ك‬ ‫حُ٘خًس‬ ‫حُلًَخص‬ ٖ‫ػ‬ ‫حُطَ٣وش‬ ٌٜٙ‫ر‬ َٟ‫ٗظل‬ٝ ‫حُِطق‬ ّٖٓٞ‫حُو‬ ٢‫ك‬ ٌَُٔ‫ح‬ ‫ٝؿٞى‬ ‫ػزض‬ ‫ٓخ‬ ‫كبًح‬ ٖ٤ُِ‫ح‬ ٝ ‫حُٔزخرش‬ ٌٕٞ‫ط‬ ٕ‫أ‬ ٠ِ‫ػ‬ ٖ٣‫حُ٤ي‬ ٟ‫ربكي‬ ٌَُٔ‫ح‬ ٢‫هطؼظ‬ ٖٓ ٬ً ‫ٗٔٔي‬ ‫حُٔ٘٤ش‬ٝ ٕ‫ُ٨ٓ٘خ‬ ‫حُطخك٘ش‬ ‫حُٔطٞف‬ ‫كٞم‬ ٠‫حُٞٓط‬ٌٕٞ٣ ٝ ‫ُِلي‬ ‫حُوخػي٣ش‬ ‫حُلخكش‬ ً‫خ‬‫ٓؼخٗو‬ ْ‫حُل‬ ‫هخٍؽ‬ ّ‫ح٩رٜخ‬‫ك٤٘خ‬ ‫رؼ٠ٜٔخ‬ ٖ‫ػ‬ ٖ٤‫حُوطؼظ‬ ‫ارؼخى‬ ‫ٗـَد‬ ‫هل٤لش‬ َ‫كظ‬ ‫رلًَخص‬‫ٛي‬ٖ٤ُ٘ٔ‫ح‬ ‫طزخػي‬ ٌَُِٔ ٖ٤‫حُٔـخٍٝط‬‫ا‬ٝ َٟ‫ح٧ه‬ ٖ‫ػ‬ ‫كيحٛٔخ‬ُ‫ح‬ ٍ‫رِٝح‬ ٍِٝ٣ ‫ر٤ٜ٘ٔخ‬ ‫كَحؽ‬ ‫٣ليع‬‫حُٔطزوش‬ ‫وٞس‬ٝ .‫ا‬ٝ ً‫خ‬‫ٓلظٞك‬ ٌَُٔ‫ح‬ ٕ‫ًخ‬ ‫ًح‬ً‫خ‬‫ٓظَحكو‬ ٝ ٢ُِ‫ح‬ ‫كخُش‬ ٢‫ك‬ ً‫خ‬‫ٟٝٞك‬ َ‫أًؼ‬ َٜ‫٣ظ‬ ‫حُظِٔم‬ ‫ٌٛح‬ ٕ‫كب‬ ٢١‫حُٔوخ‬ ‫حُـ٘خء‬ ٢‫ك‬ ‫رظِٔم‬ٝ َ‫حُلظ‬‫طظوخٍد‬ ْ‫ػ‬ ً٫ٝ‫أ‬ ‫حُـَف‬ ٢‫ٗلظ‬ ‫طظزخػي‬ ْٔ‫ه‬ ‫ىحكؼش‬ٌُٔ‫ح‬ ٢‫ه‬ ٖٓ ‫حُٜٞحث٤ش‬ ‫ٝحُلوخػخص‬ ‫حُِؼخد‬ ٖٓ. َ *‫حُٔٔغ‬ َٟ‫ٓـ‬ ٝ‫أ‬ ‫حُـِي‬ ‫١َ٣ن‬ ٖ‫ػ‬ َٜ٘‫حُو‬ ‫رٞٓخ١ش‬ ‫حُِؤش‬ ْ‫ٗـ‬ ٕ‫أ‬ ٌٖٔ٤‫ك‬ ‫حُِؤش‬ ًٍٞٔ ٚ‫كل‬ ‫أٓخ‬َٛ‫حُظخ‬‫طظلَى‬ ُْ ‫كبًح‬ ‫حُِؤش‬٢ِ‫حُٔل‬ ‫حُلي‬ ‫طلَ٣ي‬ ‫ػِٔ٤ش‬ ٍ٬‫ه‬‫حُٔ٘طوش‬ ‫طِي‬ ٢‫ك‬ ًَٔ ‫ٝؿٞى‬ ٠ِ‫ػ‬ ٍ‫٣ي‬ ‫ٌٛح‬. *ّٝ‫رَإ‬ ً‫خ‬‫ُط٤ل‬ ً‫خ‬ٔ‫ؿ‬ ١َ‫ٗـ‬ ‫ًٔخ‬ٝ ٖ٤‫حُطَك‬ ٬ً ٢‫ك‬ ‫حُِؤش‬ ‫ٓ٘طوش‬ ٠ِ‫ػ‬ ‫ح٧ٛخرغ‬‫ُِلي‬ ‫حُٔلِ٤ش‬ ‫حُلخكش‬ ٍٞ١ ٠ِ‫ػ‬ َ‫ُ٨ٓل‬ ‫ٗظخرغ‬ ‫ًٔخ‬ ‫كَهؼش‬ ٝ‫أ‬ ٢ٔ‫حُؼظ‬ ‫حُظليد‬ َ٤‫طـ‬ ‫ٓغ‬ ‫ٓظَحكوش‬ ‫ىٍؿش‬ ‫رٞؿٞى‬ َ‫ٗ٘ؼ‬ ٝ‫أ‬ ٌَُٔ‫ح‬ ٕ‫ٌُٔخ‬ ‫َٓحكوش‬ ‫ُ٤ٞٗش‬ ‫ٗ٬كع‬ ٕ‫أ‬ ٌٖٔٓ ‫ك٤غ‬ ٢ِ‫حُٔل‬ ٠ٔٔ٣ ‫ٓخ‬ ْ‫حُـ‬ ‫رطَ٣وش‬ ٞ٣َُٔ‫ح‬ ٚ‫ٗلل‬ ‫ػ٘يٓخ‬ ٕ‫ح٧ك٤خ‬ ٖٓ َ٤‫ًؼ‬ ٢‫ك‬ ‫ٗٔٔغ‬‫حُؼظٔ٤ش‬ ‫رخُلَهؼش‬.
  • 36.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 26 F-ٚ‫حُلل‬٢‫حُ٘ؼخػ‬: ُ‫ح‬ َ٣ٜٞ‫حُظ‬ ‫أٗٞحع‬ٔٓ‫ظٔظوي‬‫ش‬ًٔ ‫كخُش‬ ٢‫ك‬٢ِ‫حُٔل‬ ‫حُلي‬ ٍٞ٢ٛ: ‫أ‬)-‫هخٍؽ‬١ٞٔ‫ك‬: 1-)ٍ‫٣ٔخ‬ + ٖ٤ٔ٣ ( ً‫خ‬٤‫ؿخٗز‬ ‫ِٓحكش‬ ‫ٍٛٞس‬ٝ :ًٍٞٔ ٍ‫اظٜخ‬ ٢‫ك‬ ‫طل٤ي‬ٝ ‫حُ٘خد‬ ‫ٓ٘طوش‬ ٠‫كظ‬ ‫حُلي‬ ْٔ‫ؿ‬ًٍٞٔ ،‫حُِحٝ٣ش‬ ًٍٞٔ ‫حُِؤش‬ ًٍٞٔ ، ‫حَُأى‬. ) ‫ؿيح‬ ‫ٓليٝى‬ ٌَ٘‫ر‬ ( 2-‫أٓخٓ٤ش‬ ‫ٍٛٞس‬:‫هِل٤ش‬ٝ ‫حُلي‬ ًٍٞٔ ‫طليى‬ٝ ‫ٓٞ٣ش‬ ‫حُلي‬ ‫ُحٝ٣ش‬٩‫ح‬ ‫ٗٞع‬‫ِٗ٣خف‬
  • 37.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 27 3-‫ٍٛٞس‬‫حُوِل٤ش‬‫ح٧ٓخٓ٤ش‬:ٜٓ ٢ٛٝ٩‫ح‬ ‫ٓ٘طوش‬ ًٍٞٔ ٢‫ك‬ ‫ٔش‬ٝ ٢٘‫حٌُه‬ ‫ٍطلخم‬‫حُ٘خد‬. ‫د‬)-َ‫ىحه‬ْ‫حُل‬: ٩‫ح‬ ًٍٞٔ ٢‫ك‬ ‫ٜٓ٘خ‬ ‫٣ٔظلخى‬‫طَح‬ ٕ‫أ‬ ً‫ا‬ ٢٘‫حٌُه‬ ‫ٍطلخم‬٩‫ح‬ ‫ٓ٘طوش‬ ٠ِ‫ػ‬ ‫حَُهز٤ش‬ ‫حُلوَحص‬ ‫ًذ‬ً ٢٘‫حٌُه‬ ‫ٍطلخم‬‫ؼ‬‫ٓ٘طوش‬ ٢‫طول‬ ‫ًٓخ‬ ‫٤َح‬ ٫ ‫ٌُح‬ ٌَُٔ‫ح‬٩‫ح‬ ٍُٜٞ‫رخ‬ ‫حُٔ٘طوش‬ َ٣ٜٞ‫ط‬ ٖٓ ‫ري‬‫حٌٍُٝ٣ش‬ ٝ‫أ‬ ‫١زخه٤ش‬. 1-ٝ ٕ‫رخ٧ٓ٘خ‬ ٌَُٔ‫ح‬ ٢‫ه‬ ‫ػ٬هش‬ ‫ُظلي٣ي‬ ‫ٜٓٔش‬ : ‫حٌٍُٝ٣ش‬ٕ‫ح٧ٓ٘خ‬ ‫أً٣خص‬ ٟ‫ٓي‬. 2-‫ا‬‫حُلي‬ ْٔ‫ُـ‬ ٌَُٔ‫ح‬ ٢‫ه‬ ‫ُظلي٣ي‬ : ‫١زخه٤ش‬. ‫ؽ‬)-‫حُٔٔظلزش‬ ٍُٜٞ‫ح‬ ٞ‫رؼ‬: 1-ٝ ‫حُلي‬ ْٔ‫ؿ‬ ٌٍُٞٔ ‫ٓلززش‬ : ‫حُزخٍٗٞحٓ٤ش‬‫حُِؤش‬ ‫ػ٘ن‬ ًٍٞٔ. 2-١ٍٞ‫ٓل‬ ٢‫١زو‬‫ح٧رؼخى‬ ‫ػ٬ػ٤ش‬ ‫ٛ٤ٌِش‬ ًٝ‫خ‬‫ِٓحك‬ ٢ٔ‫حُِو‬ ّ‫حَُأ‬ ٌٕٞ٣ ‫ػ٘يٓخ‬ ‫حُِؤش‬ ٌٍُٞٔ‫ح‬ ٢‫ك‬ ‫ٜٓٔش‬ :. G-:‫حُٔؼخُـش‬ 1-‫حُٔؼخُـش‬‫حُزيث‬:‫٤ش‬ ‫ػيس‬ ‫ٛ٘خُي‬‫ا‬‫ػظزخٍح‬‫ص‬ٕ‫رخُلٔزخ‬ ‫أهٌٛخ‬ ‫٣ـذ‬. -)‫طِٔم‬:‫حَُهٞس‬ ‫حُ٘ٔؾ‬ َ٠‫٣ل‬‫ا‬ٍ٬‫ه‬ ‫حُـَٝف‬ ‫ؿ٬م‬24ٌ٘ٔٓ ‫ًُي‬ ٕ‫ًخ‬ ‫اًح‬ ‫ح٧ً٣ش‬ ٖٓ ٠ُٝ٧‫ح‬ ‫ٓخػش‬‫خ‬ُٝ ْ‫حُؼظ‬ ‫ٗظخ٣خ‬ ‫ػزخص‬ ٢‫ك‬ ‫ُ٣خىس‬ ‫ٌٔذ‬‫اؿ٬م‬ َ‫هز‬ ٝ ‫ح٧ؿ٘ز٤ش‬ ّ‫ح٧ؿٔخ‬ ٖٓ ٚ‫ط٘ظ٤ل‬ ‫٣ـذ‬ ‫حُـَف‬‫حُـَف‬ ‫ٓٔق‬ ٌٖٔ٣ِٕٞ‫حُٔخك‬ َ‫ٓؼ‬ ‫رٔٞحى‬1%. -)ُْ٧‫ح‬ ٠ِ‫ػ‬ ‫حُٔ٤طَس‬: ‫حُل‬ ًٍٞٔ ٠َٟٓ ْ‫ٓؼظ‬‫ُحثي‬ ُْ‫أ‬ ٖٓ ٕٞٗ‫٣ؼخ‬ ٫ ٢ِ‫حُٔل‬ ‫ي‬‫ا‬ٝ ٢ِ‫حُٔل‬ ٢ٌ‫حُل‬ ‫ُؼٜذ‬ ‫ح٧ً٣ش‬ ٍ‫كخ‬ ٢‫ك‬ ٫ٌٍُٞٔ‫ح‬ ٞ‫رؼ‬ ٢‫ك‬ ‫حُلي‬ ْٔ‫ُـ‬ ‫حُٔظلًَش‬ُ‫ح‬٢‫ظ‬ٝ ‫َٓ٣لش‬ َ٤‫ؿ‬ ٌٕٞ‫ط‬‫طٔزذ‬‫ا‬َ‫حُٔظٞط‬ ٞ٣َُِٔ ‫ِٗػخؽ‬. ٕٝ‫أ‬ ًٌَ‫ٗظ‬ ٕ‫أ‬ ‫٣ـذ‬‫ا‬ّ‫ٓظويح‬ٔ‫حُظ‬‫ٓ٠خى‬ ٞٛ ٖ٤‫حٍُٔٞك‬ َ‫ٓؼ‬ ١ٞ‫حُو‬ ٖ٤ٌ‫ا‬‫ٓظطزخد‬. ‫َٓحكوش‬ ‫ػٜز٤ش‬ ‫اٛخرخص‬ ‫ٝؿٞى‬ ‫اكظٔخُ٤ش‬ ‫رٔزذ‬ -)ٕ‫ح٩ٗظخ‬ ٠ِ‫ػ‬ ‫حُٔ٤طَس‬: ْ‫حُل‬ ٠ِ‫ػ‬ ‫ٓلظٞكش‬ ًٍٞٔ ٢ٛ ٕ‫ح٧ٓ٘خ‬ َٔ٘‫ط‬ ٢‫حُظ‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ًَ)‫(ًَٓزش‬ٝ ،ٝ ٕ‫ُ٪ٗظخ‬ ١ٞ‫ه‬ ٍ‫ٜٓي‬ ٢ٛ ٢ُ‫رخُظخ‬
  • 38.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 28 ٖ٤ِٔ٘‫حُز‬ ٢‫٣ؼط‬ ٕ‫أ‬ ‫٣ـذ‬V٢ِ٠‫حُؼ‬ ‫حُطَ٣ن‬ ٖ‫ػ‬1‫ٓخػخص‬ ‫ٓض‬ ًَ ‫ٝكيس‬ ‫ٓ٤ـخ‬‫ُٔيس‬2-3ْ‫حُل‬ ‫١َ٣ن‬ ٖ‫ػ‬ ْ‫ػ‬ ٠ُٝ٧‫ح‬ ّ‫ح٧٣خ‬ َ‫آه‬ ‫٧ٓزٞع‬ٝ .٣ ‫ح٧١زخء‬ ْ‫ٓؼظ‬ٕٞ‫٠٤ل‬ُ‫ح‬ٍُٝ‫ٔ٤ظَٝٗ٤يح‬400-800٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ٠َٟٓ ٌَُ ‫ِٓؾ‬ْ٤‫حُـَحػ‬ ‫ُظـط٤ش‬ ‫حُ٬ٛٞحث٤ش‬. ٝ‫اٗظ‬ ٠ِ‫ػ‬ ٚ‫رلؼخُ٤ظ‬ ِ٤ُٔٔ‫ح‬ ٖ٤ُ‫طظَحٌٓخ‬ ٢ًٔٝ٧‫ح‬ ٢‫ٗؼط‬ ٕ‫أ‬ ٌٖٔ٣ٖ٤ِٔ‫أٓز‬ + ٖ٤ٔ٤ٓ‫ؿ٘ظخ‬ ‫اػطخء‬ ٝ‫أ‬ ْ‫حُؼظ‬ ٕ‫خ‬. 2-ٕ‫ح٧ٓ٘خ‬ ٠ِ‫ػ‬ ١ٝ‫حُلخ‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ‫ٓؼخُـش‬: *)‫اىشد‬Reduction :: ٝ ،ّ‫حُؼخ‬ َ٣‫حُظوي‬ ‫طلض‬ ٙ‫اؿَحإ‬ َ٠‫ح٧ك‬ٌُٖ. ٢‫حُٟٔٞؼ‬ َ٣‫حُظوي‬ ‫طلض‬ ٙ‫اؿَحإ‬ ٌُٖٔٔ‫ح‬ ٖٓ ٝ ١‫حُٔطخ‬ ‫كِوخص‬ ‫رٞحٓطش‬ ٢‫طيٍ٣ـ‬ ‫ٍى‬ ٠ِ‫ػ‬ ٍٜٞ‫حُل‬ ٌٖٔ٣‫ُ٤ٔض‬ ٢َٛ‫ٓؼ‬ ‫كؼخُش‬‫طلض‬ ‫حَُى‬ّ‫حُؼخ‬ َ٣‫حُظوي‬ٝ‫آظطزخرٜخ‬ ‫طـي‬ ‫ٌُٜ٘خ‬ )َ‫أًؼ‬ ٝ‫أ‬ ‫أٓزٞع‬ ٌ٘ٓ ًَٔ( ‫ٗٔز٤خ‬ ‫حُوي٣ٔش‬ ٌٍُٞٔ‫ح‬ ‫كخ٫ص‬ ٢‫ك‬. ‫حُٜل٤ق‬ ‫ح٩١زخم‬ ٠ِ‫ػ‬ ٍُٞٛٞ‫ح‬ ٍ‫كخ‬ ٢‫كل‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ‫َٓآس‬ ٞٛ ١ِٞ‫حُؼ‬ ‫كخُلي‬ ،‫حَُى‬ ٢‫ك‬ ٚ٤ِ‫ػ‬ ‫ٗؼظٔي‬ ١ٌُ‫ح‬ َ٤ُ‫حُي‬ ٢ٛ ٕ‫ح٧ٓ٘خ‬ ‫ُِ٘ظخ٣خ‬ ‫حُٜل٤ق‬ ‫حَُى‬ ٢٘‫٣ؼ‬ ‫كٌٜح‬ ٞ٣َُِٔ‫حُؼظٔ٤ش‬٢‫ك‬ ‫أٓخ‬‫حُٔظؼيىس‬ ٌٍُٞٔ‫ح‬ٕ‫كب‬‫حُ٘ظخ٣خ‬ ‫اػخىس‬ٖ‫ػ‬‫ًخف‬ َ٤‫ؿ‬ ٕ‫ح٧ٓ٘خ‬ ‫١َ٣ن‬ ٝ‫ا‬ٗ‫كظق‬ ‫اؿَحء‬ ‫٣ـذ‬ ‫ٔخ‬َٗ‫ٓزخ‬)‫ر٘يس‬ ‫حُٔلظظش‬ ٌٍُٞٔ‫ح‬ ‫(ربٓظؼ٘خء‬ٝ‫ا‬‫حٌٍُٔٔٞس‬ ‫ُِ٘ظخ٣خ‬ ‫ٍى‬ ٠ِ‫ػ‬ َٜ‫ُ٘ل‬ ‫حُؼظٔ٤ش‬ ‫حُٔ٬هش‬ ّ‫ٓظوي‬ ‫حُٔلِ٤ش‬ ‫حُلخكش‬. *)‫اىرثثٍد‬Immobilization : +‫رٜخ‬ ٌْ‫٣ظل‬ ‫حُظؼز٤ض‬ ‫ٓيس‬ ٕ‫ا‬َٓ‫ػٞح‬ ‫ػيس‬: 1-ٌَُٔ‫ح‬ ‫ٓٞهغ‬. 2-ٌَُٔ‫ح‬ ٢‫ه‬ ُٖٔ‫ح‬ ‫ٝؿٞى‬. 3-ٞ٣َُٔ‫ح‬ َٔ‫ػ‬. 4-ٚ‫ؿ٤خر‬ ٝ‫أ‬ ٕ‫اٗظخ‬ ‫ٝؿٞى‬. ٝٚ٘‫ط‬ ‫هخػيس‬ ‫ٛ٘خى‬: ‫حُظؼز٤ض‬ ‫أٓخُ٤ذ‬: ْٔ‫٣٘و‬ ٕ‫ح٧ٓ٘خ‬ ‫ٝؿٞى‬ ‫ػ٘ي‬‫طؼز٤ض‬٢ِ‫حُٔل‬ ‫حُلي‬٠ُ‫ا‬ٖ٤‫ًز٤َط‬ ٖ٤‫ٓـٔٞػظ‬ ‫ح‬ ًٕٞ ٢‫ك‬ ٖ٣‫ٓؼظٔي‬َٗ‫حُٔزخ‬ ‫ُظؼز٤ض‬٫ ٝ‫أ‬ ٕ‫ح٧ٓ٘خ‬ ٠ِ‫ػ‬ 1-ٕ‫ح٧ٓ٘خ‬ ٠ِ‫ػ‬ ‫ٓؼظٔي‬ ‫طؼز٤ض‬: ‫أ‬-‫ٓزخَٗس‬ : ‫حُٔ٘٤ش‬ ‫حُو٤خ١ش‬ٝ‫أ‬‫حٌُِٔ٘ش‬ ‫حُلِوخص‬ ٠ِ‫ػ‬ ‫ٓؼظٔي‬. ‫م‬‫س‬ً‫قا‬ ً‫اىر‬ ‫تامشج‬ ‫ٍؼاىجح‬ ‫ذيقى‬ ‫اىضاوٌح‬ ً‫ف‬ ‫مسش‬ ‫ٍغ‬ ‫تاىغ‬ ‫شاب‬ ‫ػْذ‬ ‫ش‬‫أساتٍغ‬ ‫ثالز‬ / ‫اىنسش‬ ‫خظ‬ ٍِ ِ‫س‬ ‫تإصاىح‬ ‫تها‬ً‫ا‬‫إر‬: ‫أ‬-ً‫ا‬‫أسثىػ‬ ‫ّضٍف‬ ‫اىنسش‬ ‫خظ‬ ً‫ف‬ ِ‫اىس‬ ً‫تق‬. ‫ب‬-‫مسش‬‫وجىد‬ ‫ٍغ‬ً‫ا‬‫أسثىػ‬ ‫ّضٍف‬ ُ‫اإلّرا‬. ‫ج‬-‫ػَش‬40ٍِ‫أسثىػ‬ ‫إىى‬ ً‫ا‬‫أسثىػ‬ ‫ّضٍف‬ ‫فىق‬ ‫وٍا‬ ‫سْح‬. ‫د‬-‫ّح‬ ‫األطفاه‬‫ز‬ً‫ا‬‫أسثىػ‬ ‫ف‬.
  • 39.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 29 ‫د‬-‫أ‬ ّٞ‫ه‬‫٣َى‬. ‫ؽ‬-: ‫حٍُِ٣ؼخص‬ ‫ى‬-ُ‫ح‬‫ـ‬‫حُوزؼ٤ش‬ َ‫زخث‬( ‫حُؤخٗ٤ش‬ ‫ح٧ٍرطش‬ ٝ‫أ‬Barton’s Bandage).
  • 40.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 30 2-٢‫ك‬ َٗ‫حُٔزخ‬ ‫حُظؼز٤ض‬ْ‫حُؼظ‬: ‫أ‬-: ‫حُٔ٘٤ش‬ ‫حُو٤خ١ش‬‫آخ‬‫حُؼِٞ٣ش‬ ‫حُلخكش‬ ‫ه٤خ١ش‬ٝ‫أ‬‫حُٔلِ٤ش‬ ‫حُلخكش‬ ‫ه٤خ١ش‬ ‫د‬-‫حُيحثَ٣ش‬ ‫حُو٤خ١ش‬. ‫ؽ‬-‫حُؼظٔ٤ش‬ ‫حُٜلخثق‬. ‫ى‬-‫حُوخٍؿ٤ش‬ ‫حُظؼز٤ض‬ ْ٤‫ىرخر‬. ٙ-‫حُؼظٔ٤ش‬ ‫(حُٔوخُذ‬ ‫حُؼظٔ٤ش‬ ٍ‫ح٧ٝطخ‬. ) ٝ-‫رؤٓ٬ى‬ ٍٞ‫حُ٘و‬ ‫حُظؼز٤ض‬ًَٗٞ٘٤. ْ‫حُؼظ‬ ٢‫ك‬ َٗ‫حُٔزخ‬ ‫ُِظؼز٤ض‬ ‫اٟخكش‬ ٕ‫ح٧ٓ٘خ‬ ‫طؼز٤ض‬ َ٠‫حُٔل‬ ٖٓ ٚٗ‫ا‬. a)-ٕ‫ح٧ٓ٘خ‬ ٠ِ‫ػ‬ ‫حُٔؼظٔي‬ ‫حُظؼز٤ض‬: 1-٤‫ؿ‬ ٌَٗ ‫ًحص‬ ٕ‫ح٧ٓ٘خ‬ ًٕٞ ٍ‫كخ‬ ٢‫ك‬ ّ‫طٔظوي‬ :‫حُٔ٘٤ش‬ ‫حُو٤خ١ش‬ٝ ‫ي‬ٝ . ‫ٓ٘خٓذ‬٩‫ح‬ َ‫هز‬ ‫حُِٔي‬ ‫ٗي‬ ‫٣ـذ‬ّ‫ٓظويح‬ (ٚ‫طٔط٤ط‬)10%) ‫٫كوخ‬ ‫حُِٔي‬ ‫اٍطوخء‬ ‫ُٔ٘غ‬ (ٝ ،٢‫طٞه‬ ‫٣ـذ‬ُ ‫حُِٔي‬ ٢ٓ ٖٓ ٌٍ‫حُل‬ٝ ‫٣خىس‬‫ا‬ٝ ً‫خ‬٤ٓ‫هخ‬ ‫ٓ٤ٜزق‬ ٫٩‫ح‬ ‫َٓ٣غ‬‫ٗوطخع‬. ُ٘ٔ‫ح‬ ‫ُِو٤خ١ش‬ ‫١َم‬ ‫ػيس‬ ‫ٟٝؼض‬‫٤ش‬: ‫أ‬.ٍٞ‫رط‬ ‫ِٓي‬ ٌ‫٣ئه‬ :‫حُٔزخَٗس‬ ‫حُو٤خ١ش‬15ٝ ْٓٝ ٙ‫١َكخ‬ ‫٣ـٔغ‬ ْ‫ػ‬ ،ُٖٔ‫ح‬ ٍٞ‫ك‬ ‫٣ِق‬ٍٞ‫رط‬ ‫حُِٔي‬ ٌَ٘٣4-7 ٝ ْٓ، ٢ِ‫حُٔل‬ َٙ٤‫ٗظ‬ ‫ٓغ‬ ١ِٞ‫حُؼ‬ ٕ‫حُٔظًَٝخ‬ ٕ‫حُطَكخ‬ ‫٣ـٔغ‬ ٌَُٔ‫ح‬ ‫ٍى‬ ‫رؼي‬ ٞٛ ٚ‫ٓ٤جخط‬ُ ‫حُلخؿش‬ ‫ػ٘ي‬ًَ ‫اُحُش‬ ١‫أ‬ ‫حُظؼز٤ض‬ ًَ َٜ‫ك‬ ‫٣ـذ‬ َ‫أه‬ ‫١خٍة‬ ١٧ ٝ‫أ‬ ‫حُلًَش‬ ٚ‫ُلل‬ ٢ِ‫حُٔل‬ ٖ‫ػ‬ ١ِٞ‫حُؼ‬ ‫حُلي‬ َ٣َ‫ظل‬ ‫ح٧ٓ٬ى‬. ‫حُلِوخص‬ ‫ًحص‬ ‫حُٔ٘٤ش‬ ‫حُو٤خ١ش‬ .‫د‬(٢‫ا٣ل‬ َٟ‫ػ‬)ٍٞ‫رط‬ ‫ِٓي‬ ٌ‫٣ئه‬ :15ٝ ْٓ‫ٓ٘زِش‬ ٠ِ‫ػ‬ ‫٣ِق‬) ‫أىحس‬ ١‫أ‬ ٝ‫أ‬ ( ‫هطَٛخ‬3‫حُٔ٘٤ش‬ ‫رخُٔٔخكش‬ َ‫طيه‬ ْ‫ػ‬ ٖ٤‫ىٍٝط‬ ِْٓ‫حُِٔخٗ٤ش‬ ‫حُـٜش‬ ٖٓ(1)ٖٝ٤ُ٘ٔ‫ح‬ ٍٞ‫ك‬ ً‫خ‬٣ِ٤ِٛ‫ى‬ ‫حُِٔي‬ ‫٣ؼخى‬ٖ٣ٍٝ‫حُٔـخ‬(2)ْ‫ػ‬ ٖ٤ٌُِٔ‫ح‬ ‫٣ـٔغ‬(3-4)‫رؤٓ٬ى‬ ‫حُلِوخص‬ ‫طـٔغ‬ .‫حُظؼز٤ض‬ ‫ًِل٤ش‬ ‫ٓلِ٤ش‬ ‫كِوخص‬ ْٔ‫ٝه‬ ‫ػِٞ٣ش‬ ‫كِوخص‬ ْٔ‫ه‬ .‫حُظؤًي‬ ‫رؼي‬ َٟ‫أه‬ ٝ َُٝ‫ح‬ ‫رٔ٘طوش‬ ‫ٗزيأ‬ ، ‫ح٩١زخم‬ ‫ٟٝؼ٤ش‬ ٖٓٝ ‫ح٧ٓخٓ٤ش‬ ‫حُٔ٘طوش‬ ‫ٗؼزض‬ ْ‫ػ‬ ‫ٝحكي‬ ‫رطَف‬ ٖ٤‫حُطَك‬ ‫ٗ٘ي‬ٝ ‫حُِٔي‬ ٚ‫ٗو‬‫حُـِء‬ ٢٘‫ٗؼ‬ ‫حُلٔٞ٣ش‬ ‫حُ٘ٔؾ‬ ‫٣ـَف‬ ٫ ٠‫كظ‬ ٚ٘ٓ ٢‫حُٔظزو‬
  • 41.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 31 2-‫أ‬ ّٞ‫ه‬‫٣َى‬‫ؿخِٛس‬ ّ‫أهٞح‬ ٢ٛ :‫ٓظلَهش‬ ِ٤ٓ‫ٜٓخ‬ ٟٞ‫طل‬ٍٞ‫حُط‬ ٚ‫ه‬ ْ‫٣ظ‬ ٝ ‫حُٔ٘خٓذ‬ٌَٗ ٠‫٣ؼط‬ّٞ‫ه‬‫٣ؼزض‬ ٝ ٟ‫كي‬ ٠ِ‫ػ‬ ًَ ٕ‫رخ٧ٓ٘خ‬ ٢‫٣َر‬ ٝ ‫رؼ٠ٜخ‬ ‫ٓغ‬ ‫حُٔظوخرِش‬ ِ٤ٓ‫حُٜٔخ‬ ٢‫رَر‬ ٖ٤ٌ‫حُل‬. 3-‫حُوزؼ٤ش‬ َ‫حُـزخث‬:٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ٍ‫أٌٗخ‬ ‫ؿٔ٤غ‬ ٢‫ك‬ ّ‫طٔظوي‬ ‫ٓغ‬ٝ ‫حُيحثٔش‬ ٕ‫ح٧ٓ٘خ‬ ‫ٝؿٞى‬‫كخ‬ ٢‫ك‬ ‫ٓٔظويٓش‬ َ٤‫ؿ‬ ٢ٛٝ‫أ‬ ‫ح٧ً٣ش‬ ‫رٔزذ‬ ٕ‫ح٧ٓ٘خ‬ ٕ‫كويح‬ ٍ‫ا‬ٝ ‫حُيحػٔش‬ ‫حُ٘ٔؾ‬ ‫ُظٜخد‬ٌَٙٛ‫حُـزخث‬ ‫حُٔظزيُش‬ ٌٍُٞٔ‫ح‬ ٢‫ك‬ ٌ٤‫حُظ٘ل‬ ‫ٛؼزش‬. b)-‫أٓخُ٤ذ‬ْ‫حُؼظ‬ ٢‫ك‬ َٗ‫حُٔزخ‬ ‫حُظؼز٤ض‬: 1-١‫حَُرخ‬١َ‫حُيحث‬. 2-ْٖٟٔ‫حُؼظ‬: ‫أ‬.‫حُو٤خ١ش‬‫حُؼظٔ٤ش‬. ‫د‬.‫حُٜل٤لش‬‫حُؼظٔ٤ش‬. ‫ؽ‬.‫أٓ٬ى‬َ٘٘٣ًَ. 3-ْ٤‫حُظطؼ‬٢ٔ‫حُؼظ‬. 4-‫هخٍؽ‬ْ‫حُؼظ‬: ‫أ‬.‫حُظؼز٤ض‬ْ٤‫رخُيرخر‬. ‫د‬.‫حُٔوخُذ‬‫حُؼظٔ٤ش‬. 1-َِ‫ض‬ ‫اىخٍاطح‬‫اىؼظٍَح‬: ٝ‫حَُى‬ ٠ٔٔ‫ط‬‫حُٔلظٞف‬.‫حُِحٝ٣ش‬ ً‫خ‬٘ٔ٠‫ٓظ‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ًَٔ ‫ُظؼز٤ض‬ ‫كؼخُش‬ ‫١َ٣وش‬ ٢ٛ ٌَُٔ‫ح‬ ٢‫ه‬ َ‫ػز‬ ‫حُؼظٔ٤ش‬ ‫حُو٤خ١ش‬‫أٓخ‬ . ‫حُٔزي‬‫ػوذ‬ ٖ‫ػ‬ ‫ػزخٍس‬ ٜٞ‫ك‬ ‫أ‬٬ً ٠ِ‫ػ‬ ْ‫حُؼظ‬‫ؿخٗز‬٢‫ح‬ُٝ ٌََٔ٣َٔ‫ط‬‫أٓ٬ى‬0.45‫حُ٬ٛية‬ ً٫ٞ‫حُل‬ ٖٓ َِْٓ‫ػز‬ُ‫ح‬‫كلَص‬ ٢‫حُظ‬ ‫ؼوٞد‬ ٌَُِٔ ‫حُيه٤ن‬ ‫حَُى‬ ‫رؼي‬ٝ ‫حُٜ٘خ٣خص‬ ٌٙٛ ‫ٗوطغ‬ ْ‫ػ‬ ّ‫ربكٌخ‬ ‫ح٧ٓ٬ى‬ ‫أ١َحف‬ ٝ‫أ‬ ‫ٜٗخ٣خص‬ ‫ٗ٘ي‬٘‫طؼ‬‫حُؼوٞد‬ ‫أكي‬ َ‫ىحه‬ ٢١‫ُظلخى‬ ( ) ٖ٣َ‫حُظو‬ٌَُٔ‫ح‬ ‫٣َى‬ .‫ا‬ٕ‫ح٧ٓ٘خ‬ ‫ا١زخم‬ ٠ِ‫ػ‬ ً‫ح‬‫ػظٔخى‬. ‫ػ‬ ‫٣ـذ‬ّ‫ي‬‫هط‬ ٖٓ ‫٣ِ٣ي‬ ‫حُو٤خ١ش‬ ‫ططز٤ن‬ ٕ٧ ٌَُٔ‫ح‬ ٕ‫ح٩ٗظخ‬ ‫٣ٜ٤ذ‬ ‫ػ٘يٓخ‬ ‫حُؼظٔ٤ش‬ ‫حُو٤خ١ش‬ ‫ططز٤ن‬ٝ ْ‫حُؼظ‬ ٢‫ٜٗخ٣ظ‬ ‫طٔٞص‬ ‫كيٝع‬ َ ‫كيٝع‬‫ا‬٢‫ٝٗو‬ ْ‫ػظ‬ ‫ُظٜخد‬.
  • 42.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 32 2-ٌ‫اىذائش‬ ‫اىخٍاطح‬: ‫ح‬ ٝ ٕ‫ُ٨ٓ٘خ‬ َٓ‫حٌُخ‬ ‫حُلوي‬ ‫ػ٘ي‬ ٝ ٍ‫ح٧١لخ‬ ٟ‫ُي‬ َٔ‫طٔظؼ‬ ‫ٓخ‬ ‫ؿخُزخ‬‫حُ٬ٛية‬ ً٫ٞ‫حُل‬ ٖٓ ‫ِٓي‬ َ٣َٔ‫ط‬ ٠ِ‫ػ‬ ‫طؼظٔي‬ ٢ٛ0.5ٍٞ‫ك‬ ْٓ ٢‫ٛ٘خػ‬ ٞ٣ٞ‫طؼ‬ ٖٓ ‫رخ٩ٓظلخىس‬ ٝ‫أ‬ ‫ٓخروخ‬ ‫ٓؼي‬ ‫ا٣َى‬ ّٞ‫رو‬ ‫آخ‬ ٌَُٔ‫ح‬ ٢‫ٍر‬ ْ‫٣ظ‬ ٝ ٢ِ‫حُٔل‬ ‫حُلي‬ ٢٤‫ٓل‬‫ٓخرن‬‫ؿ٤ي‬. ٝ ‫أىٍى‬ ٞ٣َُٔ ‫أً٣ش‬ ‫كيٝع‬ ٍ‫كخ‬ ٢‫ك‬‫كيٝع‬ ٕٝ‫ى‬ ً‫خ‬ٔ٤ِٓ َٓ‫حٌُخ‬ ٢٠٣ٞ‫حُظؼ‬ ُٙ‫ؿٜخ‬ ٠‫٣زو‬ ٕ‫أ‬ ٌٖٔ٣ ٢ِ‫حُٔل‬ ‫حُلي‬ ٢‫ك‬ ًَٔ ٍٜٞ‫ك‬ ‫أً٣ش‬ ً‫خ‬ٗ‫أك٤خ‬ ً‫خ‬‫ٓليػ‬ ٚٔ‫ك‬ ٖٟٔ ٌَٔ٘٣ ٕ‫أ‬ ٝ‫أ‬ ٚ٤‫ك‬ ًَٔ‫حَُهٞس‬ ‫حُ٘ٔؾ‬ ٢‫ك‬ٌٖٔ٣ ً‫خ‬ٔ٤ِٓ ُ‫حُـٜخ‬ ٢‫رو‬ ‫اًح‬ .‫ا‬‫ُِو٤خ١ش‬ ٚٓ‫ٓظويح‬ ٢ُ‫ًخُظخ‬ ‫اًَ٣ِ٤ش‬ ‫ؿز٤َس‬ ‫اؿَحء‬ ٌٖٔ٣ ُ‫حُـٜخ‬ ‫ٌٛح‬ ٕ‫كويح‬ ٍ‫كخ‬ ٢‫ك‬ ‫أٓخ‬ ‫حُيحثَ٣ش‬: ٝ ‫ح٧ٓؼِش‬ ‫ىٍحٓش‬ ٍ‫كخ‬ ٢‫ك‬ ‫ح٧ىٍى‬ ‫حُلي‬ ‫١زؼخص‬ ٌ‫طئه‬‫كِٜٜخ‬) ٌَُٔ‫ح‬ ٢‫ك‬ ‫ًٔخ‬ (ٌٖٝٔٓ ٌَٗ ‫٧هَد‬ ‫اػخىطٜخ‬‫ػ‬ْٗ‫ٜ٘غ‬‫حُـز٤َس‬ ٠ِ‫ػ‬ َٜ‫ك٘ل‬‫ا‬ٝ ‫ُِٔ٤ِحد‬ ‫ٗطزخع‬ٝ ‫حُ٘ٔ٤ؾ‬٫ ٢ُ‫رخُظخ‬‫٣ليع‬١‫أ‬ ‫ُي٣٘خ‬‫اُػخؽ‬ُٞ٣َِٔ. ٝ ٌَُٔ‫ح‬ ٕ‫ٌٓخ‬ ‫ٓغ‬ ‫طظٞحكن‬ ٢ِ‫حُٔل‬ ُ‫حُـٜخ‬ ٠ِ‫ػ‬ ‫ػوٞد‬ ‫اؿَحء‬ ٌٖٔ٣ ُ‫حُـٜخ‬ ‫روخء‬ ٍ‫كخ‬ ٢‫ك‬ ‫أٓخ‬‫ح٧ٓخٓ٤ش‬ ‫حُٔ٘طوش‬ ٢‫ك‬ ‫كظلخص‬ ‫اؿَحء‬ َ‫ىحث‬ ‫رو٤خ١ش‬ ٢ِ‫حُٔل‬ ُ‫حُـٜخ‬ ‫طؼز٤ض‬ ٢‫٣ٌل‬ ً‫خ‬ٗٝ‫ٓظؼخ‬ ًٚٗٞ ٍ‫كخ‬ ٢‫كل‬ ٞ٣َُِٔ ‫رخُ٘ٔزش‬ ‫أٓخ‬ٝ ‫طؼز٤ض‬ ٕٝ‫ى‬ ١ِٞ‫حُؼ‬ ُ‫حُـٜخ‬ ‫روخء‬ ‫ٓغ‬ ‫٣ش‬ ٝ ٖ‫حٌُه‬ ّ‫كِح‬ ٝ‫أ‬ ّ‫حَُأ‬ ٍٞ‫ك‬ ١َ‫ىحث‬ ١‫ٍرخ‬ ‫ٗ٠غ‬ٗ ٢ً ‫ًُي‬‫ٔ٘غ‬ٖ‫ك٘ل‬ ٕٝ‫ٓظؼخ‬ َ٤‫ؿ‬ ٞ٣َُٔ‫ح‬ ًٚٗٞ ٍ‫كخ‬ ٢‫ك‬ ‫أٓخ‬ ،٢ِ‫حُٔل‬ ‫حُلي‬ ‫كًَش‬ ٝ ْ‫حُؼظ‬ ٖٟٔ ‫رو٤خ١ش‬ ١ِٞ‫حُؼ‬ ُ‫حُـٜخ‬ ‫ُظؼز٤ض‬ َٕٝ‫ٓ٠ط‬ً‫خ‬‫ٓخرو‬ ‫أؿَ٣ض‬ ٢‫حُظ‬ ‫حُؼوٞد‬ َ‫ػز‬ َٔ‫ط‬ ‫رؤٓ٬ى‬ ٖ٣ُ‫حُـٜخ‬ ‫٣ؼزض‬. ‫١َ٣وش‬َٔ‫حُؼ‬: ‫أٓ٬ى‬ ‫ٓغ‬ ٖ٤‫ػو‬ ‫ارَس‬ ّ‫ٍأ‬ ٝ‫أ‬ ٕ‫ٍ٣لَىح‬ ‫ارَس‬ ّ‫طٔظوي‬0.45ِْٓ،ٝ ٌَُٔ‫ح‬ ٕ‫ٌٓخ‬ ‫٣ليى‬٠ِ‫ػ‬ ٕ‫ح٧ٓ٘خ‬ ‫ا١زخم‬ ‫ػ٘ي‬ ‫ػوٞد‬ َٟ‫طـ‬ ٝ ٌَُٔ‫ح‬ ‫ؿٜش‬ ٖ٤‫١َك‬ ًَ ٠ِ‫ػ‬ ‫ػوذ‬ ، ٢ِ‫حُٔل‬ ُ‫حُـٜخ‬َٟ‫ح٧ه‬ ‫حُـٜش‬ ٢‫ك‬ ‫ػوذ‬ٝ ،ً‫خ‬ٓ‫ػخ‬ ً‫ح‬َ٣‫طوي‬ ٞ٣َُٔ‫ح‬ َ٣‫طوي‬ ‫رؼي‬‫ارَس‬ َ‫ٗيه‬ ٓ ٢ٔ٤ٔٛ ّ‫رظٔخ‬ ‫حُـِي‬ ٖٓ ٕ‫ٍ٣لَىح‬ْ‫حُؼظ‬ ‫غ‬ٝ ‫حُِٔخٗ٤ش‬ ‫حُـٜش‬ ٖٓ ‫طوَؽ‬ ٠‫كظ‬‫ح٩رَس‬ ‫حُؼوذ(ػوذ‬ ٖٟٔ ‫حُِٔي‬ َ‫٣يه‬ ‫ػ٘يٛخ‬ (1)ٝ )‫حُـِي‬ ‫ػزٍٞٛخ‬ ٕٝ‫ى‬ ٌٍ‫رل‬ ‫ح٩رَس‬ ‫طٔلذ‬(2)ُٝ‫ح‬ ‫حُـٜش‬ ٖٓ ‫طيكغ‬ ْ‫حُؼظ‬ ٖٓ ‫طلٍَٛخ‬ ‫ػ٘ي‬‫ي‬‫ِٛ٤ِ٣ش‬(3)ٝ‫هَٝؿٜخ‬ ‫ػ٘ي‬٢‫َٗر‬ ٞ٣َُٔ‫ح‬ ُ‫ؿٜخ‬ ‫ٓغ‬ ‫حُِٔي‬ ٢‫١َك‬ٖٝ٤‫ح٧ه٤َط‬ ٖ٤‫حُٔ٘طوظ‬ ٢‫ك‬ َٔ‫حُؼ‬ ٌٍَ٣. ‫حُؼِٔ٤ش‬ ‫١٤ِش‬ ْ‫حُؼظ‬ ‫ٓغ‬ ٢ٔ٤ٔٛ ّ‫رظٔخ‬ ٕ‫ٍ٣لَىح‬ ‫ارَس‬ ٠‫طزو‬ ٕ‫أ‬ ‫٣ـذ‬ ُِ ‫رخُ٘ٔزش‬١ِٞ‫حُؼ‬ ُ‫ـٜخ‬ٌٖٔ٣‫ح٧ٗق‬ ‫ٗٞى‬ ٠ِ‫ػ‬ ‫حُظؼز٤ض‬ ‫اؿَحء‬‫ك٤غ‬‫حُٔ٘طوش‬ ٢‫ك‬ ١ِ٤ِٛ‫حُي‬ ‫حُٔ٤ِحد‬ ٢‫ك‬ ١ٞٔ‫ك‬ َ‫ىحه‬ ‫ٗن‬ ١َ‫٣ـ‬ ٝ ‫ح٧ٓخٓ٤ش‬ٝ ‫ح٧ٗق‬ ‫ُ٘ٞى‬ َٜٗ ٠‫كظ‬ ‫حُٔ٘طوش‬ ‫طِٔن‬ٝ ‫ح٧ٗق‬ ‫ٗٞى‬ ٢‫ك‬ ً‫خ‬‫ػوز‬ ١َ‫ٗـ‬ْ‫ػ‬ ‫ِٓي‬ َٙ‫ػز‬ ٍَٔ٣ٖ٤‫ػوزظ‬ ٢‫ك‬ ‫حُِٔي‬ َٔ٣ ٝ ُ‫حُـٜخ‬ ‫ؿ٘خف‬ ٠ِ‫ػ‬ ‫أؿَ٣خ‬،‫حُِٔي‬ ‫ٗي‬ ْ‫٣ظ‬ ْ‫ػ‬ ‫حُ٘ن‬ ٢٤‫٣و‬
  • 43.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 33 ‫حُظؼز٤ض‬ ‫اؿَحء‬ ‫ػ٘ي‬ ‫رخ٧ٓ٬ى‬ ‫ٓٞ٣ش‬ ٖ٣ُ‫حُـٜخ‬ ‫ٗؼزض‬ ‫حُ٘خر٤ش‬ ‫حُٔ٘طوش‬ ٢‫ك‬٢‫ك‬ ‫ػوذ‬ َ‫ٝ٣لل‬ ْ‫ُِؼظ‬ َٜٗ ٠‫كظ‬ ‫حُ٘ٔ٤ؾ‬ ‫ٝٗزؼي‬ ‫حُ٘خد‬ ‫ٓ٘طوش‬ ‫ػ٘ي‬ ١ِ٤ِٛ‫حُي‬ ‫حُٔ٤ِحد‬ ٢‫ك‬ ً‫خ‬‫ٗو‬ ١َ‫ٗـ‬ ، َٙ‫ػز‬ َٔ٣ٝ ‫حُوخٍؿ٤ش‬ ‫حُوَ٘س‬َ‫ح٥ه‬ ‫حُطَف‬ ٠ِ‫ػ‬ َٔ‫حُؼ‬ ٌٍَ٣ٝ ُ‫حُـٜخ‬ ‫ٝ٣ؼزض‬ ‫حُِٔي‬. ‫حُٔلِ٤ش‬ ‫حُلـخؽ‬ ‫كخكش‬ ‫ػ٘ي‬ َ٤‫ٛـ‬ ‫ٗن‬ ١َ‫٣ـ‬ ١ٍ‫حُؼٌح‬ ّٞ‫حُو‬ ٍٞ‫ك‬ ‫حُظؼز٤ض‬ ‫ػ٘ي‬ ‫أٓخ‬،‫طوَؽ‬ ٠‫كظ‬ ‫ح٩رَس‬ َٔ‫ٝط‬ ٕ‫ٍ٣لَىح‬ ‫ارَس‬ َ‫طيه‬ َٔ‫ط‬ ‫ًُي‬ ‫رؼي‬ ‫حُـِي‬ ٖٓ ‫هَٝؿٜخ‬ ٕٝ‫ى‬ ‫ٝطٔلذ‬ ‫ُ٪رَس‬ ‫حُِٔي‬ ْ٠٣ ْ‫ػ‬ ١ٍ‫حُؼٌح‬ ّٞ‫حُو‬ ٢ٔٗ‫أ‬ ١ِ٤ِٛ‫حُي‬ ‫حُٔ٤ِحد‬ ٖٓ٢٘‫ٝك‬ ‫ح٩رَس‬ ٝ ّٞ‫حُو‬ٝ ١ِ٤ِٛ‫حُي‬ ‫حُٔ٤ِحد‬ ٖٓ ‫طوَؽ‬َ‫ح٥ه‬ ‫حُطَف‬ ٠ِ‫ػ‬ َٔ‫حُؼ‬ ٌٍَ٣ٝ ُ‫حُـٜخ‬ ‫ؿ٘خف‬ ٠ِ‫ػ‬ ١َ‫أؿ‬ ‫ػوذ‬ ٢‫ك‬ ٕ‫حٌُِٔخ‬ ‫٣ـٔغ‬. 3-‫اىؼظٍَح‬ ‫اىصفائح‬: ًٍٞٔ ‫ٓؼخُـش‬ ٢‫ك‬ ‫حُؼظٔ٤ش‬ ‫ُِٜلخثق‬ ‫ح٧ٓخٓ٤ش‬ ‫حُلخثيس‬ ٝ ‫رَى‬ ‫طِٝىٗخ‬ ‫رؤٜٗخ‬ ٢ِ‫حُٔل‬ ‫حُلي‬‫طؼز٤ض‬‫طؼز٤ض‬ ٕٝ‫ى‬ َ٠‫أك‬ ٝ ، ٖ٤ٌ‫حُل‬ٌٖٔ٣‫ا‬ًٍٞٔ ًَ ٢‫ك‬ ‫حُطَ٣وش‬ ٌٙٛ ّ‫ٓظويح‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ‫٣ظطِذ‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ٠ِ‫ػ‬ ‫حُؼظٔ٤ش‬ ‫حُٜلخثق‬ ‫ططز٤ن‬ ٝ ‫ٓليىس‬ ‫طو٘٤خص‬ٝ ّ‫حُؼخ‬ َ٣‫حُظوي‬ ٖٓ َ٣ٞ١ ‫ٝهض‬ ً‫خ‬٠٣‫أ‬ ‫حُلخ٫ص‬ ْ‫ٓؼظ‬ ٢‫ك‬ ‫حُـَحك٤ش‬ ‫حُٜٔخٍس‬ ٖٓ ‫ٓؼظزَس‬ ‫ىٍؿخص‬ ‫ؿِي٣ش‬ ‫ٗوٞم‬ َ‫ػز‬ ‫حُٜلخثق‬ ‫ططزن‬. ‫ٛ٘خى‬‫أٗٞحع‬ ‫ػيس‬‫ُِٜلخثق‬: ‫أ‬-: ‫رٔ٤طش‬ ‫ػظٔ٤ش‬ ‫ٛلخثق‬ٗ‫ٔظوي‬‫ًٞرخُض‬ ‫هِ٤طش‬ ّ–ًَّٝ–ٍٞ١ ‫ًحص‬(1ٝ ٖٗ‫ا‬ )‫حُوَ٘٣ش‬ ‫حُٜل٤لش‬ ٠ِ‫ػ‬ ‫ططزن‬ ‫حَُى‬ ‫رؼي‬ ‫رَحؿ‬ ٖ٤ٓ‫ٓٔظوي‬ ‫حُوخٍؿ٤ش‬َ‫هط‬ ‫ًحص‬ ٢1.5ٝ ٍِْٓٞ١7. ِْٓ‫أ‬‫طٌ٤لٜخ‬ ٌٖٔ٣ ٢‫حُظ‬ ّٞ٤ٗ‫حُظ٤ظخ‬ ‫رٜلخثق‬ ‫حُٜلخثق‬ ٌٙٛ ‫ٓظزيُض‬ َٜٓ‫أ‬ ٌَ٘‫ر‬. ‫د‬-‫حُ٠خؿطش‬ ‫حُٜلخثق‬:َ‫حُوط‬ . ‫طَ٘٣ل٤ش‬ ‫٧ٓزخد‬ ٝ .ٌَُٔ‫ح‬ ٢‫ه‬ ‫هَد‬ ‫٣ظٟٞغ‬ ‫ُِؼوٞد‬ َٝ‫ح٧ػ‬َ‫٣يه‬ َ‫ػز‬ ٢‫حُزَؿ‬‫ٝػ٘ي‬ ‫حُزيح٣ش‬ ٢‫ك‬ َ‫ح٧ٛـ‬ َ‫حُوط‬‫ٜٗخ٣ش‬‫حُ٘ي‬ ٢‫حُزَؿ‬ ‫٣ٜزق‬ٝ َ‫ح٧ًز‬ َ‫حُوط‬ ‫ػ٘ي‬‫ُِؼوٞد‬ ٌٖٔ٣ ٠ِ‫ػ‬ ٝ‫أ‬ ٌَُٔ‫ح‬ ٢‫ه‬ ٢‫ؿخٗز‬ ٠ِ‫ػ‬ ‫طظٟٞغ‬ ٕ‫أ‬ ‫حُ٠خؿطش‬ . ٢‫كو‬ ‫ٝحكي‬ ‫ؿخٗذ‬ ‫ططٍٞص‬‫ح٧كو٤ش‬ ‫حُ٠خؿطش‬ ‫حُٜلخثق‬٠ُ‫ا‬‫ٛلخثق‬‫ًحص‬ ‫ؿخٗز٤ش‬ ‫ػوٞد‬‫رِحٝ٣ش‬ ‫ٓخثِش‬454ٝ‫ططزن‬ ٢‫حُظ‬‫ٓزخَٗس‬ ‫حُؼِٞ٣ش‬ ‫حُلخكش‬ ٠ِ‫ػ‬ٝ‫ػ٘ي‬ٓ٢‫ك‬ ّ‫ربكٌخ‬ ٢‫حُزَؿ‬ ‫٣٘ي‬ ‫خ‬ ٚٗ‫ٌٓخ‬٣ ٫‫ليع‬٩‫رخ‬ ٌَُٔ‫ح‬ ٢‫ُو‬ َ٤ٓ‫ٗلظخف‬.
  • 44.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 34 ‫ؽ‬-‫ُؼ‬ ‫طلظخؽ‬ ٫ ٢‫حُظ‬ ٝ ‫حُٔٔظٜش‬ ‫حُٜلخثق‬. ‫٩ُحُظٜخ‬ ٢ٗ‫ػخ‬ ٢‫ؿَحك‬ َٔ )+‫ا‬‫هظ٬١خص‬‫ا‬ٝ ‫حُٜلخثق‬ ّ‫ٓظويح‬٢ٛ: *٩‫ح‬٢ٗ‫حُٔؼي‬ ‫ٍط٘خف‬) ‫حُوي٣ٔش‬ ‫حُ٘ٔخًؽ‬ ٢‫ك‬ (. *‫حُٜل٤لش‬ ًَٔ، *ْ‫حُؼظ‬ ٢‫ٜٗخ٣ظ‬ ‫طٔٞص‬. *٢‫حُزَحؿ‬ ٍ‫اىهخ‬ ‫ػ٘ي‬ ْ‫حُؼظ‬ ٢‫ٜٗخ٣ظ‬ ٖٓ ‫ٛـ٤َس‬ ‫ٗظخ٣خ‬ ًَٔ. ‫حُـٜي‬ ًَٔ * *ٝ ْ‫حُؼظ‬ ‫طٔٞص‬ ‫ٓغ‬ ٕ‫ح٩ٗظخ‬ َ‫هط‬ ٞٛ ٚ٘ٓ ٌٍ‫حُل‬ ٢‫طٞه‬ ‫٣ـذ‬ َ‫هط‬ ْٛ‫أ‬٢‫ح٧ؿ٘ز‬ ْٔ‫ُِـ‬ ٞ‫حَُك‬. 4-‫اىذتاتٍس‬:‫اىَثثرح‬ ‫اىخاسجٍح‬ ٝ .‫٣ليع‬ ‫هي‬ ‫حُلي‬ ْٔ‫ؿ‬ ٖٓ ‫ُـِء‬ ٝ‫أ‬ َٓ‫ٌُخ‬ ‫ٗي٣ي‬ ‫طلظض‬ ‫كخ٫ص‬ ‫ٛ٘خُي‬ِ‫ػ‬ ‫ٗلخكع‬ ٢ٌُ٠ٓ‫٬ٓش‬‫ك٤ٞ٣ش‬ َٟٝ‫حٌُز‬ ‫حُ٘ظ٤ش‬ ً‫خ‬‫ؿخُز‬ ٚ‫ططز٤و‬ ٌٖٔ٣ ْ٤‫رخُيرخر‬ ٢‫حُوخٍؿ‬ ‫كخُظؼز٤ض‬.
  • 45.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 35 ‫طظ‬ ‫حُظو٘٤ش‬٢‫ك‬ ٚ‫ِو‬ّٞ٤ٗ‫حُظ٤ظخ‬ ْ٤‫حُيرخر‬ ٖٓ ‫ُٝؽ‬ ٍ‫اىهخ‬3‫حَُث٤ٔ٤ش‬ ‫حٌُز٤َس‬ ‫حُ٘ظخ٣خ‬ ٖٟٔ ‫حُ٬ٛية‬ ً٫ٞ‫حُل‬ ْ٤‫ىرخر‬ ٖٓ ‫ُٝؽ‬ ٝ‫أ‬ ِْٓ ٝ ٢ٔ٤‫ٍث‬ َٜ‫ٓل‬ ‫رٞحٓطش‬ ْ٤‫حُيرخر‬ ٌٙٛ ‫ٝطـٔغ‬ٖ٤ٌ‫حُل‬ ‫طؼ٤زض‬ ٠ُ‫ا‬ ‫طلظخؽ‬ ً‫خ‬‫ؿخُز‬. )+‫ح٫ٓظطزخرخص‬ ْٛ‫أ‬: ‫ح‬ ‫حُو٤خ١ش‬ ‫ك٤غ‬ ٕ‫رخ٩ٗظخ‬ ‫ٜٓخد‬ ًَٔ ٢‫ك‬ ‫طؼز٤ض‬ ٖ٤ٓ‫ُظؤ‬ .‫أ‬ٝ ‫ُؼظٔ٤ش‬٩‫ح‬ ‫ٓ٠خى‬ ‫حُؼظٔ٤ش‬ ‫حُٜلخثق‬‫ٓظطزخرخص‬. ‫حُٔظلظظش‬ ٌٍُٞٔ‫ح‬ ٢‫ك‬ .‫د‬. ٝ ١ِٞ‫حُؼ‬ ‫حُلي‬ ًٍٞٔ ‫ٓؼخُـش‬ ٢‫ك‬ .‫ؽ‬ُٔ‫ح‬" ٌَٗ ‫ًح‬ ‫حُظؼز٤ض‬ ّ‫٣ٔظوي‬ ‫ك٤غ‬ ٢ِ‫ل‬٢‫حُٜ٘يٝه‬ ‫حُظؼز٤ض‬" . 5-‫اىَخاىة‬:‫اىؼظٍَح‬ ‫كٔٞ٣ش‬ ‫هخٍؽ‬ ‫رطَم‬ ‫طـٔغ‬ ٢‫رَحؿ‬ ‫حُٔوخُذ‬ ٖٓ ‫٣وَؽ‬ ْ‫ػ‬ ٢ِ‫حُٔل‬ ‫ُِلي‬ ‫حُٔلِ٤ش‬ ‫حُؼظٔ٤ش‬ ‫حُٔوخُذ‬ ‫طٟٞغ‬ٝ‫طؼز٤ض‬. 6-‫مش‬ ‫أسالك‬ ‫تىاسطح‬ ‫اىْقىه‬ ‫اىرثثٍد‬ٌ‫ش‬ْ‫ش‬: ‫أ‬‫أٓ٬ى‬ ‫ٓظويٓض‬٘٣ًَ٘ٝ‫أ‬ ًٍَ‫ح٧١لخ‬ ‫ػ٘ي‬ ً‫خ‬٤ِٔ‫ػ‬ ‫َٗ٘ي‬ٝ .ٌٖٔ٣‫ا‬ٕ‫أٓ٘خ‬ ٠ِ‫ػ‬ ‫كخٝ٣ش‬ ‫حُ٘ظخ٣خ‬ ٍ‫كخ‬ ٢‫ك‬ ‫حُطَ٣وش‬ ٌٙٛ ّ‫ٓظويح‬ ً٫ٝ‫أ‬ٝ‫ح٧ٗٔذ‬ َٟ‫ح٧ه‬ ‫ح٧ٓخُ٤ذ‬ َ‫طٞك‬ ّ‫ػي‬. c-‫ا‬٤‫حُظؼز‬ ‫أِٓٞد‬ ٍ‫هظ٤خ‬: ‫ض‬ *‫٣ـذ‬‫ا‬ٖٓ‫طئ‬ ٢‫حُظ‬ ‫ُِظؼز٤ض‬ ٢ٔ‫ح٧ر‬ ‫حُطَ٣وش‬ ٍ‫هظ٤خ‬‫ػزخص‬‫ر‬ ٌَُٔ‫ح‬ٓ ٌَ٘ٝ ٢َْٟ‫٣ظ‬ ٢ً َ٣ٞ١ ‫ُٞهض‬ ‫ًُي‬‫ا‬ٌَُٔ‫ح‬ ّ‫ُظلخ‬. *ٝ ٕ‫أٓ٘خ‬ ٠ِ‫ػ‬ ١ٝ‫حُلخ‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ٢‫ك‬‫َٓ٣غ‬ ‫رظؼز٤ض‬ ٌٖٔ‫ط‬ ‫حُٔؼخُـش‬ ٕ‫كب‬ ٍ‫طزي‬ ‫٣ٞؿي‬ ٫ ‫ك٤غ‬ٞ٣َُٔ‫ح‬ ‫رب١زخم‬ ٖ٤ٌ‫ُِل‬ ٝ‫ٓطخ١٤ش‬ ‫كِوخص‬ ٞ٣َُِٔ ‫٣ٟٞغ‬ ٍ‫حُظزي‬ ٍ‫كخ‬ ٢‫ك‬ُ‫ٔيس‬24ٝ ‫ٓخػش‬ٍ‫كخ‬ ٢‫ك‬‫اهظلخء‬ٍ‫طٔظزي‬ ‫حُلي‬ ْٔ‫ؿ‬ ٢‫ك‬ َٛ‫حُلخ‬ ٍ‫حُظزي‬ ٍ‫كخ‬ ٢‫ك‬ ‫أٓخ‬ ، ‫ٓؼيٗ٤ش‬ ‫رؤٓ٬ى‬ ‫حُلِوخص‬ٌْٗٝ ‫حُٔلظٞف‬ ‫حَُى‬ ٠ُ‫ا‬ ‫٣ِـؤ‬ ‫ػ٘يٛخ‬ ٍ‫حُظزي‬ٝ ‫حُؼظٔ٤ش‬ ‫حُو٤خ١ش‬ٝ‫أ‬ ٖ٤ٌ‫حُل‬ ‫طؼز٤ض‬ُ‫ح‬‫ٜل٤ق‬ ُ‫ح‬‫طؼز‬ ٕٝ‫ى‬ ‫ؼظٔ٤ش‬ٖ٤ٌ‫حُل‬ ‫٤ض‬. *٩‫ح‬ ّ‫ػي‬ ‫هطٍٞس‬ ‫رٔزذ‬ُ‫ح‬ ٠ِ‫ػ‬ َ‫ُِظيحه‬ ‫حُؼخثي‬ ّ‫ُظلخ‬‫طزو‬‫حُٔٔلخه٤ش‬ ‫ش‬ٕ‫كب‬‫ٓل‬ ‫حُٔـِن‬ ‫حَُى‬٠ٚ‫اؿَحث‬ ٖٓ ٌٖٔ‫ٗظ‬ ‫ػ٘يٓخ‬ َ٠ِ‫ػ‬ ‫ٓظزيُش‬ َ٤‫ؿ‬ ًٍٞٔ ‫ػيس‬ٝٝ ‫ًز٤َس‬ ‫ٓؼخُـش‬ ٠ُ‫ا‬ ‫طلظخؽ‬ ٫‫ٓؼخُـش‬١‫حَُرخ‬‫ٓل‬ َ‫حُيحث‬٠‫ُِظؼز٤ض‬ ‫ح٧ىٍى‬ ‫حُلي‬ ٌٍُٞٔ‫ح‬ ‫كخ٫ص‬ ‫أؿِذ‬ ٢‫ك‬ َ. ٩‫ح‬ ‫ٌٛح‬ ‫٣ٔزذ‬ ‫ػ٘يٓخ‬‫حُٔلظٞف‬ ‫كخَُى‬ ً‫ح‬‫ٗي٣ي‬ ً‫خ‬ُٔ‫أ‬ ‫ِٗ٣خف‬‫ا‬.‫أً٤ي‬ ‫ٓظطزخد‬ *ٝ ‫ًَٗ٘ي‬ ‫رؤٓ٬ى‬ ‫حُظؼز٤ض‬ ‫أٓخ‬ٝ ‫حُؼظٔ٤ش‬ ‫حُٔوخُذ‬‫حُي‬‫ٓظلظض‬ ًَٔ ٍٜٞ‫ك‬ ٍ‫كخ‬ ٢‫ك‬ ّ‫طٔظوي‬ ٢ٜ‫ك‬ ‫حُؼظٔ٤ش‬ ْ٤‫رخر‬، *‫كخُش‬ ‫طٔٔق‬ ‫ػ٘يٓخ‬ ‫حُٔ٘٘ؤ‬ ‫حٌُحط٤ش‬ ‫حُؼظٔ٤ش‬ ّٞ‫حُطؼ‬ ‫أِٓٞد‬ ‫ططز٤ن‬ ‫ك٤ـذ‬ ،‫ُحثي‬ ٌَ٘‫ر‬ ً‫خ‬‫ٗل٤ل‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ٌٕٞ٣ ‫ػ٘يٓخ‬ ‫أٓخ‬ ‫رٌُي‬ ‫حُؼخٓش‬ ٞ٣َُٔ‫ح‬. *‫ح٧ىٍى‬ ‫حُلي‬ ‫ػ٬ؽ‬: ‫ٛ٘خُي‬‫ح٧ىٍى‬ ‫حُلي‬ ٢‫ك‬ ‫حُوٜٞٛ٤خص‬ ٞ‫رؼ‬‫ٜٓ٘خ‬٩‫ح‬ٕ‫كويح‬ ‫رؼي‬ َٛ‫حُلخ‬ ٢ٔ‫حُؼظ‬ ٙ‫ٓظٜخ‬ٞ‫٣٘ول‬ ‫ك٤غ‬ ٕ‫ح٧ٓ٘خ‬‫ا‬٠ُ‫ا‬ ْ‫حُؼظ‬ ‫ٍطلخع‬ ٝ ً‫خ‬‫طوَ٣ز‬ ‫حُٜ٘ق‬‫ًُي‬ ٠ِ‫ػ‬ ‫٣ِ٣ي‬ ‫حُلخ٫ص‬ ٞ‫رؼ‬ ٢‫ك‬. ٢ُ٘ٔ‫ح‬ ٕ‫حَُ٘٣خ‬ ‫١َ٣ن‬ ٖ‫ػ‬ ْ‫حُؼظ‬ ‫كظَٝ٣ش‬ ‫حُٞػخث٤ش‬ ‫حُٜ٘يٓش‬ َ٤‫طظـ‬ ‫ك٤غ‬ َٔ‫حُؼ‬ ّ‫طوي‬ ‫رٔزذ‬ ‫ُِٜيٓخص‬ ْ‫حُؼظ‬ ‫ٓوخٝٓش‬ ‫طوظِق‬ ٝ ‫رخُظيٍ٣ؾ‬ َ‫طو‬ ٢ِ‫حُٔل‬ً‫ح‬‫ٓؼظٔي‬ ْ‫حُؼظ‬ ‫٣ٜزق‬ٝ ‫حُٔٔلخم‬ ٢‫ك‬ ‫حَُ٘٣خٗ٤ش‬ ‫حُ٘زٌش‬ ٠ِ‫ػ‬ ٚ‫طَٝ٣ظ‬ ٢‫ك‬ٝ ْ٤َٓ‫حُظ‬ ‫آُ٤ش‬ َ‫طظؤػ‬ ً‫خ‬٠٣‫أ‬ ٝ .ٌ‫حُيٗز‬ ٌَ٘‫ط‬‫ٛ٘خى‬ ٌُٖٝ ‫ح٧ىٍى‬ ‫ُِلي‬ ‫حُلٞحثي‬ ٞ‫رؼ‬٢ٛ: -ٕ‫أ‬‫ا‬ًَٔ ‫كيٝع‬ ٍ‫كظٔخ‬َ‫أه‬ٝٝ ٕ‫أٓ٘خ‬ ‫ٝؿٞى‬ ّ‫ػي‬ َ‫ح٧ه‬ ٠ِ‫ػ‬ ‫حُٔزذ‬٢‫ك‬ ٕ‫ح٩ٗظخ‬ ‫كيٝع‬ ‫ٗٔزش‬ ٕ‫أ‬ ‫ًُي‬ ٖ‫ػ‬ ‫٣٘ظؾ‬ ‫ٓٔخ‬ ‫حُلخثيس‬ َ‫أه‬ ٌَُٔ‫ح‬ ٢‫ه‬. -ٕ‫أ‬ٌٔ٣ ٚٗ٧ ‫ٓطِٞد‬ َ٤‫ؿ‬ ‫حُيه٤ن‬ ‫حَُى‬٢‫ٟٞحر‬ ٕ‫أ‬ ‫ك٤غ‬ ‫حُ٘لخء‬ ‫رؼي‬ ٞ٣َُِٔ ‫ؿي٣ي‬ ُ‫حُـٜخ‬ ٞ٣َُِٔ ‫ؿي٣ي‬ ‫ا١زخم‬ ‫ر٘خء‬ ‫اػخىس‬ ٖ ٝ ‫ح٩١زخم‬‫ٓٞؿٞىس‬ َ٤‫ؿ‬ ٕ‫ح٧ٓ٘خ‬ ٢ٛ. ‫حُٔلظٞف‬ ‫حَُى‬ ٠ُ‫ا‬ ‫ِٗـؤ‬ َ٘‫حُل‬ ٍ‫كخ‬ ٢‫ٝك‬ ،‫حُٔلظٞف‬ ‫حُطَ٣ن‬ ٕٝ‫ى‬ ‫ٛخ‬‫ٍى‬ ٍٝ‫ك٘لخ‬ ‫حُ٘ظخ٣خ‬ ‫طَحًذ‬ ٍ‫كخ‬ ٢‫ك‬ ‫أٓخ‬.
  • 46.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 36 H-‫حُِؤش‬ ًٍٞٔ: : ٠ُ‫ا‬ ‫حُِؤش‬ ًٍٞٔ ‫ٓؼخُـش‬ ْٔ‫طو‬-‫ٓلخكع‬ -٢‫ؿَحك‬. ٝ ‫حُٞظ٤لش‬ ‫أىحء‬ ٢‫ك‬ ‫حُويٍس‬ ٞٛ ‫حُٔؼخُـش‬ ‫ٗـخف‬ ّ‫ٓو٤خ‬‫حُٔ٠ؾ‬ ‫ىٍٝس‬ ٢‫ك‬ ‫حُـخٗز٤ش‬ ‫حُلًَخص‬ ‫اؿَحء‬. a-‫حُظٜ٘٤ق‬: ‫أ‬-ُٔ‫ح‬ ٖٟٔ ًَٔ‫للظش‬(a):-‫حُـخٗذ‬ ١‫أكخى‬ -‫حُـخٗذ‬ ٢‫ػ٘خث‬. ‫د‬-‫حُٔللظ‬ ‫هخٍؽ‬ ًَٔ‫ش‬(b-c):-‫حُـخٗذ‬ ١‫أكخى‬ -‫حُـخٗذ‬ ٢‫ػ٘خث‬. ً‫ح‬‫ؿي‬ ‫ٛؼذ‬ ‫حُٔللظش‬ َ‫ىحه‬ ًٍٞٔ ٚ٤‫ط٘و‬ ٖٓ٢ِ٣‫ًٔخ‬ ٌٍُٞٔ‫ح‬ ‫ٛ٘لض‬ ‫حُٔؼخُـش‬ َ‫ٗظ‬ ‫ٝؿٜش‬: 1-‫أ‬ :ٍ‫ح٧١لخ‬-.‫رخ٩١زخم‬ ‫طوَد‬ ٕٝ‫ى‬ ‫د‬-‫رخ٩١زخم‬ ‫طوَد‬ ‫ٓغ‬. 2-‫أ‬ :ٖ٤‫حُزخُـ‬-.‫رخ٩١زخم‬ ‫طوَد‬ ٕٝ‫ى‬ ‫د‬-‫رخ٩١زخم‬ ‫طوَد‬ ‫ٓغ‬.
  • 47.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 37 ‫طٜخٗ٤ق‬ ‫ػيس‬ ‫٣ٞؿي‬: ٢‫ك‬ ‫اهظِحُٜخ‬ ٌٖٔ٣ َٟ‫أه‬ ‫طٜ٘٤ق‬ **Spissel and Schroll 1972: ‫طٜ٘٤ق‬ **Lindahl1977: ‫٣ؼظٔي‬3: َ٤٣‫ٓؼخ‬ 1-٢‫حُظَ٘٣ل‬ ‫حُٔٞهغ‬ ‫كٔذ‬ 2-: ٢ِ‫حُٔل‬ ‫حُلي‬ ٢‫رخه‬ ‫ٓغ‬ ‫حُِؤش‬ ‫ػ٬هش‬ ‫كٔذ‬
  • 48.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 38 3-: ‫حُـٔـٔش‬ ‫هخػيس‬ ‫ٓغ‬ ‫حُِؤش‬ ‫ػ٬هش‬ ‫كٔذ‬ ‫طٜ٘٤ق‬ **Neff & Rasse’s Modification2006: b-: ٚ٤‫حُظ٘و‬ 1-: ‫حَُٟٔ٤ش‬ ‫حُوٜش‬ ١ٞ‫طل‬ ‫ٓخ‬ ‫ؿخُزخ‬ ٢‫حُظ‬ ٝ‫حُِؤش‬ ٟٞ‫ٓٔظ‬ ٠ِ‫ػ‬ َٗ‫ٓزخ‬ ٍٝ ٝ‫أ‬ ٖ‫حٌُه‬ ٟٞ‫ٓٔظ‬ ٠ِ‫ػ‬ ٍٝ 2-: ‫حَُٔ٣َ٣ش‬ ‫حُؼ٬ٓخص‬ -َٛ‫حُظخ‬ ‫حُٔٔغ‬ ‫ه٘خس‬ ٖٓ ‫ِٗف‬ -ًٕ٧‫ح‬ ّ‫أٓخ‬ ‫ٝحٟق‬ ٍّٞ‫ط‬ ٝ ‫ًيٓش‬ -٢ٜ‫ٝؿ‬ َ‫ط٘خظ‬ ّ‫ػي‬ -‫حُـٜش‬ ٖٓ ‫حَُأى‬ ٍٞ١ ٢‫ك‬ َٜ‫ه‬‫حُٜٔخرش‬ -‫ٓلِٜ٤ش‬ ‫١وطوش‬ -‫حُلي‬ ‫طلَ٣ي‬ ‫ػ٘ي‬ ُْ‫أ‬ -‫ا١زخم‬ ‫ٓٞء‬
  • 49.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 39 -٢ِ‫حُٔل‬ ‫حُلي‬ ‫ُؤش‬ ‫اٗلَحف‬ -‫حُٔخٟـش‬ ‫حُؼ٠٬ص‬ ‫ط٘٘ؾ‬ 3-: ٢‫حُ٘ؼخػ‬ ٚ‫حُلل‬ : َٔ٘٣ ٝ ‫ى‬ )*‫رخٍٗٞحٓ٤ش‬ ‫ٍٜٞس‬ )*‫رٟٞؼ٤ش‬ ‫أٗؼش‬ ‫ٍٛٞس‬Towne`s
  • 50.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 40 )*‫هِل٤ش‬ ‫أٓخٓ٤ش‬ ‫ؿٔـٔش‬ ‫ٍٛٞس‬ )*‫ٓخثِش‬ ‫ؿخٗز٤ش‬ ‫ٍٛٞس‬
  • 51.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 41 )*١ٍٞ‫ٓل‬ ٢‫١زو‬: ‫ح٧رؼخى‬ َ‫ػ٬ػ‬ َ٤ٌ٘‫ط‬ ‫ٓغ‬ )*٢ٔ٤١‫ٓـ٘خ‬ ٖ٤ٍٗ ‫ٍٛٞس‬ C-‫حُٔؼخُـش‬: 1-‫األطفاه‬: ‫أ‬-: ‫حُِؤش‬ ٖٟٔ ًٍٞٔ‫ط‬ ٍ‫ح٧١لخ‬ ٞ‫رؼ‬ ‫ػ٘ي‬ ًٍٞٔ ‫طليع‬ ‫هي‬ٝ ٢ٔ‫حُِو‬ ‫حُـ٠َٝف‬ ‫ٜ٤ذ‬ٝ ٢ِٜ‫حُٔل‬ ‫حُٔطق‬ً‫خ‬‫طوَر‬ ‫طٔزذ‬ ً‫خ‬٤ُ‫طخ‬ُٞٔ٘‫ح‬ ٢‫ك‬ٝ‫٣ليع‬ ‫حُلخ٫ص‬ ٞ‫رؼ‬ ٢‫ك‬‫ا‬٢ٌ‫حُل‬ َٜ‫ُِٔل‬ ٢‫ُ٤ل‬ ٝ‫أ‬ ٢ٔ‫ػظ‬ ‫ُظٜخم‬٢‫حُٜيؿ‬ٝ ،ٌٙٛ‫ا‬‫ٓٔخ‬ ‫اٟخك٤ش‬ ‫هظ٬١خص‬ ٝ . ً‫خ‬٠٣‫أ‬ ُٞٔ٘‫ح‬ ‫طؼ٤ن‬ ‫هي‬ ٢‫حُظ‬ ‫حُطز٤ؼ٤ش‬ ‫حُٞظ٤ل٤ش‬ ‫حُلًَخص‬ ٢‫ك‬ ‫اػخهش‬ ‫٣ٔزذ‬‫طؼخُؾ‬ ٍ‫ح٧١لخ‬ ‫ػ٘ي‬ ‫حُٔللظش‬ َ‫ىحه‬ ٌٍُٞٔ‫ح‬ ًَ ُ‫ح‬ ‫حُلًَخص‬ ‫رٞحٓطش‬٩‫ح‬ ‫كيٝع‬ ‫هطٍٞس‬ ٖٓ َِ‫طو‬ ٢ٌُ ‫لؼخُش‬‫ُظٜخم‬. ‫د‬-‫هخٍؽ‬ ًٍٞٔ‫حُٔللظش‬ٝ ‫ٓلخكع‬ ٌَ٘‫ر‬ ‫ٓؼخُـظٜخ‬ ‫٣ـذ‬ ٌٍُٞٔ‫ح‬ ٌٙٛ :٩‫ح‬ ‫هطٍٞس‬ ‫ٗٔزش‬ ٌٕٞ‫ط‬َ٤‫رٌؼ‬ َ‫أه‬ ٢ُ‫حُظخ‬ ‫ُظٜخم‬ ٝ . ‫حُٔللظش‬ َ‫ىحه‬ ٌٍُٞٔ‫ح‬ ٢‫ك‬ ‫كيٝػٜخ‬ ‫ٗٔزش‬ ٖٓٝ ‫هِ٤ِش‬ ‫ُٔيس‬ ‫حُظؼز٤ض‬ ْ‫٣ظ‬ ُْ‫أ‬ ‫كيٝع‬ ٍ‫كخ‬ ٢‫ك‬ ٌُٖ٢ٛ7ٝ ّ‫أ٣خ‬. ‫ًخك٤ش‬ ٌٕٞ‫ط‬ ٝ٠‫كظ‬ ١ٍٝ‫ى‬ ٚ‫كل‬ ٍ‫ح٧١لخ‬ ‫ػ٘ي‬ ‫حُ٘ي٣يس‬ ‫حُِؤش‬ ًٍٞٔ ٢ِ٣ُٞٔ٘‫ح‬ ٢ٜ‫٣٘ظ‬. 2-ٍِ‫اىثاىغ‬: ‫أ‬-ٝ ‫٣ظوَد‬ ٫ ‫ػخىس‬ ‫ح٩١زخم‬ : ‫حُـخٗذ‬ ‫أكخى٣ش‬ ‫حُٔللظش‬ ٖٟٔ ًٍٞٔ‫حُلي‬ ‫طؼز٤ض‬ ٕٝ‫ى‬ ‫ٓلخكع‬ ٌَ٘‫ر‬ ‫٣ؼخُؾ‬ ٕ‫أ‬ ‫٣ـذ‬ ٌَُٔ‫ح‬ ً‫خ‬ٗ‫أك٤خ‬ ٢ِ‫حُٔل‬. ‫ك٤٘ٔخ‬‫طؼز٤ض‬ ‫اؿَحء‬ ‫٣ـذ‬ ، ٢٤ٔ‫ر‬ ‫ا١زخم‬ ‫ٓٞء‬ ‫٣٬كع‬َٟ‫حُؼ‬ ‫رٞحٓطش‬ ٢٤ٔ‫ر‬ّ‫ح٧هٞح‬ ٝ‫أ‬ٝ .٩‫ح‬ َ‫هط‬ ‫ٛ٘خى‬‫ُظٜخم‬٠َُٟٔ‫ح‬ ‫ػ٘ي‬ ٝ ٖ٤‫حُزخُـ‬ٖ٤‫أٓزٞػ‬ ٖٓ َ‫أًؼ‬ ‫٣طزن‬ ٫‫أ‬ ‫٣ـذ‬ ‫حُظؼز٤ض‬.
  • 52.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 42 ‫د‬-ٝ ‫ٓظوَد‬ َ٤‫ؿ‬ ‫ػخىس‬ ٌٕٞ٣ ٕ‫أ‬ ‫٣ـذ‬ ‫ح٩١زخم‬ ‫ٓظزيُش‬ َ٤‫حُـ‬ ٌٍُٞٔ‫ح‬ ٢‫ك‬ :‫حُـخٗذ‬ ‫أكخى٣ش‬ ‫حُٔللظش‬ ‫هخٍؽ‬ ًٍْٞٔ٤ُ َ٤‫حُٔظـ‬ ٌَُٔ‫ح‬ ‫أٓخ‬ ‫كؼخُش‬ ‫ٓؼخُـش‬ ١٧ ‫ٍَٟٝس‬ ‫ٛ٘خى‬ٚٗ‫كب‬ُ‫ا‬ ‫ػخىس‬ ١‫٣ئى‬‫طو‬ ٠َٜ‫ه‬ ٠ُ‫ا‬ ‫ػخثي‬ ‫ٝحٟق‬ ‫ا١زخم‬ ‫َد‬‫ا‬ٝ ‫حَُى‬ ‫ٍطلخع‬ّ‫طٔخ‬ ٝ ‫٣طزن‬ ٖ٤ٌ‫حُل‬ ‫طؼز٤ض‬ ‫حُلخُش‬ ٌٙٛ ٢‫ك‬ ٌَُٔ‫ح‬ ‫ؿخٗذ‬ ٢‫ك‬ ٌَ‫حُٔز‬ ٕ‫ح٧ٓ٘خ‬‫ٓيس‬ ٚ٤ِ‫ػ‬ ‫٣لخكع‬3-4‫أٓخر٤غ‬. ‫ؽ‬-‫ٓٞف‬ ‫حُٔللظش‬ ٖٟٔ ‫ػ٘خث٤ش‬ ٌٍٞٔ‫ر‬ ٖ٤‫حُٜٔخر‬ ٖ٤‫حُزخُـ‬ ٠َُٟٔ‫ح‬ ٖٓ ْٔ‫ه‬ :‫حُٔللظش‬ ٖٟٔ ‫حُـخٗذ‬ ‫حُؼ٘خث٤ش‬ ٌٍُٞٔ‫ح‬ َٕٟٞ‫٣ظؼ‬‫ُو‬ ً٬‫ٓٔظوز‬ٝ‫أ‬ ‫ٔخٝس‬‫ا‬‫اًح‬ َٜ‫حُٔل‬ ‫ُظٜخم‬‫ا‬ٖٓ َ‫أًؼ‬ ‫حُظؼز٤ض‬ َٔ‫ٓظ‬2-3‫أٓخر٤غ‬،‫كخُلًَخص‬ ‫ٓظوَد‬ َ٤‫ؿ‬ ‫ح٩١زخم‬ ٕ‫ًخ‬ ‫اًح‬ ٝ ٌٙٛ ‫حُظؼز٤ض‬ ‫ٓيس‬ ‫رؼي‬ ‫ططزن‬ ‫حُلؼخُش‬ٝ ‫ِٓلٞظ‬ ٌَ٘‫ر‬ ‫ح٩١زخم‬ ْٛ‫ػ٘ي‬ َ٤‫٣ظـ‬ ٠َُٟٔ‫ح‬ ٖٓ ‫ػيى‬ ٌُٖ‫ٓخ‬ ً‫خ‬٤‫طيٍ٣ـ‬ ‫ح٩١زخم‬ ‫٣ظوَد‬ ٝ ‫١ٞ٣ِش‬ ‫ُلظَس‬ ٢ٌ‫حُل‬ ‫حُظؼز٤ض‬ ‫ٗطزن‬ ًُُُْ ٠ِ‫ػ‬ َٜ‫ٗل‬ ٌٖ‫ر‬ ‫ي‬‫ب‬‫حُظؼز٤ض‬ ّٞ‫ه‬ ٝ‫أ‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ٠ِ‫ػ‬ ‫حُوزؼ٤ش‬ َ‫حُـزخث‬ ّ‫ٓظويح‬ ‫ُٔيس‬ ٖ٤ٌ‫حُل‬ ٖ٤‫ر‬2ْ‫ػ‬ ، ‫أٓخر٤غ‬ٗٝ ٖ٤ٌ‫حُل‬ ٖ٤‫ر‬ ‫ح٧ٓ٬ى‬ ‫رلي‬ ّٞ‫و‬ٝ ١‫حُٔطخ‬ ‫رٞحٓطش‬ َ٤ُِ‫ح‬ ‫أػ٘خء‬ ٢‫كو‬ ٖ٤ٌ‫حُل‬ ‫طؼز٤ض‬‫طٔٔق‬ ٝ ٍ‫حُٜ٘خ‬ ‫أػ٘خء‬ ‫حُلؼخُش‬ ‫رخُلًَخص‬ ّ‫رخُو٤خ‬ ٞ٣َُِٔ‫ُٔيس‬ ‫ًُي‬ َٔ‫٣ٔظ‬6‫أٓخر٤غ‬. ‫ى‬-ّ‫ُ٨ٓخ‬ ‫ًِ٤ٜٔخ‬ ٝ‫أ‬ ‫اكيحٛٔخ‬ ٕ‫ٌٓخ‬ َ٤‫٣ظـ‬ ‫هي‬ ‫حُٔللظش‬ َ‫أٓل‬ ٖ٤‫حُِؤظ‬ ٬ً ٌَٔ‫ط‬ ‫ػ٘يٓخ‬ : ‫حُٔللظش‬ ‫هخٍؽ‬ ‫حُؼ٘خث٤ش‬ ًٍٞٔ ٝ ٢ٔٗ٧‫ح‬‫ُٔيس‬ ٢ٌ‫حُل‬ ‫حُظؼز٤ض‬ ‫ٗطزن‬ ٕ‫أ‬ ‫٣ـذ‬ ‫ٌُح‬ ‫حُوِل٤ش‬ ٕ‫ح٧ٓ٘خ‬ ٠ِ‫ػ‬ ‫ا١زخم‬ ‫ُي٣٘خ‬ ‫٣ٜزق‬ ً‫خ‬‫ؿخُز‬4-6ٍٞ١ ٖٓ ْ‫رخَُؿ‬ ‫أٓخر٤غ‬ ‫اػخىس‬ ٕ‫كب‬ ‫حُظؼز٤ض‬ ‫ٓيس‬ٝ َ٘‫٣ل‬ ‫هي‬ ٢‫حُطز٤ؼ‬ ‫حُٔؼظخى‬ ١‫حُؼٔٞى‬ ‫ُِزؼي‬ َ٤ٌ٘‫حُظ‬‫أٓخٓ٤ش‬ ‫ٓلظٞكش‬ ‫ػ٠ش‬ ‫ُي٣٘خ‬ ‫٣٘ظؾ‬. ٖٝ٤‫حُظخُ٤ظ‬ ٖ٤‫رخُطَ٣وظ‬ ٖ٤‫حُطَك‬ ٬ً ٝ‫أ‬ ‫أكي‬ ‫ٍى‬ ٖ٤‫ؿَحك‬ ‫ػيس‬ ٍٝ‫٣لخ‬ ‫ح٧ٓزخد‬ ٌُٜٙ: 1-ٝ ‫حُوِل٤ش‬ ٕ‫ح٧ٓ٘خ‬ ٠ِ‫ػ‬ ً‫خ‬‫ٓلظٞك‬ ْ‫حُل‬ ‫اروخء‬ٝ ، ‫ٍهخثن‬ ‫رٞحٓطش‬ ‫ًُي‬‫٣ٔخػي‬ ٕ‫أ‬ ٌٖٔ٣ ‫ٌٛح‬‫حَُى‬ ٠ِ‫ػ‬ ً‫خ‬٣َ‫ٗظ‬ ٝ ٌَُِٔ ١ٞ‫حُؼل‬ٍ‫كؼخ‬ َ٤‫ؿ‬ ٞٛ ً‫خ‬٤ِٔ‫ػ‬ ٌُٖ. 2-ٝ ‫حُِؤش‬ ٠ُ‫ا‬ ٍُٞٛٞ‫رخ‬ ً‫خ‬٤‫ؿَحك‬ٝ ‫ٍىٛخ‬ٝ ‫طؼز٤ظٜخ‬‫هي‬‫ا‬‫هظَف‬Brown٢‫حُـَحك‬ ‫ُِظؼز٤ض‬ ‫رٔ٤طش‬ ‫طو٘٤ش‬. 3-: ً‫اىجشاح‬ ‫اىؼَو‬ a-‫٣ٞؿي‬ ّ‫ػخ‬ ٌَ٘‫ر‬4‫حُِؤش‬ ٠ِ‫ػ‬ ًٕ٧‫ح‬ ّ‫أٓخ‬ ٖٓ ‫حُـَحك٤ش‬ ‫ُِٔيحهِش‬ ‫١َم‬ 1-Blair’s Inverted Hockey Stick Incision 2-Thoma’s Angulated Incision
  • 53.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 43 3-Dingman’s Incision 4-Popowich & Crane Incision 1 2 43 ‫الجلدي‬ ‫الشق‬ ‫العضالت‬ ‫صفاق‬ ‫تسلٌخ‬ ‫العضلٌة‬ ‫الطبقة‬ ‫شق‬ ‫المفصل‬ ‫كشف‬
  • 54.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 44 b-ًٕ٧‫ح‬ ‫هِق‬ ٖٓ َ‫ٓيه‬ c-: ٢ِ‫حُٔل‬ ‫حُلي‬ ‫طلض‬ ٖٓ َ‫ٓيه‬ 1 43 2 ً‫الجراح‬ ‫الشق‬ ‫المبطحة‬ ‫العضلٌة‬ ‫للطبقة‬ ‫وصوال‬ ‫التسلٌخ‬ ً‫الوجه‬ ‫الشرٌان‬ ‫و‬ ‫الورٌد‬ ‫ربط‬ ‫العظمٌة‬ ‫للطبقة‬ ‫وصوال‬ ‫الماضغة‬ ‫العضالت‬ ‫شق‬
  • 55.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 45 d-: ‫حٌُ٘ل٤ش‬ ‫حُـيس‬ َ‫ػز‬ َ‫ٓيه‬ e-: ١ٞٔ‫حُل‬ َ‫ىحه‬ َ‫حُٔيه‬ ‫ًز٤َس‬ ‫هزَس‬ ٠ُ‫ا‬ ‫٣لظخؽ‬ ٝ ‫ؿيح‬ ‫ٛؼذ‬ َ‫ٓيه‬ ٞٛ َٝٔ‫حُؼ‬ َ٤ٜٔ‫ُظ‬ ‫ُٝح٣خ‬ ‫ًحص‬ ‫هخٛش‬ ‫أىٝحص‬ ٝ 1 3 4 2 ‫الشق‬ً‫الوجه‬ ‫العصب‬ ‫لفرع‬ ‫موازي‬ ‫الجلدي‬ ‫التبعٌد‬ ‫و‬ ‫التسلٌخ‬ ‫العضلٌة‬ ‫الطبقة‬ ‫تسلٌخ‬ ‫و‬ ‫شق‬ ‫العظم‬ ‫كشف‬
  • 56.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 46 4-: ‫اىرثثٍد‬ ‫ح٧ٓ٬ى‬ ّ‫ربٓظويح‬ ‫حُظؼز٤ض‬ ** : ‫حُٜلخثق‬ ّ‫ربٓظويح‬ ‫**حُظؼز٤ض‬ ‫الصفائح‬ ‫تثبٌت‬ ‫خال‬ ‫ٌحتاج‬ ‫الفموي‬ ‫داخل‬ ‫الشق‬‫خاصة‬ ‫مزواة‬ ‫أدواة‬ ‫إلى‬ ‫العمل‬ ‫لتسهٌل‬ ً‫براغ‬ ‫مفك‬ ‫و‬ ‫مثاقب‬ ‫من‬
  • 57.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 47 ‫رٞحٓطش‬ ‫حُظؼز٤ض‬ **Lag screws ّ‫ربٓظويح‬ ‫حُظؼز٤ض‬ **Eckelt technique of lag screw osteosynthesis: I-ّ‫حُطؼخ‬َ‫ٝحُٔٞحث‬: ٝ ّ‫حُطؼخ‬ّ‫حُؼخ‬ َ٣‫حُظوي‬ ‫طلض‬ ٢‫ؿَحك‬ َٔ‫ػ‬ ٞ٣َُِٔ ١َ‫أؿ‬ ‫اًح‬ ‫اػطخءٛٔخ‬ ١ً‫٣ئ‬ ٫ ‫حَُ٘حد‬.‫حُلِ٤ذ‬ َ‫ٓؼ‬ َ‫حُٔٞحث‬ ‫اػطخء‬ ‫ٍرٔخ‬– ٝ ‫رؤٗزٞد‬ ِٜ‫ٓـ‬ ٕ‫ك٘ـخ‬ ٖ٤ٓ‫ٓٔظوي‬ ْٜ٤ٌ‫ك‬ ‫حُٔؼزض‬ ٠َُٟٔ‫ح‬ ‫ػ٘ي‬ ‫هخٛش‬ ... ‫حُلٔخء‬‫كخؿش‬ ‫حُٔخثِش‬ ‫حُٞؿزخص‬ ٌٙٛ ٖٓ‫طئ‬ ٕ‫أ‬ ‫٣ـذ‬ ‫ًخِٓش‬ ‫حُـٌحث٤ش‬ ٞ٣َُٔ‫ح‬.
  • 58.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 48 ٍ‫ح٧١لخ‬ ‫ػ٘ي‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ًٞٔ ‫طٔظلن‬ًٍٞٔ ‫هخٛش‬ ٝ ٢ِ‫حُٔل‬ ‫حُلي‬ ٍٝ ‫ٗظخثـٜخ‬ ‫ُوطٍٞس‬ ‫ٓٔظل٤٠ش‬ ‫ىٍحٓش‬ ٍ‫ح٧١لخ‬ ‫ػ٘ي‬ ‫حُِؤش‬٠ِ‫ػ‬ ‫حُٔ٢ء‬ ‫اٌٗحٍٛخ‬ ٝ ‫حُوِو٤ش‬ ‫حُ٘خك٤ش‬ ٖٓ ٍ‫ح٧١لخ‬ٝ .‫حُ٘لٔ٤ش‬ُٞٔ٘‫ح‬ ًِ‫َٓح‬ ٢‫ك‬ َ‫٣ئػ‬ ‫هي‬ ًَٔ ١‫أ‬ ٕ‫كب‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ٞٔ٘‫ر‬ ‫حُٜخٓش‬ ‫ُؼ٬هظٜخ‬ ً‫ح‬َ‫ٗظ‬‫ك٤ٞهلٜخ‬ ٜٚ٣ٞ٘‫ط‬ ٝ‫أ‬ ‫حُلي‬ ‫طٞهق‬ ‫حُٜ٘خ٣ش‬ ٢‫ك‬ ‫٣ٔزذ‬ ‫ٓٔخ‬. 1-ٚ‫حُلل‬١َ٣َُٔ‫ح‬: ٝ ٚ‫كل‬ ‫ُٜٓٞش‬ ‫طؼظٔي‬ٝ َ‫حُطل‬ ٖ٤‫ر‬ ٕٝ‫حُظؼخ‬ ٠ِ‫ػ‬ ً‫ح‬َ٤‫ًؼ‬ ٍ‫ح٧١لخ‬ ‫ٓؼخُـش‬ٝ ‫ؿٜش‬ ٖٓ ِٚٛ‫أ‬ٖٓ ٍ‫ح٧١لخ‬ ‫ٓؼخِٓش‬ ٢‫ك‬ َ٤‫حُوز‬ ‫حُـَحف‬ ‫ؿ‬َٟ‫أه‬ ‫ٜش‬ٝ .‫ؿ٤زٞرش‬ ٚ‫ٗز‬ ‫كخُش‬ ٢‫ك‬ ٜٚ‫حُٔظو‬ ٠ُ‫ا‬ ‫رلخىع‬ ْٜ‫اٛخرظ‬ ‫رؼي‬ ٍ‫ح٧١لخ‬ ٢‫٣ؤط‬ ‫ٓخ‬ َ‫أًؼ‬(ّٝ‫ٜٓي‬ٝ ، )َ٤ٔ‫حُؼ‬ ٖٓ ٚٗ‫ا‬ ‫ٛؼٞرش‬ ١‫أ‬ ٕٝ‫ى‬ ‫حُ٬ُٓش‬ ٙٞ‫حُلل‬ ‫اؿَحء‬.٩‫ح‬ ‫حُلخُش‬ ٌٙٛ َ‫ٓؼ‬ ٢‫ك‬ َ٠‫٣ل‬ ‫ٌُُي‬١‫أ‬ ‫اؿَحء‬ َ‫هز‬ ٞ٣َُٔ‫ح‬ ‫كخُش‬ ٖٔ‫طظل‬ ٠‫كظ‬ ٍ‫ٗظظخ‬ ٚ‫ك٤خط‬ َٝ‫٣ؼ‬ ٝ‫أ‬ ٚ٤ُ‫ا‬ ‫٣ٔ٢ء‬ ٕ‫أ‬ ٚٗ‫ٗؤ‬ ٖٓ َٔ‫ػ‬َ‫ُِوط‬. 2-ٚ‫حُلل‬٢‫حُ٘ؼخػ‬: ٌَُٔ‫ح‬ ٢‫ه‬ ‫طلـذ‬ ٢‫حُظ‬ ْ‫حُزَحػ‬ ‫ُٞؿٞى‬ ٕ‫ح٧ك٤خ‬ ٞ‫رؼ‬ ‫ٛؼذ‬ ٍ‫ح٧١لخ‬ ‫ػ٘ي‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ْٔ‫ؿ‬ ٌٍُٞٔ ٢‫حُ٘ؼخػ‬ ٚ٤‫حُظ٘و‬ ٕ‫ا‬ ‫حُٔطِٞد‬ ٠ِ‫ػ‬ ٍٜٞ‫حُل‬ ٖٓ ‫طٔ٘غ‬ ‫حُٔٔظَٔس‬ َ‫حُطل‬ ‫كًَش‬ ٕ‫أ‬ ‫ًٔخ‬‫حُٜٔيثخص‬ ‫اػطخء‬ َ٠‫٣ل‬ ‫ٌُُي‬Sedatives.(‫حُٜٔيثخص‬ َ٠‫أك‬ ٕ‫ا‬ ٢ٛ ‫حُٔٔظؼِٔش‬Nembutalٝ‫أ‬Chloral Hydrateٝ‫أ‬Seconal٩‫ح‬ ‫١َ٣وش‬ ‫أٓخ‬ٝ ُٕٝ ٠ِ‫ػ‬ ‫كظؼظٔي‬ ٍ‫ٓظؼٔخ‬َ‫حُطل‬ َٔ‫ػ‬.) 3-‫حُٔؼخُـش‬: ٕ‫ا‬‫ا‬ٍ‫هظ٤خ‬ٝ َ‫حُطل‬ َٔ‫ػ‬ ٠ِ‫ػ‬ ‫طؼظٔي‬ ‫حُظؼز٤ض‬ ‫١َ٣وش‬ٝ .ٕ‫ح٧ٓ٘خ‬ ‫رِٝؽ‬ ٍٞ‫طط‬ ٠ِ‫ػ‬ ٢ُ‫رخُظخ‬ُٖٓ‫ح‬ ٍٞٓ٧‫ح‬ٌٙٛ ‫ٓؼخُـش‬ ٢‫ك‬ ‫ٜٔٔش‬ ٩‫ح‬ ٞٛ ٌٍُٞٔ‫ح‬‫حُ٠ٍَٝ٣ش‬ ٢‫رخُ٘ٞحك‬ ّ‫ٛظٔخ‬‫حُوخٛش‬ٝ ٌَُٔ‫ح‬ ‫ٓؼخُـش‬ َ‫هز‬‫حُ٠ٍَٝ٣ش‬ ٢‫حُ٘ٞحك‬ ٌٙٛ ٖٓ: *ٕ‫ح٧ٓ٘خ‬ ‫ٓؼخُـش‬. *٩‫ح‬ ‫ٓؼخُـش‬‫هظ٬١خص‬. *‫حُؼخٓش‬ ٞ٣َُٔ‫ح‬ ‫كخُش‬ ‫ٓؼخُـش‬. *‫رخُوخٛش‬ ٌَُٔ‫ح‬ ‫ٓؼخُـش‬. *‫حُـ‬ َٔ‫حُؼ‬ ‫رؼي‬ ‫حُؼ٘خ٣ش‬٢‫َحك‬. ‫أ‬-ٕ‫ح٧ٓ٘خ‬ ‫ٓؼخُـش‬: ٝ ّ‫حُطؼخ‬ ‫ك٠٬ص‬ ٍ‫طِح‬ ْ‫ػ‬ ،‫َٓحص‬ ‫ػيس‬ َُٜٔ‫رخ‬ ْ‫حُل‬ َٜ‫ٗط‬ ‫حُٜٔخرش‬ ٕ‫ح٧ٓ٘خ‬ ‫رٔؼخُـش‬ ‫حُزيء‬ َ‫هز‬ٝ ‫حُيٓٞ٣ش‬ ‫حُؼِوخص‬‫حُِٔٔهش‬ ‫ح٧ؿ٘٤ش‬ ٝ ‫ٟٝؼٜخ‬ ‫كٔذ‬ ٕ‫ح٧ٓ٘خ‬ ‫طؼخُؾ‬ ْ‫ػ‬ٝ ‫حُٜيٓش‬ َ‫أػ‬‫آٌخ‬‫حُلي‬ ٢‫ك‬ ‫روخثٜخ‬ ‫ٗ٤ش‬٩‫ح‬ َ٠‫٣ل‬ ‫ًٔخ‬ ،ٌٖٓ‫أ‬ ٕ‫ا‬ ‫حُِز٘٤ش‬ ٕ‫ح٧ٓ٘خ‬ ٠ِ‫ػ‬ ‫روخء‬ ‫ٓؼخُـظٜخ‬. ‫د‬-‫حُؼخٓش‬ ٞ٣َُٔ‫ح‬ ‫كخُش‬ ‫ٓؼخُـش‬: ٝ ٞ٣َُٔ‫ح‬ ‫كخُش‬ ‫َٓحهزش‬ ٖٓ ‫ري‬ ٫ٝ ُٚٗٞٝ ٚٔ‫ط٘ل‬ٝ ‫حُلٔٞ٣ش‬ ‫حُللَس‬ ٚ‫كل‬ٝ ّ‫ى‬ ٖٓ ‫حُٔلَُحص‬ ‫اُحُش‬ٌٖٔ٣ ‫أؿ٘ز٤ش‬ ّ‫أؿٔخ‬ ٝ‫أ‬ ١‫ٓوخ‬ ٝ ٢ٓٞ‫حُزِؼ‬ َٟ‫حُٔـ‬ ‫طٔي‬ ٕ‫أ‬ٝ ٚ‫ٟـط‬ ّ‫٣وخ‬ ‫ًٔخ‬ ٢ٔ‫حُظ٘ل‬ٚ٠‫ٗز‬.
  • 59.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 49 ‫ؽ‬-‫ح٫هظ٬١خص‬ ‫ٓؼخُـش‬: *‫حُِ٘ف‬ ٠ِ‫ػ‬ ‫حُٔ٤طَس‬: ٝٝ ‫حُِ٘ف‬ ‫٣ٞهق‬ ‫رل٤غ‬ ‫ٗخُف‬ ٢ٜ‫ٝؿ‬ ‫ؿَف‬ ١‫أ‬ ٠ِ‫ػ‬ َٗ‫حُٔزخ‬ ٢‫رخُ٠ـ‬ ‫ًُي‬ ْ‫٣ظ‬‫ٓئهض‬ ٌَ٘‫ر‬ ُٞ٠‫كظ‬١ٞٓ‫حُي‬ ‫حُٞػخء‬ ٠ُ‫ا‬ ٍُٞٛٞ‫ح‬ ٝ ‫حُ٘خُف‬ٝ ٚ‫ٍرط‬ّ‫حُي‬ ‫اٍهخء‬‫حُؼخٓش‬ ‫حَُٔهجخص‬ ٞ٣َُٔ‫ح‬ ٠‫٣ؼط‬ ‫ًٔخ‬ .. *‫حُٜيٓش‬ ‫ٓؼخُـش‬: ‫حُِ٘ف‬ ٖ‫ػ‬ ‫حُٔٔززش‬ ‫حُٜيٓش‬ ‫ُؼ٬ؽ‬ ّ‫حُي‬ َ‫ر٘و‬ ‫حُ٘خهٜش‬ ّ‫حُي‬ ‫ًٔ٤ش‬ ‫طؼخُؾ‬‫أٓخ‬ ،ٝ ‫حُِٔل٤ش‬ َ٤ُ‫حُٔلخ‬ ‫ربػطخء‬ ‫ك٤ؼخُؾ‬ ‫ح٩ٓخٛش‬ ٚ‫ٗو‬ ‫حَُٔحهزش‬ ‫طلض‬ ٌٕٞ٤ُ ٠‫حُٔٔظ٘ل‬ ٢‫ك‬ ٞ٣َُٔ‫ح‬ ‫ٟٝغ‬ َ٠‫٣ل‬ ‫ًٔخ‬ ‫حٍُٞ٣ي‬ ‫١َ٣ن‬ ٖ‫ػ‬ ‫حٌَُٔ٣ش‬. *٩‫ح‬ ٠ِ‫ػ‬ ‫حُٔ٤طَس‬ٕ‫ٗظخ‬: ُٝ‫ٌُِِح‬ ‫حُٔ٠خى‬ َُٜٔ‫ح‬ ‫ربػطخء‬ ‫ًُي‬ ٌٕٞ٣Tetanus Antitoxin)‫ِٓٞػش‬ ٝ ‫ػٔ٤وش‬ ٝ ‫ٓلظٞكش‬ ‫ؿَٝف‬ ‫ٝؿٞى‬ ٍ‫كخ‬ ٢‫ك‬ (ٝ‫حُٜخىحص‬ ٤‫حُل‬‫ٞ٣ش‬‫ٍٝ٣ي٣خ‬ ٝ‫أ‬ ‫ػ٠ِ٤خ‬َ‫ٓؼ‬ ‫حُلخُش‬ َ‫حُؤخث‬ ‫ربػطخء‬ ‫حًُٞٓخص‬ ‫طؼخُؾ‬ ‫ًٔخ‬Ananase , Chymoral , Alpha Chymotrypsin ‫ى‬-‫رخُوخٛش‬ ٌَُٔ‫ح‬ ‫ٓؼخُـش‬‫(حُظؼز٤ض‬: ) )*‫١َ٣وش‬ ٢ٛ ٍ‫ح٧١لخ‬ ‫ػ٘ي‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ‫ُظؼز٤ض‬ ‫١َ٣وش‬ َ٠‫أك‬١‫حَُرخ‬٠ِ‫ػ‬ ‫حُٔؼظٔي‬ َ٤‫ؿ‬ ‫(حُظؼز٤ض‬ ‫حُلي‬ ٍٞ‫ك‬ َ‫حُيحث‬ ٕ‫ح٧ٓ٘خ‬: ) •‫ُِلي‬ ‫١زؼخص‬ ٌ‫طئه‬ٝ ١ِٞ‫حُؼ‬٢ِ‫حُٔل‬. •ٝ ٌَُٔ‫ح‬ ‫ٟٝؼ٤ش‬ ٍ‫طؼي‬ ‫حُـزٔ٤ش‬ ‫حُطزؼخص‬ ‫ٛذ‬ ‫رؼي‬ٝ ٚ٤‫ك‬ ٍ‫طزي‬ ‫ٝؿٞى‬ ٍ‫كخ‬ ٢‫ك‬ ‫هخٛش‬َ٘٘‫ر‬ ‫ًُي‬‫ح‬ ٢‫ه‬ ‫ٓ٘طوش‬ٍ‫حُٔؼخ‬ ٠ِ‫ػ‬ ٌَُٔ ٝ ٢ٔ‫حُـز‬٩‫ح‬ ‫ٗؼ٤ي‬٢‫حُطز٤ؼ‬ ٚ‫ٟٝؼ‬ ٠ُ‫ا‬ ‫١زخم‬. •‫ٓ٤ِحرش‬ ‫ٜٗ٘غ‬‫ا‬ٍ‫ُِٔؼخ‬ ‫ًَ٣ِ٤ش‬٨ُ ‫حُطخك٘ش‬ ‫حُٔطٞف‬ ‫ٓـط٤ش‬ ٢ِ‫حُٔل‬ٝ ‫حُٔلِ٤ش‬ ٕ‫ٓ٘خ‬‫حُٔط‬ ٖٓ ً‫خ‬ٔٔ‫ه‬ٝ ٢ٗ‫حُِٔخ‬ ٖ٤‫ل‬ ٩‫ح‬ ٖ٤٘ٓ‫ٓئ‬ ١ِ٤ِٛ‫حُي‬ٌ‫٧ه‬ ‫١زخم‬‫ا‬ٝ ‫حُٔ٤ِحرش‬ ٠ِ‫ػ‬ ‫حُؼِٞ٣ش‬ ٕ‫ح٧ٓ٘خ‬ ‫ٗطزخػخص‬ُِ‫ح‬ ٖٓ ‫طٌ٘د‬ ْ‫ػ‬ ٖٓٝ ‫ٝحثي‬ٝ ‫طِٔغ‬ْ‫٣ظ‬ ‫ًُي‬ ‫رؼي‬ ٝ ‫ٛلظٜخ‬ ٖٓ ‫ُِظؤًي‬ ٞ٣َُٔ‫ح‬ ْ‫ك‬ ٢‫ك‬ ‫طـَرظٜخ‬َ‫ك‬ ‫ُٔ٘غ‬‫٫ري‬ ‫ًظٜخ‬‫طؼز٤ظٜخ‬ ٖٓ١‫رخَُرخ‬‫حُلي‬ ٍٞ‫ك‬ َ‫حُيحث‬. •َٟ‫طـ‬( ‫حُٔوزَ٣ش‬ ٙٞ‫حُلل‬ ‫ٓوظِق‬ ‫اؿَحء‬ ‫رؼي‬ ّ‫حُؼخ‬ َ٣‫رخُظوي‬ ‫حُؼِٔ٤ش‬‫حُِ٘ف‬ َُٖٓٝ‫حُظوؼ‬ ٍُٖٓٝٞ‫حُز‬ ٚ‫كل‬. ) ٍَٝ‫رخُِك‬ ٢‫حُـَحك‬ َٔ‫حُؼ‬ ‫ٓ٘طوش‬ َ٤ٜ‫طط‬ ‫رؼي‬Zepherolٝ( ّ‫ه٤خ‬ ‫حُ٬ٛية‬ ً٫ٞ‫حُل‬ ٖٓ ٢ٗ‫ٓؼي‬ ‫ِٓي‬ َٔ‫٣ٔظؼ‬ ‫حُٔولق‬ ‫حُ٤ٞى‬0.5) َ٣‫ر‬ ٍٝ٧‫ح‬ ‫حُطَف‬ ٚ٤‫١َك‬ ٖٓ ًَ ٢‫ك‬ ٢‫ر‬‫ب‬ٝ ‫ٓٔظو٤ٔش‬ ‫رَس‬‫ر‬ ٢ٗ‫حُؼخ‬ ‫حُطَف‬‫ب‬ٝ ‫حُوخٍؽ‬ ٖٓ ‫حُٔؼٞؿش‬ ‫ح٫رَس‬ َ‫طيه‬ ،‫ٓؼٞؿش‬ ‫رَس‬٢‫ك‬ ٝ ، ‫حُِز٘٤ش‬ ‫حُؼخٗ٤ش‬ ٠‫حَُك‬ ‫ٓ٘طوش‬‫ح٫رَس‬ َ‫ٓيه‬ ْ‫ٗل‬ ٖٓ َ‫كظيه‬ ‫حُٔٔظو٤ٔش‬ ‫ح٫رَس‬ ‫أٓخ‬ ،ْ‫حُل‬ َ‫ىحه‬ ‫حُِٔخٗ٤ش‬ ‫حُ٘خك٤ش‬ ٖٓ ‫طوَؽ‬ ٝ ‫حُٔؼٞؿش‬‫حُيِٛ٤ِ٣ش‬ ‫حُ٘خك٤ش‬ ٖٓ ‫طوَؽ‬ ٌُٖٕ‫ٍ٣لَىح‬ ‫ارَس‬ ٍ‫آظؼٔخ‬ ٌٖٔ٣()ُِٔ‫ح‬ ‫٣لَى‬ ْ‫ػ‬ٍَ‫٣ظل‬ ٠‫كظ‬ َ‫ٝح٧ٓل‬ ٠ِ‫ح٧ػ‬ ٠ُ‫ا‬ ‫ي‬ ‫حُلي‬ ٖٓ َ‫ح٥ه‬ ‫حُطَف‬ ٖٓ ‫حُؼِٔ٤ش‬ ْ‫ٗل‬ َٟ‫طـ‬ .ٚ‫ر‬ ‫ػخُوش‬ ٌٕٞ‫ط‬ ٢‫حُظ‬ ‫حَُهٞس‬ ‫ح٧ٗٔـش‬ ٖٓ. •ٝ ْ‫حُل‬ ٢‫ك‬ ‫حُٔ٤ِحرش‬ ‫طٟٞغ‬‫ر‬ ‫طؼزض‬‫ب‬٧‫ح‬ ‫ٝط٘ي‬ ّ‫كٌخ‬٢‫حُظ‬ ‫ٓ٬ى‬‫أ‬ٝ ‫حُلي‬ ٍٞ‫ك‬ ‫ىهِض‬‫ًُي‬ٝ ُ‫حُـٜخ‬ ٍٞ‫ك‬ ً‫ح‬‫ؿ٤ي‬ ‫رلظِٜخ‬٩‫ح‬ ٠‫كظ‬ّ‫كٌخ‬ ٝ ُ‫حُـٜخ‬ ‫٣ٜزق‬ ‫رل٤غ‬ ّ‫حُظخ‬ّٞ‫حُو‬‫ٝحكيس‬ ‫هطؼش‬ ‫حُٔ٘٤ش‬. ٢‫ىحػ‬ ٫٩‫حُوخٍؽ‬ ٖٓ ‫ح٫رَس‬ ٍٞ‫ىه‬ ٕ‫ٌٓخ‬ ٢‫ك‬ ‫حُو٤خ١ش‬ ‫ؿَحء‬ٝ ‫حًُٞٓش‬ ‫كيٝع‬ ‫ُٔ٘غ‬ ٢‫ٟخؿ‬ ١‫ٍرخ‬ ‫ٟٝٝغ‬ ‫حُٔ٘طوش‬ َ٤ٜ‫طط‬ ٢‫٣ٌل‬ ‫اٗٔخ‬ ، ً‫ح‬َ٤‫ًؼ‬ ‫حُلي‬ ‫طلَ٣ي‬ ّ‫ػي‬ ٠ِ‫ػ‬ ‫حُٔٔخػيس‬. -٢ٓٞ‫ٓظ‬ ًَٔ‫اؿَحء‬ ‫٣ـذ‬ :‫ؿخٗذ‬ ًَ ٢‫ك‬ ٕ‫ٍرخ١خ‬. -٢‫ؿخٗز‬ ًَٔ‫اؿَحء‬ ‫٣ـذ‬ :‫ٓ٘طوش‬ ٍٞ‫ك‬ ٕ‫ٍرخ١خ‬ٝ ٌَُٔ‫ح‬‫آ‬َ‫ح٥ه‬ ‫حُطَف‬ ٢‫ك‬ ‫حٌُز٤َس‬ ‫حُٔ٘طوش‬ ٠ِ‫ػ‬ َ‫ه‬. ‫ٓظز‬ ٕ‫ًخ‬ ‫اًح‬ ‫أٓخ‬ٌٖٔ٣ ٢٤ٔ‫ر‬ ٌَ٘‫ر‬ ً٫‫ٓظزي‬ ٝ‫أ‬ ً٫‫ي‬‫ا‬ٝ ٢٘‫حٌُه‬ ‫حُٔو٬ع‬ ّ‫ٓظويح‬َٝ‫رؼ‬ ١‫حُؼخى‬ ٕ‫حُ٘خ‬ ٖٓ ٞٛ2-3َٔ٣ ‫ك٤غ‬ ْٓ ‫٣ظ‬ ْ‫ػ‬ ٖ‫حٌُه‬ ‫طلض‬ُ‫ح‬ ٍٞ‫ك‬ ‫٣ِق‬ ٝ‫أ‬ ّ‫حَُأ‬ ‫هٔش‬ ٢‫ك‬ ‫ٜخُذ‬‫ـ‬ٝ ‫ُِظؼز٤ض‬ ‫ُ٣خىس‬ ٖ٤‫ز‬‫١َكخ‬ ‫٣ؼزض‬ٙ‫أ‬ ٢‫ؿَحك‬ ّٞ‫ىر‬ ‫رٞحٓطش‬‫رٞحٓطش‬ ٝ ُ‫ح‬ ‫ٌٛح‬ ‫ٓٔخٝة‬ . ‫ُٜخم‬ ‫ٗٔ٤ؾ‬ٔ‫رُٜٔٞش‬ ‫٣ظلَى‬ ٚٗ‫أ‬ ٞٛ ‫و٬ع‬‫ػخرض‬ َ٤‫ؿ‬ ٝ
  • 60.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 50 )*ٕ‫ح٧ٓ٘خ‬ ٠ِ‫ػ‬ ‫حُٔؼظٔي‬ ‫حُظؼز٤ض‬: ٌٖٔ٣‫ا‬‫ٓظو‬ٝ ٢‫أ٣ل‬ َٟ‫ػ‬ ّ‫يح‬٢‫ك‬ ‫ٛؼٞرش‬ ‫ٗـي‬ ‫ٛ٘خ‬‫ا‬‫ِٓي‬ ّ‫ٓظويح‬0.45ِ‫ػ‬ ِْٓ‫ِٓي‬ ّ‫ٗٔظوي‬ ‫ٌُُي‬ ‫حُٔئهظش‬ ٕ‫ح٧ٓ٘خ‬ ٠0.35 ّٞ‫ه‬ ّ‫ٗٔظوي‬ ٝ‫أ‬ ِْٓ‫ا٣َى‬ٝ ‫حُٔخرن‬ ّٞ‫حُو‬ ٖٓ ‫أٍم‬ ٌٕٞ٣ ‫ك٤غ‬ ٍ‫ُ٨١لخ‬ٝ ِ٤ٓ‫ٜٓخ‬ ٠ِ‫ػ‬ ١ٞ‫٣ل‬ ٫ٌٖٔ٣‫ا‬‫كخَٛحص‬ ّ‫ٓظويح‬ ١‫ٓطخ‬ ٝ‫أ‬ ‫أٓ٬ى‬ ‫رٞحٓطش‬ ٖ٤ٌ‫حُل‬ ‫طؼزض‬ ْ‫ػ‬ ‫ُٜن‬ ‫ًٔزُٞ٣ض‬ ‫رٞحٓطش‬ ‫حُيحثٔش‬ ٕ‫ح٧ٓ٘خ‬ ٠ِ‫ػ‬ ‫طؼز٤ض‬ ْ٣ٞ‫طو‬. -‫حُزخُؿش‬ َ٤‫ؿ‬ ٕ‫ح٧ٓ٘خ‬: ٖٓ َ‫أه‬ ٞ٣َُٔ‫ح‬ َٔ‫ػ‬ ٕ‫ًخ‬ ‫اًح‬9ٝ‫أ‬10١ٞ‫٣لظ‬ ٢ٌ‫حُل‬ ْٔ‫حُـ‬ ٕ‫كب‬ ‫ٓ٘ٞحص‬ٝ ، ْ‫حُؼظ‬ ٢‫ك‬ ٕ‫ح٧ٓ٘خ‬ ٠ِ‫ػ‬‫حُٔل٤ي‬ َ٤‫ؿ‬ ٖٓ ٌٕٞ٣ ٢‫ك‬ ‫ٛلخثق‬ ٝ‫أ‬ ‫ػظ٤ٔش‬ ْ٤‫ىرخر‬ ٝ‫أ‬ ‫ػظٔ٤ش‬ ‫ه٤خ١ش‬ ‫ططز٤ن‬ٝ ٍ‫ح٧كٞح‬ ٌٙٛ٩‫ح‬ ‫حُلخ٫ص‬ ٞ‫رؼ‬ ٢‫ك‬‫ٓظؼ٘خ‬‫ُٔ٘طوش‬ َ٤‫حٌُز‬ ٍ‫حُظزي‬ َ‫هز‬ ‫ث٤ش‬ ٩‫ح‬‫ٗي٣ي‬ ٌٍ‫رل‬ ‫حُٔلِ٤ش‬ ‫حُلخكش‬ ‫ه٤خ١ش‬ ٌٖٔ٣ ‫حُلي‬ ‫ُحٝ٣ش‬ ٝ‫أ‬ ٢٘‫حٌُه‬ ‫ٍطلخم‬. ٙ-٢‫حُـَحك‬ َٔ‫حُؼ‬ ‫رؼي‬ ‫حُؼ٘خ٣ش‬: •٫٩‫ح‬ ‫حُٔ٤ِحرش‬ ٠ِ‫ػ‬ ‫حُٔلخكظش‬ ٖٓ ‫ري‬ً‫َ٣ِ٤ش‬ٝ١‫حَُرخ‬َٔ‫حُؼ‬ ‫رؼي‬ ٢‫حُ٠خؿ‬٩‫ح‬ ‫ً٤ل٤ش‬ َٛ٧‫ح‬ ْ٤ِ‫طؼ‬ ‫ٓغ‬ ٢‫حُـَحك‬َ‫حُطل‬ ‫ػظ٘خء‬. •‫٣ـذ‬‫ا‬ٝ ‫حُظؼز٤ض‬ ‫كظَس‬ ‫١٤ِش‬ َ‫حُٔٞحث‬ ٠ِ‫ػ‬ َ‫حُطل‬ ‫روخء‬ٌ‫حُظـ‬ ‫َٓحػخس‬ٝ ‫رخُل٤ظخٓ٤٘خص‬ ‫حٌُخك٤ش‬ ‫٣ش‬‫حُٔوٞ٣خص‬. •ٍَٝٓ ‫رؼي‬20-30‫اُحُش‬ ٌٖٔ٣ ٢‫حُـَحك‬ َٔ‫حُؼ‬ ٖٓ ّٞ٣١‫حَُرخ‬َ‫حُيحث‬ٝ٩ ‫كخؿش‬ ٫ ‫ٛ٘خ‬ٝ َ٣‫حُظوي‬ ٍ‫ٓظؼٔخ‬‫حُلخ٫ص‬ ٞ‫رؼ‬ ٢‫ك‬ ٌُٖ َ‫ٗ٠ط‬ ‫هي‬ ‫حُوخٛش‬‫ٌُُي‬. َٝ‫حُطل‬ ‫َٗحهذ‬ َ‫ٗظ‬ ٕ‫أ‬ ‫٣ـذ‬٪ُ ‫١ٞ٣ِش‬ ‫ُلظَس‬ ٌَٔ‫ر‬ ‫حُٜٔخد‬ٝ ٚ٣‫ُي‬ ٢ِ‫حُٔل‬ ‫ُِلي‬ ُٞٔ٘‫ح‬ ‫اػخهش‬ ّ‫ػي‬ ٠ِ‫ػ‬ ٕ‫١ٔج٘خ‬ٝ‫أ‬ ‫اػخهش‬ ّ‫ػي‬ ‫حُزِٝؽ‬ ٠ِ‫ػ‬ َ٤‫حُظؤػ‬
  • 61.
  • 62.
  • 63.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 51 ًٍٞٔ١ِٞ‫حُؼ‬ ‫حُلي‬ A–‫أٓزخد‬ًٍٞٔ‫حُلي‬١ِٞ‫حُؼ‬ٝٚ‫حُٞؿ‬: ٫‫ط‬‫وظِق‬‫أٓزخد‬ًٍٞٔ‫حُلي‬١ِٞ‫حُؼ‬ٖ‫ػ‬‫أٓزخد‬ًَٔ‫حُلي‬٢ِ‫حُٔل‬ٌَ٘‫ر‬ّ‫ػخ‬ٝ‫رٔزذ‬‫ٓٞهغ‬‫حُلي‬١ِٞ‫حُؼ‬٢‫ك‬‫حُؼِغ‬ ٢ٓٞ‫حُٔظ‬ٖٓٚ‫حُٞؿ‬ٚٗ‫كب‬٠ٔ‫٣ل‬ٖٓ‫حُٜيٓخص‬‫رخُلي‬٢ِ‫حُٔل‬َ‫ح٥ًؼ‬‫رَُٝح‬ٝ‫ًٌُي‬ْ‫رخُؼظ‬٠٘‫حُٞؿ‬،٢‫ح٥ٗل‬،٢ٜ‫حُـز‬.ٝ‫ٌُُي‬ ٢ٜ‫ك‬‫ؿٔ٤ؼخ‬َ‫أًؼ‬‫طؼَٟخ‬ٌَُِٖٔٓ‫حُلي‬١ِٞ‫حُؼ‬،ٌٝٙٛ‫حُ٘ٔزش‬( ٍ‫طوي‬1١ِٞ‫ػ‬ )‫ا‬( ٠ُ4ًٍٞٔ )٢‫ك‬‫حُلي‬‫كٔذ‬ ( ٢ِ‫حُٔل‬ Rowe،1900 .) ٝ‫ا‬ٕ‫ًخٗض‬ٌٙٛ‫حُ٘ٔزش‬َ‫٣و‬‫حُلَم‬‫ر٤ٜ٘خ‬٢‫ك‬‫ح٩كٜخث٤خص‬‫حُلي٣ؼش‬،‫ك٤غ‬‫ا‬‫ُىحىص‬ٌٍُٞٔ‫ح‬‫حُٞؿٜ٤ش‬‫ٓغ‬ٍٞ‫طط‬‫حُٔيٗ٤ش‬‫حُلي٣ؼش‬ٝ . َ‫طؼظز‬َُٟٝٞ‫ح‬ٌَ٘‫ر‬ّ‫ػخ‬ْٛ‫أ‬‫ح٥ٓزخد‬‫حُٔليػش‬ٌٍُٞٔ‫حُلي‬ٍٝ ( ١ِٞ‫حُؼ‬‫رٔزذ‬‫ٛيٓش‬‫رٞحٓطش‬َ‫ٗو‬،١ٞ‫ٓو‬،‫أُؼخد‬ ‫ٍ٣خٟ٤ش‬،٠ٓ‫َٓح‬) ‫ٗخٍ٣ش‬‫أٓخ‬‫أٓزخد‬‫حُؼ٘ق‬ٜ‫حُ٘و‬٢َ‫كظؼظز‬‫هِ٤ِش‬٢‫ك‬‫اكيحع‬ًٍٞٔ‫حُلي‬ٝ . ١ِٞ‫حُؼ‬َ‫طؼظز‬‫كٞحىع‬‫حُٔ٤خٍحص‬َ‫أًؼ‬ ‫ح٥ٓزخد‬‫طٞحطَح‬. ‫ا‬ٌٌََُٕٗٔ‫ح‬ٝٚ‫ٗيط‬ٕ‫٣ظؼِوخ‬‫رٟٔٞغ‬‫حُٜيٓش‬ٝ‫ٗيطٜخ‬،‫ًٔخ‬ٕ‫٣ظؼِوخ‬‫ر‬‫ب‬‫ػظزَحص‬‫ػي٣يس‬‫ٜٓ٘خ‬: *‫طَ٘٣ل٤ش‬ًٌَْ٘ٝ‫كـ‬ٝ‫ٟٝغ‬ٝ‫ًؼخكش‬ٝ‫ػ٬هش‬ْ‫حُؼظ‬‫رخ٥ػ٠خء‬‫حُٔـخٍٝس‬. َ‫طئػ‬ *‫حُ٘ٔؾ‬‫حَُهٞس‬‫حُٔـط٤ش‬ّ‫ُِؼظخ‬٠ُ‫ح‬‫كي‬‫ٓخ‬٢‫ك‬ٌٌٍَُٗٞٔ‫ح‬ٝ‫ىٍؿش‬ٍ‫حُظزي‬٢‫ك‬‫حُ٘ظخ٣خ‬. ْ‫*٣٘ـ‬ٍ‫حُظزي‬٢‫ك‬ٌٍُٞٔ‫ح‬‫حُٞؿٜ٤ش‬‫حُلٌ٤ش‬ٖ‫ػ‬‫ا‬ٙ‫طـخ‬ٝ‫ٗيس‬‫حُوٞس‬‫حَُحٟش‬ٝ‫ٟٗٞق‬: )+‫ػ٘يٓخ‬ٌٕٞ‫ط‬‫حُٜيٓش‬‫ٓ٘ول٠ش‬‫رخُ٘ٔزش‬‫ُِلي‬١ِٞ‫حُؼ‬‫طليع‬ًٍٞٔ‫حُ٘ظٞء‬٠‫حُٔ٘و‬.
  • 64.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 52 )+‫أٓخ‬‫حُٜيٓخص‬٢‫حُظ‬ٌٕٞ‫ط‬٠ِ‫أػ‬ٖٓ‫ًُي‬‫كظليع‬‫ًٍٔٞح‬‫ٓظؼيىس‬ٝ‫أ‬‫َٛٓ٤ش‬٢‫ك‬‫حُلي‬١ِٞ‫حُؼ‬ٝ‫طٜزق‬‫ًٍٔٞح‬٢‫ك‬ ( ‫ٓلظظش‬ ‫حُٜيٓخص‬‫ح٥ٗي‬ٝ) ٠ِ‫ح٥ػ‬ ٌَٝ٘‫ر‬ّ‫ػخ‬: -‫حُوٞس‬‫حُـزٜ٤ش‬‫ًحص‬‫حُيٍؿش‬‫حُٔؼظيُش‬‫ًخُ٘خطـش‬ٖ‫ػ‬١ٞ‫حُٔو‬‫ٓٞف‬‫طٔزذ‬ًَٔ‫ٓ٘ن‬‫حُلي‬١ِٞ‫حُؼ‬ٝ‫أ‬ًَٔ‫ُٞكٍٞص‬ ‫ٛ٘ق‬ٍٝ‫أ‬. -‫أٓخ‬‫حُوٞس‬‫حُـزٜ٤ش‬‫ًحص‬‫حُيٍؿش‬ْ‫ح٥ػظ‬َ‫ٓؼ‬‫أً٣ش‬‫طول٤ق‬‫حَُٔػش‬٠‫حُلـخث‬(٠ِ‫ػ‬‫ٗخٍ٣ش‬ ‫ىٍحؿش‬‫٣ٔزذ‬ ) ٬‫ٓؼ‬‫ًُي‬ًَٔ ( ‫ُٞكٍٞص‬2–3ٝ )‫ًَٔح‬‫ٜٓٔ٤خ‬ٖٓ‫هٞس‬ٍ‫ٜٓي‬ ٖٓ ‫ؿزٜ٤ش‬‫ًخُ٘خطـش‬ ( ٠ُ‫ػخ‬ٖ‫ػ‬‫َٛحٝس‬ٝ‫أ‬( ‫ُٞكٍٞص‬ ًَٔ ‫طٔزذ‬ ) ‫ػٜخ‬3) ‫رخ٩ٟخكش‬ٌٍُٞٔ‫أٗل٤ش‬‫ؿَرخُ٤ش‬. -ْ‫ٓؼظ‬‫حُوٞس‬‫حُـزٜ٤ش‬‫طليع‬‫ا‬‫ِٗ٣خكخ‬‫هِل٤خ‬ٝ‫أ‬ِٓ‫ل‬‫٤خ‬ٝ‫أ‬( ‫َٛٓخ‬‫ا‬‫ُِلي‬ ) ‫ٗلٜخٍح‬١ِٞ‫حُؼ‬. -٣‫أ‬‫ش‬‫َٟرش‬ٝ‫أ‬‫ٛيٓش‬‫ُٔ٘ظٜق‬ٚ‫حُٞؿ‬ٖٓ‫حُـخٗذ‬‫ح‬٘‫ُٞك‬٢‫طٔزذ‬‫ًٍٔٞح‬‫ٝؿ٘٤ش‬ٝ‫ىٍٝحٗخ‬‫ُِلي‬١ِٞ‫حُؼ‬٠ُ‫ح‬‫حُـخٗذ‬ َ‫حُٔوخر‬. *‫٣ِؼذ‬َ‫حُـ‬ِ٠‫حُؼ‬٢‫ىٍٝح‬‫أ‬‫ٓخٓ٤خ‬ًٍٞٔ ‫اِٗ٣خف‬ ٢‫ك‬‫حُلي‬٢ِ‫حُٔل‬،‫أٓخ‬٢‫ك‬‫حُلي‬١ِٞ‫حُؼ‬‫كِٜخ‬ٍٝ‫ى‬ٟٞٗ‫ػخ‬٢‫ك‬ٌٍُٞٔ‫ح‬ . ‫ًُي‬َ‫ػز‬ ‫حُٜلخثق‬‫حُ٘خك٤ش‬‫حُلٌ٘٤ش‬‫ٓظٔٔق‬‫ُِؼ٠٬ص‬‫حُـ٘خك٤ش‬‫طلَ٣ن‬٪ُ‫ح‬٢‫ك‬ ٢ٔ‫حُؼظ‬ ٍ‫طٜخ‬‫حُلي‬١ِٞ‫حُؼ‬ٌٍُٞٔٔ‫ح‬ٝ‫ك٘٤خ‬‫أٗٔ٤خ‬ ٝ‫أ‬ ‫ٓٔززخ‬‫طٔخٓخ‬‫ٓزٌَح‬‫ُ٦ٍكخء‬ٝ‫ػ٠ش‬‫ٓلظٞكش‬ ٩‫ح‬‫ِٗ٣خف‬٢‫حُوِل‬‫ُِلي‬١ِٞ‫حُؼ‬َٜ‫٣ظ‬ً‫ب‬١‫ٗ٠ـخ‬٢‫ك‬ٚ‫ٝؿ‬ ( ٚ‫حُٞؿ‬‫ٓلِطق‬َ‫ًٔ٘ظ‬ٖ‫حُٜل‬). ٩‫ح‬‫ِٗ٣خف‬٢ِ‫حُٔل‬‫ُِلي‬١ِٞ‫حُؼ‬َٜ‫٣ظ‬١ِٝ‫ط‬٢‫حك‬ٚ‫ٝؿ‬ ( ٚ‫حُٞؿ‬‫ٓ٠ِغ‬ٚ‫ٗخه‬. ) ّ‫حُؼظخ‬ B-‫حُظٜ٘٤ق‬ ‫حُٜؼذ‬ ٖٓ‫ا‬. ‫حُلٌ٤ش‬ ‫حُٞؿٜ٤ش‬ ٌٍُٞٔ‫ح‬ ٢‫ك‬ ‫حُُٔ٘ٔٞش‬ ّ‫ُِؼظخ‬ ‫ىه٤ن‬ ٠‫ٗؼخػ‬ ٝ َٟ٣َٓ ْ٤٤‫طو‬ ‫١٬م‬‫ا‬ًًٍٞٔ َٔ٘‫ط‬ ‫ٓخ‬ ‫ؿخُزخ‬ ١ِٞ‫حُؼ‬ ‫حُلي‬، ‫حُٔـخٍٝس‬ ‫حُٞؿٜ٤ش‬ ّ‫حُؼظخ‬ ‫ٗؼظٔي‬١ِٞ‫حُؼ‬ ‫حُلي‬ ًٍٞٔ ْٔ‫٣و‬ ‫طٜ٘٤ق‬ ‫كخُ٤خ‬‫ا‬٠ُ: ‫ؿِث٤ش‬ ًٍٞٔ. ‫طخٓش‬ ًٍٞٔ. 1-‫اىقسٍَح‬ ( ‫اىنسىساىجضئٍح‬): ‫ا‬‫ػَٟش‬ ٕ‫ح٥ٓ٘خ‬ َ‫أًؼ‬ ‫٥ٜٗخ‬ ‫حُوٞح١غ‬ ‫أٓ٘خم‬ ‫هخٛش‬ ، ‫كيٝػخ‬ ‫حُـِث٤ش‬ ٌٍُٞٔ‫ح‬ َ‫أًؼ‬ ٢ٛ ‫ح٥ٓ٘خم‬ ًٍٞٔ ٕ. ‫حُٔزخَٗس‬ ‫حُٜيٓخص‬ ٠‫ُظِو‬ ٕ‫ح٥ٓ٘خ‬ ٠ِ‫ػ‬ ‫طليع‬ ٢‫حُظ‬ ‫حُزٔ٤طش‬ َُٟٝٞ‫ح‬ ‫رٔزذ‬ ٌٍُٞٔ‫ح‬ ٌٙٛ ‫طليع‬ ٝ. ‫ططز٤ن‬ ‫رٔزذ‬ ٠‫حُٔ٘و‬ ‫حُ٘ظٞء‬ ٌَٔ٘٣ ‫هي‬ ٝ٩‫ح‬ ‫ؿخٗز٤ش‬ ٝ‫أ‬ ‫أٓخٓ٤ش‬ ‫ٓزخَٗس‬ ‫هٞس‬٢ِ‫حُٔل‬ ‫حُلي‬ ٠ِ‫ػ‬ ‫١زوض‬ ‫ٛخػيس‬ ‫ر٠َرش‬ ٝ‫أ‬ . ٙ‫طـخ‬ ١ِٞ‫حُؼ‬ ٠‫حُٔ٘و‬ ‫حُ٘ظٞء‬ ًٍٞٔ ‫٣ٔزذ‬ ‫ٓٔخ‬. 2-‫اىراٍح‬ ‫اىنسىس‬: ‫ا‬ّٕ‫ُؼظخ‬ ٠‫حُـَحك‬ ٝ ٠‫حُظَ٘٣ل‬ َ‫حُظيحه‬ ‫رٔزذ‬ ، ‫ٛؼذ‬ َٓ‫أ‬ ١ِٞ‫حُؼ‬ ‫ُِلي‬ ‫حُظخٓش‬ ٌٍُٞٔ‫ح‬ ‫طٜ٘٤ق‬٫‫ا‬ ٚ‫حُٞؿ‬ ّ‫ػظخ‬ ‫ٓغ‬ ١ِٞ‫حُؼ‬ ‫حُلي‬ ‫أ‬‫ح‬ ّ‫هخ‬ ٢‫حُظ‬ ‫حُظـخٍد‬ ٕ( ‫ٓ٘ش‬ ‫ُٞكٍٞص‬ ُْ‫ُؼخ‬1901٠ِ‫ػ‬ )‫حُـؼغ‬ ْ‫ؿٔخؿ‬.ّ‫ػظخ‬ ٠ِ‫ػ‬ َُٝ‫ح‬ ‫ططز٤ن‬ ٝ ، ‫حَُهٞس‬ ‫حُ٘ٔؾ‬ ‫اُحُش‬ ‫رؼي‬ ٚ‫حُٞؿ‬) ٖ٤‫ٓؼ‬ ‫اٍطلخع‬ ٖٓ ْ‫ُِـٔخؿ‬ َ‫حُل‬ ١‫ح٩ٓوخ‬ َ‫ػز‬ (‫كٔذ‬ ( ‫حُظخٓش‬ ١ِٞ‫حُؼ‬ ‫حُلي‬ ًٍٞٔ ْ٤ٔ‫طو‬ ٖٓ ‫حُظـخٍد‬ ٌٙٛ ٚ‫ٌٓ٘ظ‬ ، ) ٌَُِٔ ٟٞ‫ٓٔظ‬ ٠ِ‫أػ‬‫ا‬٢ٛ ‫أٗٞحع‬ ٝ‫أ‬ ‫أٛ٘خف‬ ‫ػ٬ػش‬ ٠ُ:
  • 65.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 53 ‫ىىفىسخ‬ *1: ٌ‫اىؼائ‬ ‫اىنسش‬ ‫أو‬ ٧‫ح‬ ٌٍُٞٔ‫ح‬ ( ‫أ٣٠خ‬ ‫ػِ٤ٜخ‬ ‫٣طِن‬ ‫ًٔخ‬ًٍٞٔ ْٓ‫رخ‬ ‫طؼَف‬ ٝ ) ‫كو٤ش‬( Guerin ). ٣ٕ‫ح٥ٓ٘خ‬ ًٍٟ ‫كٞم‬ َٝ‫ٓؼظ‬ ٌَ٘‫ر‬ ‫أكو٤خ‬ ‫٣ٔظي‬ ٝ ، ‫ُ٦ٗق‬ ‫حٌُٔؼَ٣ش‬ ‫حُٞك٘٤ش‬ ‫حُلخكش‬ ٢‫ك‬ ٌٍُٞٔ‫ح‬ ٖٓ ‫حُ٘ٞع‬ ‫ٌٛح‬ ‫زيأ‬٠ِ‫ػ‬‫أ‬ٍٝ ‫حُـ٤ذ‬٢ٌ‫حُل‬‫حُلٌ٘٤ش‬ ‫حُـ٘خك٤ش‬ ‫حُٜل٤لش‬ َ‫٣ؼز‬ ٠‫كظ‬ ٠٘‫حُٞؿ‬ ‫حُ٘ظٞء‬ َ‫أٓل‬ ‫٣ٔظي‬ ٝ(َ‫ىحه‬ ‫أٓخ‬ . ‫ؿخٗذ‬ ًَ ٢‫ك‬ ) ٠‫حُـ٘خك‬ ‫حُ٘خطت‬ ‫ٗٞى‬ ٖ‫ػ‬ ٢‫ح٥ٗل‬ ِ‫حُلخؿ‬ َٜ‫ك٤٘ل‬ ، ‫ح٥ٗق‬‫حُٔ٤ٌؼش‬ ْ‫ػظ‬ ‫هخػيس‬ َ‫ػز‬ ‫٣ٔظي‬ ٝ ، ‫حُل٘ي‬ ْ‫ػظ‬ ٝ ٠ٓ‫ح٥ٓخ‬ ‫ح٥ٗق‬. َٓ‫ًخ‬ ٌٕٞ٣ ٍٝٝ‫أ‬ ، ٠‫حُٔ٘و‬ ‫حُ٘ظٞء‬–‫هخع‬–‫حُِٜزش‬ ‫حُل٘ي‬ ‫هزش‬ ، ‫حُـ٤ذ‬،‫حُـٔـٔش‬ ٖ‫ػ‬ ‫ٓ٘لِٜش‬ًِٚٔ‫رؤ‬ ١ِٞ‫حُؼ‬ ‫حُلي‬ ٌٕٞ٣ ‫ًٔخ‬ ٌُٚٗٞ ، ‫ٓظلًَخ‬( ‫حَُهٞس‬ ‫رخُ٘ٔن‬ ٢‫كو‬ ‫ٓؼِوخ‬ ‫أٛزق‬‫حُـ٤ذ‬ ٝ ‫ح٥ٗق‬ ٝ ْ‫ُِل‬ ٠١‫حُٔوخ‬ ‫رخُـ٘خء‬)‫ٌُُي‬ ٝ‫ا‬‫رٔويٓش‬ ٚ‫حُلخك‬ ‫أٓٔي‬ ‫ًح‬ َٓ‫ًخ‬ ‫ك٤ـي‬ ، ًَٚ‫ك‬ ٝ ١ِٞ‫حُؼ‬ ‫حُلي‬‫ٌُُي‬ . ‫ُِلًَش‬ َ‫هخر‬ ١ِٞ‫حُؼ‬ ‫حُلي‬ٝ ، ‫رخُؼخثٔش‬ ٌٍُٞٔ‫ح‬ ٌٙٛ ‫ىػ٤ض‬‫ػ٘خث٤ش‬ ٝ‫أ‬ ‫أكخى٣ش‬ ٌٕٞ‫ط‬ ‫هي‬ ‫حُـخٗذ‬. ‫حَُٔ٣َ٣ش‬ ‫ٝحُؼ٬ٓخص‬ ٝ‫ح٧ػَح‬: *‫حُلي‬ ٌ‫٣ظو‬ ‫هي‬ ٖ٤‫حُـ٘خك٤ظ‬ ٖ٤‫حُؼ٠ِظ‬ ‫ٗي‬ ‫رٔزذ‬‫ٝحُوِق‬ َ‫ح٧ٓل‬ ٞ‫ٗل‬ ‫ٟٝؼ٤ش‬ ١ِٞ‫حُؼ‬،‫ػ٠ش‬ ‫ٓ٘خٛيس‬ ٌٖٔ٣ ‫ٌُُي‬ ٝ .‫أٓخٓ٤ش‬ ‫ٓلظٞكش‬‫حُلًَش‬ َ‫ك‬ ٝ‫أ‬ ‫ٓلٍ٘ٞس‬ ‫رٟٞؼ٤ش‬ ١ِٞ‫حُؼ‬ ‫حُلي‬ ‫٣ظٞحؿي‬ ‫هي‬. *‫رَٔػش‬ ٍٞ‫طظط‬ ٢‫حُظ‬ ‫حًُٞٓش‬ ‫رٔزذ‬ ‫حُلـخؽ‬ ‫طلض‬ ‫رخُؼٜذ‬ ّ‫ح٩كٔخ‬ ٚ‫ٗو‬ ‫٣ليع‬ ‫هي‬. *٢٘‫حُٞؿ‬ ‫حُ٘خطت‬ ‫طلض‬ ‫ىٓٞ٣ش‬ ‫ًيٓش‬ *٢ٌ٘‫حُل‬ ٍُ‫حُي‬ ٖٓ ‫هَ٣زخ‬ ٌَُٔ‫ح‬ ٢‫ه‬ َٔ٣ ‫ػ٘يٓخ‬ ‫حُـخٗذ‬ ١‫أكخى‬ ٌَُٔ‫ح‬ ٌٕٞ٣ ٕ‫أ‬ ٌٖٔ٣ٝ .‫هزش‬ ٢‫ك‬ ‫حٌُيٓش‬ ‫ط٬كع‬ ‫ٛ٘خ‬ ‫حُل٘ي‬ *ٌٍُٞٔٔ‫ح‬ ‫حُطزن‬ " ‫ٛٞص‬ ‫كيٝع‬cracked-potsouncٕ‫ح٧ٓ٘خ‬ ٠ِ‫ػ‬ ‫حُوَع‬ ‫ػ٘ي‬.
  • 66.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 54 *‫ىىفىسخ‬2: ًٍ‫اىهش‬ ‫اىنسش‬ ‫أو‬ ‫ط‬َ‫ئػ‬ٌٍُٞٔ‫ح‬ ٌٙٛ٠ِ‫ػ‬ّ‫حُؼظخ‬: ‫حُلي‬١ِٞ‫حُؼ‬. ٢‫ح٥ٗل‬. ٠‫حُيٓؼ‬. ١‫حُٞطي‬. ٢ُ‫حُـَرخ‬. ‫ا‬‫ح٩ٛخرخص‬ ٢‫ك‬ ‫٣ليع‬ ٍ‫حُظزي‬ ‫ٌٛح‬ ٝ ‫ح٥ٗٔ٤ش‬ ٝ ‫حُٞك٘٤ش‬ ‫حُـ٘خك٤ش‬ ‫حُؼ٠٬ص‬ َٔ‫ػ‬ ‫رٔزذ‬ ‫ٛ٘خ‬ ‫ٓظٞهغ‬ ١ِٞ‫حُؼ‬ ‫حُلي‬ ٢‫ك‬ ٍ‫حُظزي‬ ٕ ٢‫ح٥ٗل‬ ٢ٜ‫حُـز‬ ٍُ‫حُي‬ َ‫أٓل‬ ‫ح٥ٗق‬ َٔ‫ؿ‬ ‫أؿِحء‬ ‫أٟؼق‬ ‫ػ٘ي‬ ٌَُٔ‫ح‬ ‫٣زيأ‬ ٠ٔ‫ػظ‬ ‫رظلظض‬ ‫حُٔظَحكوش‬ ‫حُ٘ي٣يس‬. ٣ ٝ٠‫حُيٓؼ‬ ْ‫حُؼظ‬ َ‫ػز‬ ٝ ٠ٌ‫ُِل‬ ٢ٜ‫حُـز‬ ‫حُ٘ظٞء‬ َ‫ػز‬ ٖ٤‫ُِـخٗز‬ ‫ٔظي‬‫ا‬ٌَُٔ‫ح‬ ٢‫ه‬ ٍِ٘٣ ْ‫ػ‬ . ‫ح٥ٗل٤ش‬ ‫حُيٓؼ٤ش‬ ‫ُِو٘خس‬ ‫ح٥ٓخٓ٤ش‬ ‫حُلخكش‬ ٠ُ ‫هَرٜخ‬ ٝ‫أ‬ ‫حُلـخؽ‬ ‫طلض‬ ‫حُؼوزش‬ ٝ ‫حُلـخؽ‬ ‫طلض‬ ‫رخُلخكش‬ َٔ٣ ٝ ، ٠ٓ‫ح٥ٓخ‬ ‫حُلـخؽ‬ ‫هخع‬ َٔ٘٤ُ ّ‫ح٥ٓخ‬ ٝ ٠٘‫حُٞك‬. ‫ح٥ٓخٓ٤ش‬ ٕ‫حُـيٍح‬ ٍٞ١ ٠ِ‫ػ‬ َ‫ُ٦ٓل‬ ْ‫ػ‬( ‫ُٞكٍٞص‬ ٢‫ك‬ ‫ًٔخ‬ . ‫ٝك٘٤خ‬ ٠٘‫حُٞؿ‬ ْ‫حُؼظ‬ ‫طلض‬ ‫٣ٔظي‬ ‫ٛ٘خ‬ ٖٓ ٝ ، ٠ٌ‫حُل‬ ‫ُِـ٤ذ‬1. ) ‫رٔٔظ‬ ٌُٖ ٝ ٟ‫ُِٞطي‬ ٠‫حُـ٘خك‬ ‫حُ٘خطت‬ َ‫٣ؼز‬ ٝ ٠ٌ‫حُل‬ ٠‫حُـ٘خك‬ ِْ‫حُؼ‬ َ‫ػز‬ ٝ ‫حُلٌ٤ش‬ ‫حُليرش‬ ٍٞ١ ٠ِ‫ػ‬ ‫٣ٔظي‬ ْ‫ػ‬ٞٛ ‫ٓٔخ‬ ٠ِ‫أػ‬ ٟٞ ( ‫ُٞكٍٞص‬ ًَٔ ٢‫ك‬1). ‫ُلخؿ‬ ١ِٞ‫حُؼ‬ ‫حُؼِغ‬ َ‫ػز‬ ٌَُٔ‫ح‬ ٢‫ه‬ ‫ك٤ٔظي‬ ‫ح٥ٗق‬ َ‫ىحه‬ ‫أٓخ‬ُ‫ح‬ ْ‫ػظ‬ ‫ٓ٘ظٜق‬ ٝ ‫حُـَرخُ٤ش‬ ‫حُٜل٤لش‬ َ‫ػز‬ ٝ ‫ح٥ٗق‬ ِٔ‫٤ٌؼش‬ٌٙٛ ‫طظٔزذ‬ ٝ ‫ُِلي‬ ٢ٜ‫حُـز‬ ‫حُ٘ظٞء‬ ٝ ٢‫ح٥ٗل‬ ْ‫حُؼظ‬ ًٍٞٔ ‫طٔزذ‬ ٢‫حُظ‬ ٝ ١ِٞ‫حُؼ‬ ‫حُلي‬ ٖٓ ‫حُؼِٞ٣ش‬ ‫ُِٔ٘طوش‬ ‫َٟرش‬ ٝ‫أ‬ ‫ٛيٓش‬ ٖ‫ػ‬ ٌٍُٞٔ‫ح‬. ٝ‫ح٧ػَح‬‫ٝحُؼ٬ٓخص‬‫حَُٔ٣َ٣ش‬: ‫طلَ٣ي‬ ‫ٓلخُٝش‬ ‫ػ٘ي‬ ٝ ١َ٣َُٔ‫ح‬ ٚ‫رخُلل‬ *، ٢ٜ‫حُـز‬ ٢‫ح٧ٗل‬ ٍُ‫حُي‬ ‫ػ٘ي‬ ‫رخُلًَش‬ ّ‫ح٧كٔخ‬ ٌٖٔ٣ ١ِٞ‫حُؼ‬ ‫حُلي‬ *ًٕٞ‫حَُح‬ ‫رؼ٬ٓش‬ ‫٣ؼَف‬ ‫ٓخ‬ ٝ‫أ‬ ٖ٤‫حُؼ‬ ٍٞ‫ك‬ ‫حٌُيٓش‬ ‫ٓغ‬ ‫طظَحكن‬ ‫حُلـخؽ‬ ٍٞ‫ك‬ ‫حًُٞٓش‬Racon sign. *‫حٌُيٓش‬ ٝ‫أ‬ َٗ‫حُٔزخ‬ َُٝ‫ح‬ ‫رٔزذ‬ ‫٣ليع‬ ‫ٌٝٛح‬ ‫ٗخثغ‬ ‫حُلـخؽ‬ ‫طلض‬ ‫حُؼٜذ‬ ّ‫اكٔخ‬ ٚ‫ٗو‬. *‫حُٔلظٞكش‬ ‫حُؼ٠ش‬ ‫ٓغ‬ ‫٣ظَحكن‬ ‫ٓخ‬ ‫ٝؿخُزخ‬ ‫ح٩١زخم‬ ‫ٓٞء‬. *ٌٖٔ٣ ( ٢ٜ‫حُـز‬ ٢‫ح٧ٗل‬ ٍُ‫حُي‬ ‫ػ٘ي‬ ‫ٓ٬كظظٜخ‬ ٌٖٔ٣ ‫ًٔخ‬ ْ‫رخُـ‬ ‫ُِلـخؽ‬ ‫حُٔلِ٤ش‬ ‫حُلخكش‬ ‫ػ٘ي‬ ‫ىٍؿش‬ ‫ٓ٬كظش‬ ٌٖٔ٣ ‫رخُظلَ٣ي‬ ‫ًُي‬ ‫ٓ٬كظش‬). *‫ٝحَُػخف‬ ‫ح٧ٗق‬ َ‫ػز‬ ٢ًُٞ٘‫ح‬ ٢‫حُيٓخؿ‬ َ‫حُٔخث‬ ‫ِٗف‬. *٢ٔٗ٫‫ح‬ ٢‫حُٔآه‬ ١‫حَُرخ‬ ‫طِٔم‬ ‫رٔزذ‬ ٖ٤٘٤‫حُؼ‬ ٖ٤‫ر‬ ‫حُٔٔخكش‬ ‫طزخػي‬
  • 67.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 55 *‫ىىفىسخ‬3‫اىَؼرشضح‬ ‫اىنسىس‬ ‫أو‬: ٩‫ح‬ ‫طلَم‬ ٌٍُٞٔ‫ح‬ ٌٙٛ ‫طٔزذ‬ ٝ٩‫ح‬ ( ٍ‫طٜخ‬َٓ‫ًخ‬ ‫طلَم‬ ‫٩كيحع‬ ‫ًخك٤ش‬ ‫حُوٞس‬ ٌٕٞ‫ط‬ ‫ػ٘يٓخ‬ ‫طليع‬ ٢ٛ ٝ ، ٢‫حُولل‬ ٢ٜ‫حُٞؿ‬ ) ٍ‫ٗلٜخ‬ ٖٓ ‫حُٞؿٜ٤ش‬ ّ‫ُِؼظخ‬‫ا‬ٖٔ٠‫طظ‬ ٝ ‫حُولل٤ش‬ ‫ٍطزخ١خطٜخ‬٠٘‫حُٞؿ‬ ْ‫حُؼظ‬ ٝ ‫ح٥ٗق‬ ْ‫ػظ‬ ٌٍُٞٔ‫ح‬ ٌٙٛ. ‫ٓلِطلخ‬ ٬ٌٗ ٚ‫حُٞؿ‬ ‫ٓؼط٤خ‬ ‫ُِوِق‬ ‫ٓ٘يكؼش‬ ٚ‫حُٞؿ‬ ٖٓ ٢ٓٞ‫حُٔظ‬ ‫حُؼِغ‬ ٝ ١ِٞ‫حُؼ‬ ‫حُلي‬ ٌٕٞ٣.٢ٜ‫حُـز‬ ٍُ‫حُي‬ ‫ػ٘ي‬ ٌَُٔ‫ح‬ ‫٣زيأ‬ ٠‫حُيٓؼ‬ ٢‫ح٥ٗل‬ ‫حُٔ٤ِحد‬ ٖٓ ١ِٞ‫حُؼ‬ ْٔ‫حُو‬ َ‫ػز‬ ٖ٤‫ُِطَك‬ ٚ‫٣ظـ‬ ٝ ، ٠ٌ‫حُل‬ ٢ٜ‫حُـز‬ ٝ ٢‫ح٥ٗل‬. ٠ِ‫ػ‬ ٝ . ‫حُزَٜ٣ش‬ ‫حُؼوزش‬ ّ‫أٓخ‬ ‫طٔخٓخ‬ ‫ٗوطش‬ ٠ُ‫حُـَرخ‬ ْ‫حُؼظ‬ ٍٞ١ ٠ِ‫ػ‬ ‫هِل٤خ‬ ‫٣ٔظي‬ ٝ‫ا‬‫رخُؼوزش‬ ٠ٔ‫حُٔل‬ ٟ‫حُٞطي‬ ْ‫حُؼظ‬ ٕ‫أ‬ ٍ‫ػظزخ‬ ‫٣٠ؼق‬ ‫ٌُح‬ ‫ؿيح‬ ٖ٤‫ػو‬ ‫حُزَٜ٣ش‬‫ا‬‫ر‬ ٌَُٔ‫ح‬ ٢‫٣ٜز‬ ْ‫ػ‬ َٟٜ‫حُز‬ ‫حُ٘لن‬ ‫ٌٛح‬ ٢‫ك‬ ٌَُٔ‫ح‬ ٍ‫كظٔخ‬‫ب‬٠ُ‫ح‬ ٚ٘ٓ ٝ ‫حُلـخؽ‬ ‫طلض‬ ‫حُ٘لن‬ ‫ريح٣ش‬ ٙ‫طـخ‬ ٤ُ‫ػخ‬ ْ‫ػ‬ ‫حُلٌ٘٤ش‬ ‫حُٞطي٣ش‬ ‫حُللَس‬ٖ٤‫حُلٌ٘ظ‬ ٖ٤‫حُـ٘خك٤ظ‬ ٖ٤‫حُٜل٤لظ‬ َ‫ػز‬ ‫خ‬. ٔ٣‫ر‬ ٌَُِٔ ٕ‫ػخ‬ ٢‫ه‬ ‫حُلـخؽ‬ َ‫ىحه‬ ٖٓ َ‫ب‬ٍ‫حُـيح‬ ٍٞ١ ٠ِ‫ػ‬ ٠ِ‫ُ٦ػ‬ ‫ُ٤ٔظي‬ ٢ِ‫حُٔل‬ ‫حُلـخؽ‬ ‫طلض‬ ‫حُ٘ن‬ ٍٞ١ ٠ِ‫ػ‬ ٠ٓ‫أٓخ‬ ٙ‫طـخ‬ ‫ػ٘ي‬ ‫ُِلـخؽ‬ ٠٘‫حُٞك‬٩‫ح‬‫حُٞط‬ ٠‫حُـ٘خك‬ ٝ ٠٘‫حُٞؿ‬ ٍ‫طٜخ‬١‫ي‬‫٣ٔظي‬ ْ‫ػ‬‫ا‬. ٟ‫حُٞطي‬ ٢ٜ‫حُـز‬ ٍُ‫حُي‬ ٠ُ ‫ا‬ٖ٤‫حُٞؿ٘٤ظ‬ ٖ٤ٓٞ‫حُو‬ ًَٔ ٕ( ‫ٛ٘ق‬ ‫ُٞكٍٞص‬ ًَٔ َٟ‫ٓـ‬ ْٔ‫٣ظ‬3‫ح٥ٗق‬ ‫(هخٍؽ‬ ٠‫حُوخٍؿ‬ ).) ‫حُٜل٤لش‬ ٢‫ك‬ ‫طللض‬ ٝ ‫طِٔم‬ ‫ػخىس‬ ‫٣ٔزذ‬ ٝ . ٠ُ‫حُـَرخ‬ ْ‫ُِؼظ‬ ‫حُؼٔٞى٣ش‬ ‫حُٜل٤لش‬ ‫هخػيس‬ َ‫ػز‬ ٌَُٔ‫ح‬ ٢‫ه‬ َٔ٤‫ك‬ ‫ح٥ٗق‬ َ‫ىحه‬ ‫أٓخ‬ ٝ ، ‫حُٜٔلٞ٣ش‬َ‫ػز‬ ٠ِ‫حُيحه‬ ٌَُٔ‫ح‬ ٢‫ه‬ َٔ٣ ‫أه٤َح‬‫ا‬ٟ‫رخُٞطي‬ ‫حُٔ٤ٌؼش‬ ْ‫ػظ‬ ٍ‫طٜخ‬. ٩‫ح‬ َِ‫ه‬ َٔ‫٣ٌظ‬ ‫ٌٌٛح‬ ٍٝ‫طٜخ‬‫طظَحك‬ ، ٢‫حُولل‬ ٢ٜ‫حُٞؿ‬‫ٝؿٜ٤ش‬ ٌٍٞٔ‫ر‬ ‫ػخىس‬ ٌٍُٞٔ‫ح‬ ٌٙٛ ‫ن‬‫ح‬ ّ‫ػظخ‬ ٢‫ك‬ ‫ٓظؼيىس‬‫طظَحكن‬ ‫ًٔخ‬ ٚ‫ُٞؿ‬ ‫ؿخُزخ‬‫ح٥ٓخٓ٤ش‬ ‫حُولل٤ش‬ ‫حُللَس‬ ٢‫ك‬ ًَٔ ‫ٝؿٞى‬ ٠ِ‫ػ‬ ٬٤ُ‫ى‬ ‫ٌٛح‬ ٌٕٞ٣ ٝ ‫ح٥ٗق‬ ٖٓ ٠ًُٞ٘‫ح‬ ٠‫حُيٓخؿ‬ َ‫حُٔخث‬ ٕ٬٤ٔ‫ر‬. ٩‫ح‬ ‫٣ـذ‬ ‫ٛ٘خ‬ ٝٙ‫ٗظزخ‬‫ا‬ّ‫ػي‬ ٠ُ‫ا‬َ‫هز‬ ٟٝ‫٣ي‬ ٚ‫كل‬ ٝ‫أ‬ ‫ٓيحهِش‬ ٟ‫أ‬ ‫ؿَحء‬‫ا‬‫ٓظيػخء‬ٟ‫ٓي‬ ‫ُٔؼخ٣٘ش‬ ٠‫ػٜز‬ ‫ؿَحف‬ٝ ‫حُيٓخؿ٤ش‬ ‫ح٩ٛخرش‬ . ‫ٓؼخُـظٜخ‬ ٖ٤‫حُطَك‬ ٢‫ك‬ ٝ‫أ‬ ‫ٝحكي‬ ‫رطَف‬ ، ٞ٣َُٔ‫ح‬ ْ‫ٗل‬ ٢‫ك‬ ‫ٓؼخ‬ ٌٍُِٞٔ ‫ُٞكٍٞص‬ ‫طٜ٘٤ق‬ ٖٓ ‫حُؼ٬ػش‬ ‫ح٥ٗٞحع‬ ‫طليع‬ ‫هي‬. ‫كٞحىع‬ ٢‫ك‬ ٖ٤٤ٗ‫حُٔي‬ ‫ػ٘ي‬ ‫طليع‬ ‫هي‬ ‫أٜٗخ‬ ٫‫ا‬ ، ‫حُلَٝد‬ ٢‫ك‬ ‫طليع‬ ‫ٓخ‬ ‫ؿخُزخ‬ ٢ٜ‫ك‬ ‫حُٔلظظش‬ ٌٍُِٞٔ ‫رخُ٘ٔزش‬ ‫أٓخ‬ٝ‫أ‬ ‫حُ٘ي٣يس‬ ‫حُٔ٤خٍحص‬ ْ‫كـ‬ ‫كلٔذ‬ ‫ٓؼخُـظٜخ‬ ‫أٓخ‬ ٝ . ‫حُ٘ٔؾ‬ ٢‫ك‬ ‫ًز٤َح‬ ‫ٓخى٣خ‬ ‫ٍٟ٤خ‬ ‫ط٘ٞٛخ‬ ٝ ّ‫حُؼظخ‬ ٢‫ك‬ ‫ًز٤َح‬ ‫طلظظخ‬ ‫طليع‬ ٢‫حُظ‬ ‫حُ٘خٍ٣ش‬ ‫حُطِوخص‬ ٢‫ك‬ ‫ٌٓخٜٗخ‬ ٝ ‫ح٩ٛخرش‬. ٝ‫ح٧ػَح‬‫ٝحُؼ٬ٓخص‬‫حَُٔ٣َ٣ش‬: *ٖ‫حُٜل‬ ٚ‫ٝؿ‬Dish face.ٖٓ ٢ٓٞ‫حُٔظ‬ ‫ٝحُؼِغ‬ ١ِٞ‫حُؼ‬ ‫حُلي‬ ّ‫ػظخ‬ ٌٕٞ‫ط‬ ‫ك٤غ‬٬ٌٗ ‫ٓؼط٤ش‬ ‫ُِوِق‬ ‫ٓ٘يكؼش‬ ٚ‫حُٞؿ‬ ‫ٓلِطلخ‬ *٢٘‫حُٞؿ‬ ٢ٜ‫حُٞؿ‬ ‫حُٔؼوي‬ ‫كًَش‬. *٢ًُٞ٘‫ح‬ ٢‫حُيٓخؿ‬ َ‫حُٔخث‬ ٕ٬٤ٓ. *‫حُلـخؽ‬ ٍٞ‫ك‬ ‫ٝحٌُيٓش‬ ‫حًُٞٓش‬.
  • 68.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 56 *٢َُٟ‫ح‬ ‫حُٔآم‬ ‫طزخػي‬ *ٖ٤‫حُؼ‬ )ٍ‫ٝهٞٙ(ؿئ‬ َٔ‫ٓلظ‬ ‫ٗلغ‬ ‫ٓغ‬ ‫حُؼ٤٘٤ش‬ ‫حُلًَخص‬ ٢‫ك‬ ‫طليى‬. *‫ح٫ٗٔ٤ش‬ ‫حُـ٘خك٤ش‬ ٖٓ َ‫أًز‬ ٍٝ‫ى‬ ‫حُٔخٟـش‬ ‫حُؼ٠ِش‬ ‫ٝطِؼذ‬ ‫ح٫ٓخٓ٤ش‬ ‫حُٔلظٞكش‬ ‫حُؼ٠ش‬ ّ‫ػخ‬ ٢‫ك‬1993: ٢‫حَُٔؿؼ‬ ‫ُِظٜ٘٤ق‬ ‫ح٧ٓخٓ٤ش‬ ‫رخُٔزخىة‬ ّ‫حُٔٔخ‬ ٕٝ‫ى‬ ٌُٖ ٝ ‫ُٞكٍٞص‬ ‫طٜ٘٤ق‬ ٠ِ‫ػ‬ ‫طؼي٣٬ص‬ ‫ػيس‬ ‫أىهِض‬ )*‫ُٞكٍٞص‬1ٞ‫ٓ٘ول‬ ١ِٞ‫ػ‬ ‫كي‬ ًَٔ : ‫ُٞكٍٞص‬1a‫ٓغ‬ ٞ‫ٓ٘ول‬ ١ِٞ‫ػ‬ ‫كي‬ ًَٔ :‫هطغ‬ ‫ػيس‬ ‫ٝؿٞى‬ )*‫ُٞكٍٞص‬2٢َٓٛ ًَٔ : ‫ُٞكٍٞص‬2a‫ح٧ٗق‬ ْ‫ػظ‬ ًَٔ ‫ٝؿٞى‬ ‫ٓغ‬ ٢َٓٛ ًَٔ : ‫ُٞكٍٞص‬2b٢ُ‫حُـَرخ‬ ٢‫ح٧ٗل‬ ‫حًَُٔذ‬ ٢‫ك‬ ًَٔ ‫ٓغ‬ ٢َٓٛ ًَٔ : )*‫ُٞكٍٞص‬3:َٝ‫ٓؼظ‬ ًَٔ ‫ُٞكٍٞص‬3a‫ح٧ٗق‬ ْ‫ػظ‬ ًَٔ ‫ٝؿٞى‬ ‫ٓغ‬ َٝ‫ٓؼظ‬ ًَٔ : ٍٞ‫ُٞك‬‫ص‬3b:ًَٔ٢َٓٛ‫ٓغ‬ًَٔ٢‫ك‬‫حًَُٔذ‬٢‫ح٧ٗل‬٢ُ‫حُـَرخ‬ )*‫ُٞكٍٞص‬4‫ُٞكٍٞص‬ ًَٔ ٞٛ :2ٝ‫أ‬3‫حُـٔـٔش‬ ‫هخػيس‬ ٢‫ك‬ ًَٔ ‫ٓغ‬ ‫ُٞكٍٞص‬4a‫ُِلـخؽ‬ ‫حُؼِٞ٣ش‬ ‫حُلخكش‬ ًَٔ ٚ٤ُ‫ا‬ ‫٣٠خف‬ : ‫ُٞكٍٞص‬4b‫ُِلـخؽ‬ ‫حُؼِٞ٣ش‬ ‫حُلخكش‬ ًَٔ ٝ ‫ح٧ٓخٓ٤ش‬ ‫حُولل٤ش‬ ‫حُللَس‬ ٢‫ك‬ ًَٔ ‫اُ٤ش‬ ‫٣٠خف‬ : ‫ُٞكٍٞص‬4c:٢‫ك‬ ًَٔ ٚ٤ُ‫ا‬ ‫٣٠خف‬‫حُلـخؽ‬ ٍ‫ؿيح‬ ًَٔ ‫ٓغ‬ ‫ح٧ٓخٓ٤ش‬ ‫حُولل٤ش‬ ‫حُللَس‬
  • 69.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 57 C-ٝ‫ح٧ػَح‬ ٢ِ٣ ‫ٓخ‬ ‫ؿٔ٤غ‬ ٝ‫أ‬ ٞ‫رؼ‬ ‫حُلي‬ ٢‫ك‬ ًَٔ ‫كيٝع‬ ٖ‫ػ‬ ْ‫ط٘ـ‬ ‫هي‬ ٢‫حُظ‬ ٝ‫ح٧ػَح‬ ٖٔ٠‫طظ‬: ‫رٔزذ‬ *‫ٗي‬ٖ٤‫حُؼ٠ِظ‬ٖ٤‫حُـ٘خك٤ظ‬‫هي‬ٌ‫٣ظو‬‫حُلي‬١ِٞ‫حُؼ‬‫ٟٝؼ٤ش‬ٞ‫ٗل‬َ‫ح٧ٓل‬‫حُوِق‬ ٝ,‫ٌُُي‬ٌٖٔ٣‫ٓ٘خٛيس‬‫ػ٠ش‬‫ٓلظٞكش‬ ‫أٓخٓ٤ش‬،‫هي‬ ٝ‫٣ظٞحؿي‬‫حُلي‬١ِٞ‫حُؼ‬‫رٟٞؼ٤ش‬‫ٓلٍ٘ٞس‬ٝ‫أ‬َ‫ك‬‫حُلًَش‬. ‫هي‬ *‫٣ليع‬ٚ‫ٗو‬ّ‫ح٩كٔخ‬‫رخُؼٜذ‬‫طلض‬‫حُلـخؽ‬‫رٔزذ‬‫حًُٞٓش‬٢‫حُظ‬ٍٞ‫طظط‬‫رَٔػش‬. ‫ًيٓش‬ *‫ىٓٞ٣ش‬‫طلض‬‫حُ٘خطت‬٢٘‫حُٞؿ‬ ٌٖٔ٣ *ٕ‫أ‬ٌٕٞ٣ٌَُٔ‫ح‬١‫أكخى‬‫حُـخٗذ‬‫ػ٘يٓخ‬َٔ٣٢‫ه‬ٌَُٔ‫ح‬‫هَ٣زخ‬ٍُٖٓ‫حُي‬٢ٌ٘‫حُل‬.ٝ‫ٛ٘خ‬‫ط٬كع‬‫حٌُيٓش‬٢‫ك‬‫هزش‬‫حُل٘ي‬ ‫كيٝع‬ *‫ٛٞص‬"‫حُطزن‬ٌٍُٞٔٔ‫ح‬cracked-potsounc‫ػ٘ي‬‫حُوَع‬٠ِ‫ػ‬ٕ‫ح٧ٓ٘خ‬. ‫ا‬ *‫حُؼ٠ش‬ ‫ُظٞحء‬. *ٝ ،‫حُِؼخد‬ ٕ٬٤ْٓ‫حُل‬ ‫اؿ٬م‬ ٠ِ‫ػ‬ ‫حُويٍس‬ ّ‫ػي‬ ٝ‫أ‬ ‫ٛؼٞرش‬ ٖٓ ‫حُظِكِف‬ ‫ًُي‬ ٚ‫٣ٔزز‬ ‫ٓخ‬ ‫ٗظ٤ـش‬ ‫ًُي‬. *‫حُوخٍؽ‬ ٠ُ‫ا‬ ‫حُلي‬ َُٝ‫ر‬. *ّ‫ػي‬‫ا‬‫ٓؼخ‬ ٕ‫ح٧ٓ٘خ‬ ٢‫ٛل‬ ّ‫ٗظظخ‬. *‫حُلي‬ ٢‫ك‬ ّ٫‫آ‬. *‫حُظِكِف‬ ‫ك٤ٜخ‬ ‫كيع‬ ٢‫حُظ‬ ‫حُـٜش‬ ٖٓ ًٕ٧‫ح‬ ‫هِق‬ ‫ًَِٓٛخ‬ ٌٕٞ٣ ٚ‫حُٞؿ‬ ٢‫ك‬ ّ٫‫آ‬. ‫حُلًَش‬ ‫ٓغ‬ ‫ٓٞءح‬ ‫طِىحى‬ ّ٫٥‫ح‬ ٌٙٛ ٕ‫أ‬ ًٌَ٣ٝ٢‫حُ٠ـ‬ ‫ٓغ‬ ٝ‫أ‬. D-‫حُٔ٠خػلخص‬ ٢ِ٣ ‫ٓخ‬ ٖ٤‫حُلخُظ‬ ٢‫ًِظ‬ ٖ‫ػ‬ ْ‫ط٘ـ‬ ‫هي‬ ٢‫حُظ‬ ‫حُٔ٠خػلخص‬ ٖٔ٠‫طظ‬: ْ‫حُظ٘ل‬ َٟ‫ٓـ‬ ‫اٗٔيحى‬. ‫حُِ٘٣ق‬. ٝ‫أ‬ ّ‫حُي‬ ٍٖٞٛٝ٤‫حَُثظ‬ ٠ُ‫ا‬ َ‫حُٔٞحث‬ ٝ‫أ‬ ّ‫حُطؼخ‬ ‫كظخص‬. ٝ ٌِْ‫حُظ‬ ٢‫ك‬ ‫حُٔئهظش‬ ‫حُٜؼٞرش‬ّ‫حُطؼخ‬ ٍٝ‫ط٘خ‬. ‫كيٝع‬‫ا‬‫ُظٜخ‬‫٣ظطِذ‬ ‫ٓخ‬ ،‫حُلي‬ ٝ‫أ‬ ٚ‫حُٞؿ‬ ٢‫ك‬ ‫رخص‬‫ا‬‫حُل٤ٞ٣ش‬ ‫حُٔ٠خىحص‬ ّ‫ٓظويح‬. ّ‫ػي‬‫ا‬٧‫ح‬ ‫ؿ٬م‬‫ؿ٤ي‬ ٌَ٘‫ر‬ ٕ‫ٓ٘خ‬. E-١ِٞ‫حُؼ‬ ‫حُلي‬ ٌٍُٞٔ ١َ٣َُٔ‫ح‬ ٚ٤‫حُظ٘و‬ 1-ٚ٤‫حُظ٘و‬: ٩‫ح‬ ‫حُلخ٫ص‬ ٢‫ك‬٫ٝ‫أ‬ ‫٣ـذ‬ ‫ٓؼخك٤ش‬ٝ ‫حُِ٘٣ق‬ ٠ِ‫ػ‬ ‫حُٔ٤طَس‬ ْ‫ػ‬ ٢ٔ‫حُظ٘ل‬ َٟ‫حُٔـ‬ َ٤‫طير‬‫ُظلي٣ي‬ ‫ٓٞؿِس‬ ‫َٟٓ٤ش‬ ‫هٜش‬ ٌ‫ٗؤه‬ ‫ًُي‬ ‫رؼي‬ ٝ ‫ٓزذ‬٧‫ح‬ ‫كيٝع‬ ُٖٓٝ ‫ًٔخ‬ ‫ً٣ش‬َ٣ٜٞ‫ط‬ ْ‫٣ظ‬ٝ ٢‫آؼخك‬٨ُ ‫ىه٤ن‬َٛ‫ظخ‬ َ٤‫ؿ‬ ‫ُِل٤خس‬ ‫ٜٓيى‬ َٜ‫ٓظ‬ ١‫أ‬ ٝ‫أ‬ ‫حَُٔحكوش‬ ‫ً٣خص‬ْ‫ػ‬ ٖٓ ٝ ‫َٟٓ٤ش‬ ‫هٜش‬ ٌ‫أه‬ ٌٖٔ٣ 2-‫حَُٟٔ٤ش‬ ‫حُوٜش‬ ٝ ‫ٓٞؿِس‬ ٌٕٞ‫ط‬ ٕ‫أ‬ ‫٣ـذ‬‫ٛخىكش‬ٝٝ َُٝ‫ح‬ ‫ر٘ٞع‬ ‫حُٔظؼِوش‬ ‫حُٔؼِٞٓخص‬ َٔ٘‫ط‬‫ا‬ٝ ٚٛ‫طـخ‬ٚ٤‫حُظ٘و‬ ٞ‫ٗل‬ ٚ‫حُظٞؿ‬ ٢‫ك‬ ‫ُظٔخػي‬ ٚ‫ٗيط‬ ْ٤ُِٔ‫ح‬
  • 70.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 58 3-١َ٣َُٔ‫ح‬ ٚ‫حُلل‬ ‫ح‬: ٢ٌ‫ك‬ ٢ٜ‫ٝؿ‬ َٝ‫ر‬ ‫ٜٓخد‬ ٞ٣َُٔ ‫حُٞؿٜ٤ش‬ ‫ُٔ٬ٓق‬ *ٝ ‫رخًُٞٓش‬ ٠‫ٓـط‬ ٚ‫حُٞؿ‬ ٌٕٞ٣ٝ ٍّٞ‫ٓظ‬ ٚ‫ٝؿ‬ ‫ٓغ‬ ‫حٌُيٓش‬ٝ ٠ٓ‫حُٔي‬ ‫حُِؼخد‬ ٍَٝٔ‫ر‬ ‫طٔٔق‬ ‫ٓلظٞكش‬ ٙ‫ٗلخ‬٧‫ح‬ ‫٣ليع‬‫ػ٘ي‬ ُْ‫كًَش‬ ٝ ‫ًٔخ‬ ٢ِ‫حُٔل‬ ‫حُلي‬ٝ ‫حُزِغ‬ ‫٣ٜؼذ‬ٝ ‫حُظٜٞ٣ض‬‫ػظٔ٤ش‬ ‫ر٘ٞحطت‬ ‫حُـِي‬ ْ‫ؿ‬ ‫ػ٘ي‬ ‫أك٤خٗخ‬ َ‫ٗ٘ؼ‬ ‫ًٔخ‬ ‫حُٔ٠ؾ‬ َ٤‫٣ٔظل‬ *ٙٞ٘‫حُظ‬:ٝ ٍّٞ‫حُظ‬ ٠ُ‫ا‬ ٙٞ٘‫حُظ‬ ‫ٌٛح‬ ‫٣ؼٞى‬٩‫ح‬ٝ ‫حُلخىع‬ ‫ٗظزخؽ‬ٝ ‫حُظٜظي‬ ٠ُ‫ا‬ٝ ‫حَُهٞس‬ ‫حُ٘ٔؾ‬ ٢‫ك‬ َٛ‫حُلخ‬ ١ً‫حُظؤ‬ٕ‫كب‬ ‫حُٞحهغ‬ ٢‫ك‬ ٚ‫طلظ‬ ‫حُٞحهؼش‬ ٌٍُٞٔ‫ح‬ ‫ُ٘يس‬ ٢‫حُٔزيث‬ ٖ٤ٔ‫حُظو‬ ٢‫ك‬ ‫٣ٔخػي‬ ٙٞ٘‫حُظ‬ ‫ٌٛح‬ *ٝ ‫ٓ٘ظٔخ‬ ١َ٣َُٔ‫ح‬ ٚ‫حُلل‬ ٌٕٞ٣ ٕ‫أ‬ ‫٣ـذ‬٫ ‫رل٤غ‬ ٬ٜ‫ٓل‬‫ٓ٘طوش‬ ١‫أ‬ َٜٔٗ,ٝ‫حُٔ٬كظش‬ ٢ٛ ٚ‫ُِلل‬ ‫حُظوِ٤ي٣ش‬ ‫حُطَ٣وش‬ ُ‫ح‬‫ٔظزٞػش‬‫ٓغ‬ ْ‫رخُـ‬‫ٓ٬كظش‬ٝ ٢‫حُـخٗز‬ َ‫حُظ٘خظ‬ ّ‫ػي‬٧‫ح‬ٝ ٢ٓ‫ٓخ‬٢ُٜٔٔ‫ح‬ *‫اؿَحء‬ ‫٣ـذ‬٨ُ ِ‫ٓٞؿ‬ ٚ‫كل‬٢‫أٗل‬ ٕ٬٤ٓ ‫ٝؿٞى‬ ٖ٤‫ٓ٬كظ‬ ‫ٗق‬(٧‫ح‬ ‫رخُِ٘ف‬ ٠‫٣ـط‬ ‫هي‬ ١ٌُ‫ح‬٢‫ٗل‬)‫هي‬ ٝ‫أ‬ٕ٬٤ُٔ‫ح‬ ٚ‫٣ظـ‬ّٞ‫حُزِؼ‬ ٠ُ‫ا‬ ٧‫ح‬‫ػ٘ي‬ ٢‫ٗل‬ٝ ٞ٣َُٔ‫ح‬ ٚ‫٣لل‬٢‫ٓٔظِو‬ ‫رٟٞغ‬ ٞٛ *ٝ ّ‫حَُأ‬ ‫ُلَٝس‬ ٚ‫كل‬ ‫اؿَحء‬ ‫٣ـذ‬ٝ ‫حُٔؼخ٣٘ش‬ ْ‫طظ‬ ٕ‫أ‬ ٠ِ‫ػ‬ ‫حُـٔـٔش‬‫ٓؼخ‬ ١‫أ‬ ‫اؿَحء‬ َ‫هز‬ ْ‫حُـ‬ٓ‫ٝؿٞى‬ ‫ٗ٬كع‬ ‫كوي‬ ‫٣يٝ٣ش‬ ‫ِش‬ ‫ط٘ط٤زخص‬ٝٝ ٕ‫رخُ٘خ‬ ٢‫حُ٠ـ‬ ‫طلض‬ ٠‫كظ‬ ‫ٗخُكش‬ ‫ؿَٝف‬٠ُ‫ا‬ َ٤٘‫ط‬ ‫حُٔٞؿٞىحص‬ ٌٙٛ‫ا‬‫(كًَش‬ ٕ‫أ‬ ‫ًٔخ‬ ٢‫هلل‬ ًَٔ ‫ٝؿٞى‬ ‫ٌٓخٗ٤ش‬ ‫حُلو‬ ‫حُؼٔٞى‬ ‫اٛخرش‬ ٠ُ‫ا‬ َ٤٘‫ط‬ ‫هي‬ ‫حُِط٤ق‬ ْ‫حُـ‬ ٝ‫أ‬ ‫رخُلًَش‬ ‫حُظَٜ٣ش‬ ٚٓ٫‫آ‬ ٞ٣َُٔ‫ح‬)١َ *ٝ ‫حَُٔكِش‬ ٌٙٛ ٢‫ك‬ ٖ٤‫ُِؼ‬ ٢‫١ز‬ ٚ‫كل‬ ‫اؿَحء‬ ‫٣ـذ‬ ‫ًٔخ‬٨ُ ‫ُط٤ق‬ ‫ٗي‬ ٖٔ٠‫ط‬ ٖ٤‫ُِؼ‬ ٢٤ٔ‫حُز‬ ٚ‫حُلل‬‫ؿل‬ٝ ‫ًٔخ‬ ٕ‫خ‬َٔ‫ؿ‬ ٌٖٔ٣ ٝ‫أ‬ ْ‫ٓؼو‬ ‫رٔخء‬ ٖ٤‫حُؼ‬ٝ ٚ‫حُلل‬ ّ‫اطٔخ‬ ‫حُِ٘ف‬ ‫اػخهش‬ ٍ‫كخ‬ ٢‫ك‬ ‫َٓ١ذ‬ ٖ‫هط‬ٝ ٖ٤‫حُؼ‬ ‫ٝظ٤لش‬ ٚ‫كل‬ ‫رٜيف‬ ‫ًُي‬‫حُلًَش‬ ‫ٝؿٞى‬ ٚ٤‫ط٘و‬ ٖ٤‫ُِؼ‬ ‫حٌُحط٤ش‬ *٧‫ح‬ٝ ‫ح٫ؿِٜس‬ ًَ ٌٍ‫رل‬ ‫ِٗ٘ع‬ ٕ‫أ‬ ‫٣ـذ‬ ْ‫حُٔ٘ظ‬ ١ٞٔ‫حُل‬ َ‫ىحه‬ ٚ‫حُلل‬ ٢ٛ ‫حُظخُ٤ش‬ ‫ُٝٞ٣ش‬ٝ ٍٞٔ‫حُـ‬‫حُٔ٘لِٜش‬ ٝ‫أ‬ ‫حٌٍُٔٔٞس‬ ٕ‫حُظ٤ـخ‬ ٝ٧‫ح‬٧‫ح‬ ّ‫ؿٔخ‬٩‫ح‬ ٖٓ ٢ٔ‫حُظ٘ل‬ َُٔٔ‫ح‬ ‫ُلٔخ٣ش‬ ‫ؿ٘ز٤ش‬ٝ ٕ‫حُِٔخ‬ ‫هخػيس‬ ٚ‫ٗلل‬ ْ‫ػ‬ ‫ٗٔيحى‬ٝ ٢ٓٞ‫حُزِؼ‬ ‫حُـ٘خء‬ ٍٞ‫ك‬ ‫ٓخ‬ٝ ‫حُِٜخس‬ ٖ٤‫حُُِٞط‬.٧‫ح‬ ‫حُِؼخر٤ش‬ ‫حُـيى‬ ‫أه٘٤ش‬ ٢‫ك‬ ‫ؿَٝف‬ ٝ‫أ‬ ‫ط٘ط٤زخص‬ َٜ‫٣ظ‬ ‫هي‬ ْ‫حُل‬ ‫ُوخع‬ ‫ىه٤وخ‬ ‫كلٜخ‬ ٕ‫أ‬ ‫ًٔخ‬٤ٓ‫ٓخ‬‫ش‬ ‫ا‬ *ٓ ٚ‫كل‬ ‫ؿَحء‬ٜ‫ل‬١ِ٤ٛ‫ى‬ ٢‫ٓ٘و‬ ًَٔ ٠ُ‫ا‬ ٖٓ ١‫أ‬ ‫كًَش‬ َ٤٘‫ط‬ ٕ‫أ‬ ٌٖٔ٤‫ك‬ ‫كيس‬ ٠ِ‫ػ‬ ٖٓ ًَ ٚ‫رلل‬ ّٞ‫ٗو‬ : ١ِٞ‫حُؼ‬ ‫ُِلي‬ َ ٢ٌ٘‫ك‬ ٝ‫أ‬ *٩‫ح‬ ‫ٓٞء‬ٝ ‫حُٔٔ٤ِس‬ ‫حُؼ٬ٓخص‬ ْٛ‫أ‬ ٖٓ َ‫:٣ؼظز‬ ‫١زخم‬ٝ ‫حُٞحٟلش‬ٝ‫أ‬ ‫حُٜيٓش‬ َ٤‫كزظؤػ‬ ْ٤ُِٔ‫ح‬ ٚ٤‫حُظ٘و‬ ‫ٟٝغ‬ ٢‫ك‬ ‫٣ٔخػي‬ ٚ٣َ‫طل‬
  • 71.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 59 ٝ ٌَُٔ‫ح‬ ‫هطغ‬ ٢‫ك‬ ٍ‫طزي‬ ‫٣ليع‬ ‫حُؼ٠٬ص‬ ‫ط٘٘ؾ‬‫ا١زخ‬ ‫ٓٞء‬ ٢ُ‫رخُظخ‬‫م‬ ٝ ‫ٝحٟق‬ َ٤ُ‫ى‬ ُٜٞ ٢ِ‫حُٔل‬ ‫حُلي‬ ‫ٓ٬ٓش‬ ‫ٓغ‬ ‫ا١زخم‬ ‫ٓٞء‬ ‫ٝؿٞى‬ ٕ‫ا‬ٝ ١ِٞ‫حُؼ‬ ‫حُلي‬ ٢‫ك‬ ًَٔ ‫ٝؿٞى‬ ٠ِ‫ػ‬ ‫أً٤ي‬ٖٓ ْ٤ُ ٌُٖ ١َٝ٠ُ‫ح‬‫ا‬١ِٞ‫حُؼ‬ ‫حُلي‬ ًٍٞٔ ًَ ٢‫ك‬ ‫ٝحؿزش‬ ‫ػ٬ٓش‬ ٍٙ‫ػظزخ‬(٧‫ح‬ ٌٍُٞٔ‫ح‬‫ح٫١زخم‬ ٢‫ك‬ ٍ‫طزي‬ ‫٫٣ليع‬ ‫هي‬ ‫حُظخٓش‬ ‫كو٤ش‬) 4-ْ‫حُـ‬ ٗ *٩‫ح‬ ٚ‫رخُلل‬ َ‫٘ظو‬٧‫ح‬ ‫حُليٝى‬ ٠ِ‫ػ‬ ٢‫ٛزؼ‬ٝ ‫ٓخٓ٤ش‬ٝ ٢ٌ‫حُل‬ ‫حُـ٤ذ‬ ٕ‫ُـيٍح‬ ‫حُـخٗز٤ش‬٩‫ح‬ ‫ُ٘ليى‬ ‫حُلـخؽ‬ ‫كٞحف‬٩‫ح‬ ٝ‫أ‬ ٍ‫ٓظَٔح‬‫ٗوطخع‬ ٩‫ح‬ ‫طلَم‬ ٝ‫أ‬ ‫حُيٍؿش‬ ْ‫طـ‬ ‫ك٤غ‬ ْ‫حُؼظ‬ ‫ٓطق‬ ٢‫ك‬‫رٟٞٞف‬ ٍ‫طٜخ‬ *َ٤٘‫ط‬ ٢٘‫حُٞؿ‬ ٢ٌ‫حُل‬ ٢٘‫حُٞؿ‬ ٍُ‫حُي‬ ‫ٓ٘طوش‬ ٢‫ك‬ ‫حُيٍؿش‬‫ا‬‫حُلـخؽ‬ ‫طلض‬ ‫حُلخكش‬ ٢‫ك‬ ًَٔ ٠ُ‫أ‬‫حُلي‬ ٢‫ك‬ ٢َٓٛ ًَٔ ٠ُ‫ا‬ ٝ ١ِٞ‫حُؼ‬ *‫ح‬ ‫ٓ٘طوش‬ ٢‫ك‬ ‫حُيٍؿش‬‫ُٞكٍٞص‬ ٠ُ‫ا‬ َ٤٘‫ط‬ ٢ٜ‫حُـز‬ ٢٘‫حُٞؿ‬ ٍُ‫ُي‬3 *٧‫ح‬ ‫كًَش‬‫ح٫ٗق‬ ْ‫ػظ‬ ٢‫ك‬ ًَٔ ‫كيٝع‬ ٠ُ‫ا‬ َ٤٘‫ط‬ ْ‫رخُـ‬ ‫ٗق‬ **ٝ‫أ‬ ‫حُ٘ظخ٣خ‬ ٢‫ك‬ ‫حُِحثي‬ ٍ‫حُظزي‬ ‫ه٘٤ش‬ ْ‫حُـ‬ ‫كًَخص‬ ‫اؿَحء‬ ‫ػ٘ي‬ ‫حُ٘ي٣ي‬ ٌٍ‫حُل‬ ‫٣ـذ‬ : ‫ٓ٬كظش‬ٗ‫ا‬٧‫ح‬ ‫أكي‬ ‫وطخع‬‫حُيٓٞ٣ش‬ ‫ٝػ٤ش‬‫أ‬ٝ ٧‫ح‬ ‫أكي‬‫ػٜخد‬ *ٝ ‫ر٤ي‬ ّ‫حَُأ‬ ‫رظؼز٤ض‬ ّٞ‫ٗو‬ُ‫ح‬ ‫طلَ٣ي‬‫لي‬٧‫ح‬ ‫رخُ٤ي‬ ١ِٞ‫حُؼ‬َٟ‫ه‬ ·‫ُٞكٍٞص‬ ًٍٞٔ ٢‫ك‬1َٜ‫ٓ٘ل‬ ٌَ٘‫ر‬ ٢‫حُٔ٘و‬ ْ‫حُؼظ‬ ‫٣ظلَى‬ ·ٝ ‫حُل٘ي‬ ‫هزش‬ ًٍٞٔ ٢‫ك‬ٜ‫ؿ‬ ٖٓ ٬ً ‫طظلَى‬ ‫هي‬ ‫حُٜٔٔ٤ش‬ ‫حُٔ٘ن‬٥‫ح‬ ٖ‫ػ‬ َٜ‫ٓ٘ل‬ ٌَ٘‫ر‬ ١ِٞ‫حُؼ‬ ‫حُلي‬ ٢‫ظ‬َ‫ه‬ ·٧‫ح‬ ‫حُ٘ظٞء‬ ‫ٓويٓش‬ ٢‫ك‬ ‫كًَش‬ ‫٫كظ٘خ‬ ‫اًح‬ ‫أٓخ‬‫ُٞكَص‬ ٠ُ‫ا‬ َ٤٘٣ ‫كٌٜح‬ ٢‫ٗل‬2‫أ‬َٓ‫ًخ‬ ‫كًَش‬ ‫ٓخ‬‫حُؼِغ‬ٚ‫حُٞؿ‬ ٖٓ ٢ٓٞ‫حُٔظ‬ َ٤٘٣ ‫كٌٜح‬‫ا‬‫ُٞكٍٞص‬ ٠ُ3 ‫ٓ٬كظش‬‫ٓخ‬ ‫اًح‬ :‫ُٞكٍٞص‬ ًَٔ ‫طلي٣ي‬ ْ‫ط‬3١ِٞ‫حُؼ‬ ‫ُِلي‬ ‫ُحثي‬ َ٣‫طزي‬ ٝ‫أ‬ ‫طلَ٣ي‬ ١‫أ‬ ‫طـ٘ذ‬ ‫ك٤ـذ‬ ·٩‫ح‬ ‫حُؼ٬ٓخص‬ ٖٓ َ‫طؼظز‬ :‫حُلَهؼش‬ٝ ‫٣ـخر٤ش‬‫ك٤غ‬ ٚ٤‫حُظ٘و‬ ٢‫ك‬ ‫حُٔٔخػيس‬‫أ‬ٕ‫ا‬‫ٛٞص‬ ٢‫طؼط‬ ْ‫حُؼظ‬ ٢‫ٜٗخ٣ظ‬ ‫كظٌخى‬ ‫ٝحٟلش‬ ‫كَهؼش‬ ·٧‫ح‬‫حُٔ٠ؾ‬ ٝ‫أ‬ ْ‫حُـ‬ ‫أػ٘خء‬ ٚ٤‫ُِظ٘و‬ ‫َٓٗيح‬ َ‫٣ؼظز‬ :ُْ ·‫حُؼٜز٤ش‬ ‫حُؼ٬ٓخص‬ٝ :٩‫ح‬ ‫٣ـذ‬ ٢‫حُظ‬ ‫حُٜخٓش‬ ‫حُؼ٬ٓخص‬ ٖٓ ٢ٛٙ‫ٗظزخ‬‫ا‬ٜ٤ُ‫خ‬‫ٓخ‬ ‫ؿخُزخ‬ ْ‫حُظٞحث‬ ‫ٓؼِغ‬ ‫كؼٜذ‬ٌٍٞٔ‫ر‬ َ‫٣ظؤػ‬
  • 72.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 60 ُ٘ٔ‫ح‬ ٢‫ك‬ ٍ‫هي‬ ‫ٓليػخ‬ ١ِٞ‫حُؼ‬ ‫حُلي‬‫٣ؼٜزٜخ‬ ٢‫حُظ‬ ‫خ١ن‬ ·ٝ٩‫ح‬ ٢‫ك‬‫حَُه‬ ‫حُ٘ٔؾ‬ ‫طِٔم‬ ‫ٓغ‬ ‫حُٔظَحكوش‬ ‫ٛخرخص‬ُٞ‫ح‬ ‫حُؼٜذ‬ ‫ُلَٝع‬ ١ً‫طؤ‬ ‫٣ليع‬ ‫هي‬ ‫ٞس‬‫ؿ‬‫ٓليػ‬ ٢ٜ‫خ‬ٞ‫رؼ‬ ٢‫ك‬ َِٗ ‫٣ؼٜزٜخ‬ ٢‫حُظ‬ ‫حُؼ٠٬ص‬ ·ٝ‫ح٧ػَح‬ ‫ًخٗض‬ ‫اًح‬ ‫ٓئهض‬ ١ً‫حُظؤ‬ ‫ٌٛح‬ ٌٕٞ٣ ‫هي‬‫ٗخطـش‬ٖ‫ػ‬‫ا‬ٝ ١ٞٓ‫ى‬ ٍّٞ‫ر‬ ٝ‫أ‬ ْ‫حُؼظ‬ ‫ر٘ظخ٣خ‬ ‫حُؼٜذ‬ ١‫ٗ٠ـخ‬ٍ‫رِٝح‬ ٍِٝ‫ط‬ ‫ُِؼٜذ‬ ‫حُ٘ي٣ي‬ ١ً‫حُظؤ‬ ‫ػ٘ي‬ ْ‫ىحث‬ َُِ٘‫ح‬ ٌٕٞ٣ ٝ‫أ‬ ‫حُٔزذ‬. ·٩‫ح‬ ٢‫ك‬ ‫طليع‬ : ‫حُٔ٠خػلش‬ ‫حَُإ٣ش‬ٝ ‫حُ٘ي٣يس‬ ‫ٛخرخص‬‫هخٛش‬٢‫ك‬ٝ‫أ‬ ‫ُِلـخؽ‬ ‫حُٔلِ٤ش‬ ‫حُلخكش‬ ًًٍٍٞٔٞٔ ٢‫ك‬‫هخع‬ ٝ ‫طلُٜٞخ‬ ٝ‫أ‬ ٖ٤‫حُؼ‬ ١ٞ‫ُٜز‬ ١‫٣ئى‬ ‫ٓٔخ‬ ‫حُلـخؽ‬‫ا‬ٝ‫كي‬ ٠ُ‫ا‬ ١‫٣ئى‬ ‫ٓٔخ‬ ٢‫حُطز٤ؼ‬ ‫ٌٓخٜٗخ‬ ٖٓ ‫ٗـَحٍٛخ‬ٝ ‫حُٔ٠خػلش‬ ‫حَُإ٣ش‬ ‫ع‬‫طؼٞى‬ ٢‫حُظ‬ ٌَُٔ‫ح‬ ‫ٍى‬ ‫رؼي‬ ‫ُطز٤ؼظٜخ‬ F-: ‫حُؼ٬ؽ‬ ٩‫ح‬ ‫ٗيس‬ ٠ِ‫ػ‬ ‫حُؼ٬ؽ‬ ‫٣ؼظٔي‬ٝ ‫ٛخرش‬٧‫ح‬ ٖٓٝ َ٠‫ك‬٩‫ح‬ ‫حُ٘ظ٤ـش‬ ٕ‫ُ٠ٔخ‬٩‫ح‬ ‫٣ـذ‬ ‫ُِؼ٬ؽ‬ ٚ٤‫٣ـخر‬‫َٓحع‬( ٍ٬‫ه‬ ‫حُٔؼخُـش‬ ‫ريء‬ ٢‫ك‬30 ‫ىه٤وش‬٠‫كظ‬2‫ًلي‬ ٚ‫ٓخػ‬‫أ‬)٠ِ‫ػ‬‫طير٤َٛخ‬ ‫٣ـذ‬ ٢‫حُظ‬ ٝ ‫حُؼٜز٤ش‬ ‫أٜٛٔخ‬ ٝ ( َٟ‫أه‬ ‫ؿخٗز٤ش‬ ‫اٛخرخص‬ ١‫أ‬ ‫ٝؿٞى‬ ّ‫ػي‬ ٍ‫كخ‬ ٢‫ك‬ ‫ًُي‬ ٝ ) ٢ٌ‫حُل‬ ٢ٜ‫حُٞؿ‬ ‫رخُؼ٬ؽ‬ ‫حُزية‬ َ‫هز‬. ٝ‫ُِٔؼخُـ‬ ُٚٓ٬ُ‫ح‬ ‫ح٫ؿَحءحص‬ ٖٓ‫ش‬: -‫ا‬‫رؼخى‬‫أ‬َ‫ٓؼ‬ ٚ‫حُٞؿ‬ ٢‫ك‬ ‫ٓؼ٤وخص‬ ١ٝ‫أ‬ ‫حُوًٞس‬٧‫ح‬ٝ ٚ‫ه٘ؼ‬‫ؿ٤َٛخ‬ -‫حُظ‬‫ؤ‬ٖٓ ‫ًي‬ّ‫ػي‬‫ٗي٣ي‬ ‫ِٗف‬ ‫ٝؿٞى‬‫أ‬ٍّٝٞ‫ط‬ٝ ْ‫حُظ٘ل‬ ‫٣ٔ٘غ‬ ‫هي‬‫ا‬ْ‫حُظ٘ل‬ ‫حُٜٔخد‬ ‫٣ٔظط٤غ‬ ‫رل٤غ‬ ‫ٓلظٞكخ‬ ‫حُٜٞحء‬ َٟ‫ٓـ‬ ‫روخء‬ ٌٖٔ٣ ( ُٜٚٞٔ‫ر‬‫أ‬٩‫ح‬ ‫٣ليع‬ ٕ٧‫رخ‬ ‫ٗٔيحى‬ٚ‫ٗٔـ‬‫أ‬٧‫ح‬ ٝٝ )ٚ‫حُـَ٣ز‬ ّ‫ؿٔخ‬ٝ ٙ‫حُ٘ي٣ي‬ ‫حُلخ٫ص‬ ٢‫ك‬‫ػ٘ي‬‫ا‬ٞ‫هل‬ ٌٖٔ٣ ْ‫حُظ٘ل‬ ‫ػخهش‬ ٩‫ح‬ٚ‫ٛخر‬ٝ( ١ٞٔ‫ك‬ ٢‫ٛٞحث‬ ‫ِٓٔي‬ ‫ٟٝغ‬‫أ‬) ْ‫حُظ٘ل‬ ٠ِ‫ػ‬ ٙ‫ُِٔٔخػي‬ ٢‫ٛٞحث‬ ‫ٗزٞد‬. -‫ط٘ظق‬‫حُـَٝف‬ ٝ ‫حُظٔلـخص‬ ٝ ٕٝ‫حُوي‬‫حُلخؿش‬ ‫كخُش‬ ٢‫ك‬ ١‫طوخ‬ ٝ ‫حُٜٔخرش‬ ٚ‫حُٔ٘طو‬ ٢‫ك‬ -ٝ ٍّٞ‫حُظ‬ َ٤ِ‫ُظو‬ ٚ‫حُٞؿ‬ ٠ِ‫ػ‬ ‫ػِؾ‬ ‫ًٔخىحص‬ ‫ٟٝغ‬ُْ٧‫ح‬ -ٚ‫حُٞؿ‬ ٟٞ‫ٓٔظ‬ َ‫ؿؼ‬‫أ‬ٝ َ‫حُٔٞحث‬ ‫ٍؿٞع‬ ٢‫ك‬ ٙ‫ُِٔٔخػي‬ ‫حُوِذ‬ ٟٞ‫ٓٔظ‬ ٖٓ ٠ِ‫ػ‬ٝ ‫طـٔؼٜخ‬ ‫ٓ٘غ‬َ٤ِ‫طو‬ ٠ِ‫ػ‬ ‫٣ٔخػي‬ ‫ٌٛح‬ ٍّٞ‫حُظ‬ -‫ح‬ ْٔ‫ؿ‬ ‫طيكجش‬َ٤ِ‫ُظو‬ ‫ُٜٔخد‬‫ا‬‫ٛيٓش‬ ‫كيٝع‬ ٍ‫كظٔخ‬ ً ٕ‫ح٩ٗظخ‬ ‫ؿ٤خد‬ ٢‫ك‬‫ب‬‫ُٞكٍٞص‬ ( ١ِٞ‫حُؼ‬ ‫حُلي‬ ًٍٞٔ ٕ‫كب‬ ، ١٬‫هظ‬1٢ٌ‫ك‬ ٖ٤‫ر‬ ‫طؼز٤ض‬ . ) ‫ٓلظٞف‬ َ٤‫ؿ‬ ًَٔ ( ‫رَٔػش‬ ٢‫ط٘ل‬ ) ‫ر‬‫ب‬ّ‫ه٤خ‬ ِْٗ‫ٓظخ‬ ‫أٓ٬ى‬ ّ‫ٓظويح‬26Gauge‫حٌُِٔ٤ش‬ ّ‫ح٧هٞح‬ ٠ُ‫ا‬ ٢‫طَر‬ ،(Erich arch bar fixation)٠ِ‫ػ‬ ‫ٓٔزوخ‬ ‫طؼزض‬ ٢‫حُظ‬ ١ِٞ‫حُؼ‬ ‫حُلي‬ٝ‫ٌِٓ٤ش‬ َٟ‫ػ‬ ٠ُ‫ا‬ ٝ‫أ‬ ٠ِ‫حُٔل‬. ٕ‫أ‬ ٌٖٔ٣ ‫حُِٔحف‬ ١ِٞ‫حُؼ‬ ‫حُلي‬‫٣ؼخى‬ٝ‫٣ي‬ ‫رَى‬ ‫حُٜل٤ق‬ ٚ‫ٟٓٞؼ‬ ٠ُ‫ا‬١٢٤ٔ‫ر‬‫أ‬ٝ‫ٗٔظط٤غ‬‫ًُي‬‫ر‬‫ب‬٢‫حُو‬ ‫هَد‬ ‫٣ٟٞغ‬ ‫ِٓي‬ ّ‫ٓظويح‬ ، ‫اٍ٣ي‬ ّٞ‫ه‬ ٍٞ‫ك‬ ٢ٓٞ‫حُٔظ‬‫ر‬ ‫٣ٔٔق‬ ١ٌُ‫ح‬ َٜٝ‫حُٔ٘ل‬ ١ِٞ‫حُؼ‬ ‫حُلي‬ ًَٔ ‫ٔلذ‬( Impact )ٝ ّ‫ح٧ٓخ‬ ٠ُ‫ا‬‫ر‬ َ‫ح٧ٓل‬‫ب‬ٙ‫طـخ‬ ، ‫ح٩١زخم‬ٝ‫أ‬‫ر‬‫ب‬‫كٌ٤ش‬ ٖ٤‫ر‬ ١‫ٓطخ‬ ‫كِوخص‬ ّ‫ٓظويح‬. ٝ ، ‫حُٔزٌَس‬ ‫حُلخ٫ص‬ ٢‫ك‬ ‫رُٜٔٞش‬ ‫ُٞكٍٞص‬ ًٍٞٔ ‫ٍى‬ ْ‫٣ظ‬ٌٌُُٖٔ‫ح‬ ‫كخ٫ص‬ ٢‫ك‬ٍٞٝ ‫حُٔ٘لَٜس‬ٌُٔ‫ح‬ٍٞ‫حُوي٣ٔش‬ُ‫ح‬ ٖٓ‫ٜؼذ‬‫ًُي‬ ‫ٝ٣لظخؽ‬َٓ٧‫ح‬ٝ ‫هٞس‬ ٠ُ‫ا‬‫ر٘يس‬ ‫ٍى‬. ٠ٓ‫أٓخ‬ َ‫ؿ‬ ٠ُ‫ا‬ ٝ‫أ‬ ٝ ٢‫حُٞظ٤ل‬ ‫ح٩١زخم‬ ٖ٤ٓ‫طؤ‬ ‫اػخىس‬ ٞٛ ٌٍُٞٔ‫ح‬ ٌٙٛ ٢‫ك‬ ‫حُٔؼخُـش‬ ‫ٓلظخف‬‫ًُي‬١ِٞ‫حُؼ‬ ‫حُلي‬ ‫طؼز٤ض‬ َ‫هز‬. ٝ ، ‫ٓخروخ‬ ‫ٝٛق‬ ‫ًٔخ‬ ‫رخُ٘ي‬ ‫حَُى‬ ‫ٛ٘خ‬ ‫ٗطزن‬ٝ ‫ػِ٤ٜخ‬ ٍٞ‫ٓؼ‬ َ٤‫ؿ‬ ‫حَُى‬ ‫رؼي‬ ‫ُِظؼز٤ض‬ ّ‫حَُأ‬ ‫أكِٓش‬ ٕ‫كب‬ ّ‫ػخ‬ ٌَ٘‫ر‬ٝ ‫َٓ٣لش‬ َ٤‫ؿ‬٠ِ‫ػ‬ ٝ ، ٢‫ًٝخك‬ ‫ؿ٤ي‬ ٢ٌ‫حُل‬ ٖ٤‫ر‬ ‫حُظؼز٤ض‬ ٕ‫كب‬ ٍ‫كخ‬ ًَ‫ٌُٔخٜٗخ‬ ‫ك٤َىٛخ‬ ‫حُؼِٞ٣ش‬ ٌَُٔ‫ح‬ ‫هطؼش‬ ٠ِ‫ػ‬ ٢‫رخُ٠ـ‬ ّٞ‫ك٤و‬ ٠ِ‫حُٔل‬ ‫حُلي‬ ٍٝ‫ى‬ ‫أٓخ‬ ٠ُ‫ا‬‫حُ٘لخء‬ ْ‫٣ظ‬ ٕ‫أ‬
  • 73.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 61 ٌَُٔ‫ح‬ ‫ٓٞهغ‬ ‫كٞم‬ ‫ِٛزش‬ ‫ٗوطش‬ ٍٝ‫أ‬ ٠ُ‫ا‬ ١ِٞ‫حُؼ‬ ‫حُلي‬ ‫رظؼِ٤ن‬ ‫حُظؼز٤ض‬ ٠ِ‫ػ‬ َٜ‫ُ٘ل‬ ‫طَ٘٣ل٤ش‬ ‫ٗوطخ‬ ‫ُٞكٍٞص‬ ًٍٞٔ ٢‫ك‬ َٔ‫ٗٔظؼ‬ ، ) ٢٘‫حُٞؿ‬ ‫حُ٘ظٞء‬ ، ‫حُٔلِ٤ش‬ ‫حُلـخؽ‬ ‫كخؿش‬ ، ‫حٌُٔؼَ٣ش‬ ‫حُلخكش‬ ( َ‫ٓؼ‬ *ٝ٢‫ك‬( ‫ىىفىسخ‬ ‫مسىس‬1)‫ك‬‫ب‬‫حُلـخؽ‬ ‫طلض‬ ‫حُلخكش‬ ٠ِ‫ػ‬ ْ‫٣ظ‬ ‫رخ٧ٓ٬ى‬ ‫حُظؼز٤ض‬ ٕ٩‫ح‬ ‫ٓغ‬ٓ‫ظلخ‬ٝ ْ٤ُِٔ‫ح‬ ٠ِ‫حُٔل‬ ‫حُلي‬ ٖٓ ‫ىس‬ ١ِٞ‫حُؼ‬ ‫حُلي‬ ‫ُٔٞهغ‬ َ٤ُ‫ًي‬ ٠ُ٘ٔ‫ح‬ ‫ح٩١زخم‬. ًْ‫طؼخ‬ ٌَ٘‫ر‬ ‫حَُٔٗش‬ ‫ح٧ُ٤خف‬ ‫طظٟٞغ‬ ٕ‫أ‬ ٌُٖٔٔ‫ح‬ ٖٓ ٚٗ‫كب‬ ، ‫حُزيح٣ش‬ ٖٓ ٌَُٔ‫ح‬ ‫ٍى‬ ْ‫ط‬ ‫اًح‬‫ا‬ٝ ، ‫ح٩ُحكش‬ ٝ‫أ‬ ‫حَُى‬ ٙ‫طـخ‬‫حُلي‬ ‫ؿِذ‬ ‫٣ـذ‬ ٝ ، ‫حَُى‬ ‫ططز٤ن‬ ‫ريء‬ ٖٓ ‫ٓخػخص‬ ‫ر٠غ‬ ٍ٬‫ه‬ ‫حُٜل٤ق‬ ‫ٓٞهغ‬ ٠ُ‫ا‬ ١ِٞ‫حُؼ‬ً ‫اًح‬‫خ‬‫ح‬ ُٕ‫ٜٓخرخ‬ ١ِٞ‫حُؼ‬ ‫لي‬(٫ ٚٗ‫أ‬ ‫ُيٍؿش‬ ‫ر٘يس‬ ) ‫ٓ٘لَٜح‬ ‫ػ٘ي‬ ‫ك٤ـذ‬ ، ‫حُٔخروش‬ ‫رخُطَم‬ ٙ‫ٍى‬ ٌٖٔ٣ٛ‫خ‬‫ا‬ٍٝ ٢‫ِٓو‬ َ‫ٓؼ‬ ‫حَُى‬ ٢‫ٓ٬ه‬ ٍ‫ٓظؼٔخ‬. ‫رؼي‬ ‫حُٔ٘خٛيس‬ ٌٍُٞٔ‫ح‬ ٕ‫كب‬ ‫ًًَٗخ‬ ‫ًٝٔخ‬2-3٩‫ح‬ ‫ٓٞء‬ ‫كخ٫ص‬ ‫ًٌُي‬ ، ٢ٌ‫حُل‬ ٖ٤‫ر‬ ‫رخُ٘ي‬ ٝ‫أ‬ ‫٣يٝ٣خ‬ ‫طَى‬ ٫ ‫ح٩ٛخرش‬ ٖٓ ‫أٓخر٤غ‬ّ‫ُظلخ‬ ٌَ‫حُٔز‬( Early Malunion )ٝ‫حُٔ٘ل٠َس‬ ٌٍُٞٔ‫ح‬Impacted ))ٝ ‫ؿَحك٤خ‬ ٝ‫أ‬ ٠ٌِ٤ُٜ‫ح‬ ‫حَُى‬ َ‫رٞٓخث‬ ‫َُِى‬ ‫أك٤خٗخ‬ ‫طٔظـ٤ذ‬ ٢ٜ‫ك‬ ‫حُلخ٫ص‬ ٌٙٛ ٢‫ك‬ ٫‫ا‬ ٢‫هخٍؿ‬ َ‫ؿ‬ ‫طلو٤ن‬ ٢‫ك‬ ‫ٓو٘غ‬ َ٤‫ؿ‬ ٚٗ‫أ‬ ‫ػِٔخ‬ ( ّ‫حَُأ‬ ّ‫ُلِح‬ ‫أك٤خٗخ‬). *‫أٓخ‬( ‫ىىفىسخ‬ ‫مسىس‬2)ٝ ، ٚ‫ٓ٘خر‬ ‫رؤِٓٞد‬ َ‫كظير‬ٕ‫أ‬ ‫حُـَحف‬ ٠ِ‫ػ‬ ‫٣ـذ‬ٌَُٔ‫ح‬ ٕ‫أ‬ ‫ٓظًٌَح‬ ‫رخُـش‬ ‫رؼ٘خ٣ش‬ ‫٣يٝ٣خ‬ ٌٍُٞٔ‫ح‬ ٌٙٛ ‫٣َى‬ ٝ ، ٠‫حُلـخؿ‬ ٠ٔٗ٧‫ح‬ ٍ‫حُـيح‬ َٔ٘٣ٝ ، ‫ح٧ٓخٓ٤ش‬ ‫حُلـخؽ‬ ‫أٍٟ٤ش‬‫أ‬ ٕ‫ا‬١٢‫ك‬ ًٟ‫طؤ‬ ‫٣ٔزذ‬ ‫هي‬ ‫ُحثي‬ ‫طلَ٣ي‬ُ‫ح‬ٝ ‫حُيٓؼ٤ش‬ ‫ح٧ٗل٤ش‬ ‫و٘خس‬ ٝ ‫حُلـخؽ‬ ‫طلض‬ ‫حُؼٜذ‬‫ر‬ ‫حُظؼز٤ض‬ ‫ططز٤ن‬ ‫رؼي‬٤ٝ ٢‫ح٧ٗل‬ ٢ٜ‫حُـز‬ ٍُ‫حُي‬ ْ‫رـ‬ ّٞ‫ٗو‬ ‫كبٗ٘خ‬ ٢ٌ‫حُل‬ ٖ‫حُلخكش‬ٖٔ٠ُ٘ ‫ُِلـخؽ‬ ‫حُٔلِ٤ش‬ ٌَُِٔ ّ‫طخ‬ ‫ٍى‬. *ٝ‫أٓخ‬( ‫ىىفىسخ‬ ‫مسىس‬3)‫ُٞكٍٞص‬ ٢‫ك‬ ‫ًٔخ‬1،2( ‫ُٞكٍٞص‬ ًٍٞٔ ٕ‫كب‬3ٝ ١ِٞ‫حُؼ‬ ‫حُلي‬ ‫رٟٞغ‬ ‫طَى‬ )١‫رب‬ ٫ٝ‫أ‬ ٠ِ‫حُٔل‬‫زخ‬‫م‬ ٘ٓ٢٢ٌ‫ك‬ ٖ٤‫ر‬ ‫طؼز٤ض‬ ‫ٗطزن‬ ْ‫ػ‬ ، ًَِٟٓ. : ‫اىشد‬ ** ‫ً٬رش‬ ‫ػ٘طَ٣ن‬ ٝ‫أ‬ َُٕٔ‫ح‬ ‫حُ٘ي‬ ‫١َ٣ن‬ ٖ‫ػ‬ ‫آخ‬Rowe`s
  • 74.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 62 ‫ً٬رش‬ ّ‫آظويح‬ ٌٖٔ٣ ٝ‫أ‬Hayton Williams : ‫اىرثثٍد‬ ** A)‫طؼز٤ض‬٢ِ‫حُيحه‬: َ‫هز‬ ٖٓ ‫َٓس‬ ٍٝ٧ ‫أٓظؼِٔض‬MICHELETّ‫ػخ‬1972( ‫ًٜلخثق‬Miniplate٢‫ػ٬ػ‬ ‫ػزخص‬ َ‫طٞك‬ ٢‫حُظ‬ ٝ ‫حُوَ٘س‬ ‫أكخى٣ش‬ ) ‫ح٧رؼخى‬‫ُِٞظ٤لش‬ ‫حَُٔ٣ؼش‬ ‫حُؼٞىس‬ ٝ ‫ح٩ٓظ٘لخء‬ ‫ٓيس‬ ٖٓ ٞ‫طول‬ ٢‫حُظ‬ ٝ ٍ‫ح٩ٗلظخ‬ ‫كًَخص‬ ‫رٌُي‬ ‫طٔ٘غ‬ ٝ
  • 75.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 63 ‫أ‬-‫ُظؼز٤ض‬٢‫١َك‬ْ‫حُؼظ‬َٗ‫حُٔزخ‬: ‫حُٜٔلَس‬ ‫حُٜلخثق‬ +Miniplates: ) ‫ػ٘ن‬ ٕٝ‫ى‬ ٝ‫أ‬ ‫ػ٘ن‬ ‫ٓغ‬ ( ‫ٓٔظو٤ٔش‬ : ٍ‫ح٧ٌٗخ‬ ‫ٓوظِلش‬X،H،L،TٝY : ‫ٓوظِلش‬ ‫ٓٞحى‬ ٖٓ ‫طٜ٘غ‬-ً٫ٞ‫حُل‬ّٝ‫حُٔوخ‬‫ُِٜيأ‬ -ّٞ٤ٗ‫حُظ٤ظخ‬ٖ٤‫ر‬ ‫طظَحٝف‬ ‫ػوخٗش‬ ‫ًحص‬ ٫‫آظؼٔخ‬ َ‫ح٧ًؼ‬ :0.6ٝ1.5‫هخٍؿ٤ش‬ ٍ‫أهطخ‬ ‫ًحص‬ ٢‫رزَحؿ‬ ‫طؼزض‬ ٝ ْٓ ٖ٤‫ر‬ ‫طظَحٝف‬0.7ٝ2‫ٓظلَهش‬ ٍ‫أ١ٞح‬ ‫ٓغ‬ ْٓ -ّٞ٤ُ‫حُل٤ظخ‬‫حٌُٞرخُض‬ٌَُّٝ‫ٝح‬ٝmolydenum)) -‫ٓٔظٜش‬Resorbable(Polylactide،‫حُزُٞ٤َٔحص‬polyglycolic) +‫ح٧ٓ٬ى‬َ‫ػز‬‫ػظٔ٤ش‬.:-ٟٞ‫ٓٔظ‬ٍ‫ػخ‬(٢ٜ‫حُـز‬٢٘‫حُٞؿ‬٢ٜ‫ٝحُـز‬٢‫ح٧ٗل‬) -ٟٞ‫حُٔٔظ‬٢ٓٞ‫حُٔظ‬(١ٍ‫حُٔيح‬‫كخكش‬/‫حُٞؿ٘ش‬‫ىػخٓش‬) -ٟٞ‫ٓٔظ‬ٞ‫ٓ٘ول‬(‫حُٔ٘و٤ش‬/‫ٓ٘ظٜق‬‫حُل٘ي‬.)
  • 76.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 64 ‫د‬-‫ح٧ٓ٬ى‬‫طؼِ٤ن‬(‫طؼز٤ض‬ٌَ٤ُٜ‫ح‬٢ٔ‫حُؼظ‬) +: ٢ٜ‫ؿز‬-: ٢ٓٝ‫أ‬(٤ُ‫لٍٞص‬٢ٗ‫حُؼخ‬‫ٝحُؼخُغ؛‬‫كي‬َ٤‫ؿ‬َ‫ٓٔظو‬)‫رظؼِ٤ن‬ ٠‫طيػ‬ ٝKufner‫حُلي‬ ‫طؼِ٤ن‬ ْ‫٣ظ‬ ٝ ٢ٜ‫حُـز‬ ٢ٓٝ٧‫ح‬ ٢‫حُو‬ ٠ِ‫ػ‬ ‫ٍُ٣ؼش‬ ‫رٞحٓطش‬ -٢٘‫حُٞك‬(٤ُ‫لٍٞص‬٢ٗ‫حُؼخ‬‫ٝحُؼخُغ؛‬‫كي‬َ‫ٓٔظو‬)‫رظؼِ٤ن‬ ٠‫طيػ‬ :Thoma ١ِٞ‫حُؼ‬ ‫حُٔ٤ِحد‬ ‫هخع‬ ٠ُ‫ا‬ ٫ٞٛٝ ‫حُٞؿ٘٤ش‬ ّٞ‫حُو‬ ‫هِق‬ ‫ٓخ‬ ٠ُ‫ا‬ ٢ِ٠‫ػ‬ ‫طِٔ٤ن‬ ‫اؿَحء‬ ْ‫٣ظ‬ ‫حُلخؿذ‬ ‫كٞم‬ ٢‫ؿَحك‬ ‫ٗن‬ ‫اؿَحء‬ ‫رؼي‬ ٕ‫ٍ٣لَىح‬ ‫ارَس‬ ٍ‫اىهخ‬ ْ‫٣ظ‬‫ِٓي‬ ٍ‫اىهخ‬ ْ‫٣ظ‬ ْ‫ػ‬ ٢ٗ‫حُؼخ‬ ‫حُ٠خكي‬ ٢٘‫ٝك‬ ١ِٞ‫حُؼ‬ ‫حُٔ٤ِحد‬ ‫هخع‬ ‫ٗؼوذ‬ ٝ ٙ‫اؿَحء‬ ْ‫ط‬ ١ٌُ‫ح‬ ‫حُ٘لن‬ َ‫ػز‬ 0،45‫كٞم‬ ‫حُلخكش‬ ٢‫ك‬ ‫ػوزش‬ ٖٟٔ ‫حُِٔي‬ ‫طؼز٤ض‬ ‫رؼي‬ ٝ ‫حُلخؿذ‬ ‫كٞم‬ ٢‫حُـَحك‬ ‫حُ٘ن‬ ‫هخٍؽ‬ ٠ُ‫ا‬ ٚ‫ٓلز‬ ْ‫٣ظ‬ ٝ ‫ح٩رَس‬ ٖ٤‫ػ‬ ٖٟٔ ‫حُِٔي‬ ‫اػخىس‬ ْ‫٣ظ‬ ٝ ) ‫ٌِٓ٤ش‬ ‫ه٤خ١ش‬ ٝ‫أ‬ ‫طؼز٤ض‬ ‫ٛل٤لش‬ ٖٟٔ ٝ‫أ‬ ( ‫حُلـخؽ‬‫ا٣َ٣ي‬ ّٞ‫رو‬ ‫حُِٔي‬ ٢‫ٜٗخ٣ظ‬ ٢‫ٍر‬ ْ‫٣ظ‬ ٝ َُٔٔ‫ح‬ ْ‫ٗل‬ َ‫ػز‬ . ‫رخُؼوخٓش‬ ٢‫ٌٗظل‬ ٝ ْ‫حُل‬ َ‫ىحه‬ ٢‫حُـَحك‬ ‫حُؼوذ‬ ‫ُو٤خ١ش‬ ٢‫ىحػ‬ ٫ ٝ ‫حُ٘ن‬ ‫ه٤خ١ش‬ ْ‫٣ظ‬ ْ‫ػ‬ ) ‫ٓزخَٗس‬ ٕ‫ح٧ٓ٘خ‬ ٠ِ‫ػ‬ ٝ‫أ‬ (
  • 77.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 65 +٢٘‫حُٞؿ‬ ٍٞ‫ك‬ َ‫حُيحث‬ ١‫حَُرخ‬: ‫ٓ٘ظٜق‬ ٢‫ك‬ ‫حُِٔي‬ ٍ‫اىهخ‬ ْ‫٣ظ‬ ٌُٖ ٝ ‫حُظو٘٤ش‬ ْ‫ر٘ل‬‫حُلخكش‬ ٖٓ ٢ٜ‫حُـز‬ ٢٘‫حُٞؿ‬ ٝ ٢‫حُٜيؿ‬ ٢٘‫حُٞؿ‬ ٍُ‫حُي‬ ٖ٤‫ر‬ ٖٓ ‫حُٔٔخكش‬ . ٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ‫طلض‬ ٝ ‫حُٜيؿ٤ش‬ ‫حُؼ٠ِش‬ ‫ٛلخم‬ ‫كٞم‬ ٌٕٞ٣ ‫حُظِٔ٤ن‬ ٝ ‫حُؼِٞ٣ش‬ +٢٘‫حُٞؿ‬-٢ٜ‫حُـز‬: ‫حُؼِٞ٣ش‬ ‫حُؼخٗ٤ش‬ ٝ ٠ُٝ٧‫ح‬ ‫ح٧ٍكخء‬ ‫كٞم‬ ‫ٗن‬ ‫اؿَحء‬ ْ‫٣ظ‬ ْ‫حُل‬ َ‫ىحه‬ ٖٓ ٍٞ‫رط‬1٧‫ح‬ ٠ِ‫ػ‬ ْٓ٠ُ‫ا‬ ٍُٞٛٞ‫ح‬ ٠‫كظ‬ ‫حُ٘ٔؾ‬ ‫طِٔ٤ن‬ ْ‫٣ظ‬ ٝ َ‫ه‬ ‫حَُإ٣ش‬ ‫رٞحٓطش‬ ٝ ) ٢٘‫حُٞؿ‬ ٢ًَٓ ( ١ِٞ‫حُؼ‬ ٢ٌ‫ُِل‬ ٢٘‫حُٞؿ‬ ‫حُ٘خطت‬ ٍ‫اىهخ‬ ٝ ‫ػِ٤ٜخ‬ ‫حُظؼِ٤ن‬ ‫حَُٔحى‬ ‫حُ٘وطش‬ ٢‫ك‬ ْ‫حُؼظ‬ ‫ػوذ‬ ْ‫٣ظ‬ ‫حُٔزخَٗس‬ ‫رخُـز٤َس‬ ٝ‫أ‬ ‫ا٣َ٣ي‬ ّٞ‫رو‬ ٚ‫ٍرط‬ ٝ ٢‫ؿَحك‬ ‫ِٓي‬ ٫ٞٛ‫أ‬ ‫حُ٘ن‬ ‫ه٤خ١ش‬ ْ‫٣ظ‬ ْ‫ػ‬ +‫حُلـخؽ‬ ‫طلض‬ ‫حُلخكش‬: ‫حُِٔي‬ َ٣َٔ‫ط‬ ٝ ْ‫حُؼظ‬ ‫ُؼوذ‬ ‫حُلـخؽ‬ ‫طلض‬ ‫ٗن‬ ‫اؿَحء‬ ‫ٛ٘خ‬ ‫٣ـذ‬ ٫ٝ‫أ‬ ‫حُطَ٣وش‬ ْ‫ر٘ل‬ ٕ‫ٍ٣لَىح‬ ‫ارَس‬ ‫رٞحٓطش‬ ٢‫حُـَحك‬ ‫حُلـخؽ‬ ‫طلض‬ ‫حُؼٜذ‬ ‫أً٣ش‬ ‫ُظـ٘ذ‬ ٙ‫ح٩ٗظزخ‬ ‫٣ـذ‬ ٌُٖ ٝ َ‫ىحه‬ ‫ٗن‬ ‫ٛ٘خى‬ ٕ‫ًخ‬ ٍ‫كخ‬ ٢‫ك‬ ٕ‫ٍ٣لَىح‬ ‫ارَس‬ ٖ‫ػ‬ ‫ح٩ٓظـ٘خء‬ ٌٖٔ٣ ‫حُؼِٞ٣ش‬ ‫ح٧ٍكخء‬ ٟٞ‫ٓٔظ‬ ٠ِ‫ػ‬ ١ٞٔ‫ك‬ ٘ٛٝ ‫حُلـخؽ‬ ‫طلض‬ ‫ٗن‬ ‫اؿَحء‬ ٠ُ‫ا‬ ‫حُلخؿش‬ ٕٝ‫ى‬ ‫ٓظزؼش‬ ‫١َ٣وش‬ ‫خى‬ ‫ح٩ًظلخء‬ ْ‫٣ظ‬ ٝ ‫آظؼٔخُٜخ‬ ‫ؿيح‬ ٍ‫حُ٘خى‬ ٖٓ ٝ ‫طو٘٤خ‬ ‫ٓؼويس‬ ‫١َ٣وش‬ ‫ٌُٜ٘خ‬ ٢ُ‫ػخ‬ ‫طِٔ٤ن‬ ٝ ٞ٣َ‫ػ‬ ١ٞٔ‫ك‬ َ‫ىحه‬ ‫ر٘ن‬ ‫ك٤ٜخ‬
  • 78.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 66 +‫حٌُٔؼَ٣ش‬ ‫حُلظلش‬: ‫ِٜٓش‬ ‫١َ٣وش‬ ٢ٛ ٝ ‫ٓزخَٗس‬ ‫ٍإ٣ش‬ ٝ ١ٞٔ‫ك‬ َ‫ىحه‬ ‫ر٘ن‬ ‫ٛ٘خ‬ ٢‫ٌٗظل‬ +،‫حُيػخٓش‬َ‫ػز‬‫ح٧ٗق‬ +ٍٞ‫ك‬‫حُٔ٘ن‬ B)‫طؼز٤ض‬:٢‫حُوخٍؿ‬ ‫أ‬-: ٢ِ‫ٓل‬ ٢ٌ‫ك‬ ٢‫هلل‬ ٢‫حُولل‬ ٢ٜ‫حُٞؿ‬ ٍ‫ح٩١خ‬ +: ‫حُطَ٣وش‬ٍ ٝ ‫هي٣ٔش‬‫ٌُٜ٘خ‬‫اؿظٔخػ٤خ‬ ‫ٓظوزِش‬ َ٤‫ؿ‬ ٝ ‫ػِٔ٤خ‬ ‫ٓؼويس‬ ‫ٌُٜ٘خ‬ ٝ ‫طو٘٤خ‬ ‫ِٜٓش‬ ‫أٝطخى‬ ‫طؼز٤ض‬ ْ‫٣ظ‬ ‫ك٤غ‬) ٚ‫حُٞؿ‬ ًَِٓ ‫طٜ٤ذ‬ ٢‫حُظ‬ ٝ ‫حُٔظلظظش‬ ٌٍُِٞٔ ‫٣ٔظطذ‬ ًٚٗٞ ( ‫حُؼ٬ع‬ ‫حُٞؿٜ٤ش‬ ‫حُٔٔظٞ٣خص‬ ٠ِ‫ػ‬ ‫كٔذ‬ ‫حُٞطي‬ ‫طؼز٤ض‬ ٕ‫ٌٓخ‬ َ٤٤‫طـ‬ ٌٖٔ٣ ( ‫حٌُه٘٤ش‬ ‫حُؼوزش‬ ٟٞ‫ٓٔظ‬ ‫طلض‬ ٢‫حُٔل‬ ‫حُلي‬ ٠ِ‫ػ‬ ‫ح٧ٝطخى‬ ٖٓ ٖ٤‫ُٝؿ‬ ‫حُزيح٣ش‬ ٢‫ك‬ ‫٣ؼزض‬ ٤‫حُلـخؿ‬ ‫حُلخكش‬ ٠ِ‫ػ‬ ‫ح٧ٝطخى‬ ٖٓ ٖ٣َ‫آه‬ ٖ٤‫ُٝؿ‬ ‫٣ؼزض‬ ، ‫حُٔٞؿٞىس‬ ٌٍُٞٔ‫ح‬ٖٓ ٖ٤‫ُٝؿ‬ ‫طؼز٤ض‬ ‫حُلخؿش‬ ٍ‫كخ‬ ٢‫ك‬ ٝ ٌٖٔ٣ ، ‫حُؼِٞ٣ش‬ ‫ش‬ ٢ٗ‫ٓؼي‬ ٍ‫ا١خ‬ ‫رٞحٓطش‬ ‫أكو٤خ‬ ٝ ‫هخٛش‬ ‫أٝطخى‬ ‫رٞحٓطش‬ ‫ػٔٞى٣خ‬ ‫ح٧ٝطخى‬ َٛٝ ْ‫٣ظ‬ ٝ ٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ْٔ‫ؿ‬ ٠ِ‫ػ‬ ‫ح٧ٝطخى‬ ٢‫حُولل‬ ٢ٜ‫حُٞؿ‬ ٍ‫ح٩١خ‬ ‫ٓغ‬ َٓ‫حُظؼخ‬ ‫ُُٜٔٞش‬ ‫ٓؼيٗ٤ش‬ َٛ‫ٓلخ‬ ٖ‫ػ‬ ‫ػزخٍس‬ ‫حُٞٛ٬ص‬
  • 79.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 67 +ٍ‫ا١خ‬Halo: ‫ُٓ٘٤خ‬ ّ‫أهي‬ ٌُٚ٘ ٝ ٢‫حُولل‬ ٢ٜ‫حُٞؿ‬ ٍ‫ح٩١خ‬ َ٤‫ًز‬ ‫كي‬ ٠ُ‫ا‬ ٚ‫٣٘ز‬ ٍ‫ح٩١خ‬ ‫ٌٛح‬ ‫ؿٔ٤غ‬ ‫طؼزض‬ ‫ػِٞ٣ش‬ ‫ٓؼيٗ٤ش‬ ‫هخػيس‬ ٫‫ا‬ ١ٞ‫٣ل‬ ٫ ٌُٚ٘ ٝ ‫حُظو٘٤ش‬ ْ‫ٗل‬ ُٞ‫ٛخ‬ ٍ‫ا١خ‬ ‫٣ؼظٔي‬ ‫طوَ٣زخ‬ ‫ح٧ٝطخى‬ ‫٣ؼ٤ن‬ ‫ٓخ‬ ٞٛ ٝ ‫ٜٓ٘ق‬ ٢ٗ‫ٓؼي‬ ‫ٝطي‬ ٠ِ‫ػ‬ ١ٞ‫٣ل‬ ًٚٗٞ ‫ح٧ٓخٓ٤ش‬ ُٞ‫ٛخ‬ ٍ‫ا١خ‬ ‫ٌِٓ٘ش‬ ٓ‫حُظؼخ‬ ‫ٛؼذ‬ ٚٗ‫أ‬ ٝ ‫حُظـٌ٣ش‬ ‫ػِٔ٤ش‬َ٣ٞ‫طط‬ ْ‫ط‬ ‫أٓخٓخ‬ ‫ح٧ٓزخد‬ ‫ٌُٜح‬ ٝ َ٣‫حُؼي‬ ٝ َ ٢‫حُولل‬ ٢ٜ‫حُٞؿ‬ ٍ‫ح٩١خ‬ ‫حُـزٔ٤ش‬ ْ٣ٍ‫رخ‬ ‫هزؼش‬ +: ‫كبٜٗخ‬ ‫حُٔؼيٗ٤ش‬ ‫حُيػخٓخص‬ ٝ ‫حُوٞحػي‬ ٖ‫ػ‬ ‫ػٟٞخ‬ ٝ ‫حُظؼز٤ض‬ ٢‫ك‬ ّ‫ح٧هي‬ ‫حُطَ٣وش‬ ٢ٛ ٞ٣َُٔ‫ح‬ ٠ِ‫ػ‬ ‫كٍٞ٣خ‬ ‫طٜ٘غ‬ ٢ٛ ٝ ْ‫حُـز‬ ٖٓ ‫حُولل٤ش‬ ‫حُوزؼش‬ ٚ‫٣٘ز‬ ‫ٓخ‬ ٠ِ‫ػ‬ ١ٞ‫طل‬ ٖٓ ٝ‫طٜٔ٤ٜٔخ‬ ‫رؼي‬ ‫ػِ٤ٜخ‬ َ٣‫حُظؼي‬ َ٤‫حُٔٔظل‬ ‫د‬-٢‫هلل‬٢ٌ‫ك‬١ِٞ‫ػ‬: ‫كخ٫ص‬ ٢‫ك‬ ‫طٔظطذ‬ ‫ًخٗض‬‫ٝؿٞى‬ّ‫ػي‬٩‫ح‬ٍ‫ٓظوَح‬٢ٓ‫ح٧ٓخ‬٢‫حُوِل‬ٌَٖٓ٤ُٜ‫ح‬٢ٔ‫حُؼظ‬ٚ‫حُٞؿ‬. ‫آظط‬ ‫ٓ٠خى‬ َ‫طؼظز‬ ٝ ٠‫حُٔ٘ل‬ ٢‫ك‬ ‫١ٞ٣ِش‬ ‫ٗوخٛش‬ ‫ُلظَس‬ ‫طلظخؽ‬ ٝ ‫َٓٛوش‬ ‫أؿِٜس‬ َ‫طؼظز‬ ‫أٜٗخ‬ ٫‫ا‬ٝ ‫حُولل٤ش‬ ‫ح٩ٛخرخص‬ ‫كخ٫ص‬ ٢‫ك‬ ‫زخد‬ّ‫ػي‬ ... ‫حَُٜع‬ ٝ ٕ‫ح٩ىٓخ‬ ‫كخ٫ص‬ ٝ ٢ٌُ٘ٛ‫ح‬ ٍ‫ح٩ٓظوَح‬ +ْ٤‫ىرخر‬‫كٞم‬‫حُلـخؿ٤ش‬. +ْ٤‫ىرخر‬‫ٝؿ٘٤ش‬. +‫ا١خٍحص‬Halo. +‫ا١خٍحص‬LEVANT.
  • 80.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 68 G-٧‫ح‬ٝ ‫حَُٔحكوش‬ ‫ً٣خص‬٩‫ح‬‫هظ٬١خص‬: ٩ ‫ٗظَح‬‫ٍطزخ١خص‬ٝ ‫حُؼ٠ِ٤ش‬ ١ِٞ‫حُؼ‬ ‫حُلي‬ٝ ‫ٝػخث٤ش‬ ‫كِٓخ‬ ٟٞ‫٣ل‬ ًٚٗٞٝ ، ‫حُٔـخٍٝس‬ ‫حُؼظٔ٤ش‬‫حُـَحف‬ ٠ِ‫ػ‬ ‫ٌُح‬ ‫ٛخٓش‬ ‫ػٜز٤ش‬‫أ‬ٌٕٞ٣ ٕ ‫ر‬ ‫طخٓش‬ ‫ىٍح٣ش‬ ٠ِ‫ػ‬‫ؤ‬‫ر‬ ‫حُٜٔخد‬ ٞ٣َُٔ‫ح‬ ٕ‫ؤ‬‫ً٣خص‬‫ٝؿٜ٤ش‬‫ر‬ ‫ػخىس‬ ‫٣ٜخد‬‫ب‬ٝ ‫هظ٬١خص‬‫أ‬‫ٓ٘خ١ن‬ ٢‫ك‬ ‫َٓحكوش‬ ‫ً٣خص‬‫أ‬ٝ ‫ًخُـٔـٔش‬ َٟ‫ه‬‫حُؼٔٞى‬ ٝ َٟ‫حُلو‬ٝ ٍ‫حُٜي‬‫حُظ٘لٔ٤ش‬ ‫حُطَم‬ٝ‫حُلـخ‬ ‫ؿٞف‬٩‫ح‬ ‫ٓزذ‬ ‫كٔذ‬ ‫ؽ‬ٝ ‫ٛخرش‬‫٣ـذ‬‫أ‬ٝ ‫طليى‬ ٕ‫حُٜ٘خث‬ ‫حُؼ٬ؽ‬ َ‫هز‬ ‫رَٔػش‬ َ‫طير‬٢ ٚ‫حُٞؿ‬ ٌٍُٞٔ. ٝٝ ‫ًحطٜخ‬ ‫رلي‬ ‫ُِل٤خس‬ ‫ٜٓيى‬ َ٤‫ؿ‬ ٚ‫حُٞؿ‬ ‫ٓ٘ظٜق‬ ًٍٞٔ ًٕٞ ٖٓ ْ‫رخَُؿ‬‫كخى‬ ْ‫ط٘ل‬ ‫طٞهق‬ ‫طٔزذ‬ ‫هي‬ ‫ٌُٜ٘خ‬‫أ‬ٝ ، َ٣ِ‫ؿ‬ ‫ِٗف‬ ٝ٠ُ‫رخُظخ‬ ٝ ، َ٤‫حُظير‬ ‫كَٔػش‬ُ‫ح‬ ‫حُٔؼخُـش‬‫ٔٞؿٜش‬‫أ‬‫ٓخٓ٤ش‬‫ُٔ٘غ‬٧‫ح‬‫ً٣خص‬‫حُل٤خس‬ ‫طٜي٣ي‬ ٝ‫أ‬ ْ‫حُظلخه‬ ٖٓ ‫حَُٔحكوش‬، ‫ط‬ ٌٖٔ٣‫ؤ‬ٞ٣َُِٔ َٓ‫حٌُخ‬ ‫حُٟٞغ‬ َ‫٣ٔظو‬ ٠‫كظ‬ ٌٍُِٞٔ ‫حُلخٓٔش‬ ‫حُٔؼخُـش‬ َ٤‫ؿ‬ ٧‫ح‬ ٍ‫طٌَح‬ ‫رٔزذ‬ٝ ‫ُٔؼخُـش‬ َٛ‫ٓئ‬ ٠‫١ز‬ ‫كَ٣ن‬ ‫ٓ٬كظش‬ ‫طلض‬ ‫حُزيح٣ش‬ ٌ٘ٓ ٞ٣َُٔ‫ح‬ ‫ٟٝغ‬ ‫٣ـذ‬ ‫حَُٔحكوش‬ ‫ً٣خص‬ٝ ، َُٟٝٞ‫ح‬ ٚ٤‫ط٘و‬ ٩ ‫ًُي‬٩‫ح‬ ‫حُٔؼخُـش‬ ‫ؿَحء‬٨ُ ‫ٓؼخك٤ش‬ُ‫ح‬ ‫ً٣خص‬ٔ‫َحكوش‬. ٧‫ح‬ ٖٓ‫حَُٔحكوش‬ ‫ً٣خص‬‫حُ٘خثؼش‬: ‫ط٬كع‬ ‫ك٤غ‬ ، ‫ٝحُؼ٤٘٤ش‬ ‫حُلـخؿ٤ش‬ ‫ح٫ً٣خص‬٢‫ك‬20٧‫ح‬ ٖٓ %ٝ ، ‫حُٞؿٜ٤ش‬ ‫ً٣خص‬َٗ‫ٓزخ‬ ٌَ٘‫ر‬ ‫طليع‬ ٢ٛ‫ٗظ٤ـش‬ُ‫حُلـخؽ‬ َٝ‫أ‬ٝ ٝ ١ِٞ‫حُؼ‬ ‫حُلي‬ ًٍٞٔ ‫ٗظ٤ـش‬ َٗ‫ٓزخ‬ َ٤‫ؿ‬ ٌَ٘‫ر‬ٝ ، ٠٘‫حُٞؿ‬ ْ‫حُؼظ‬‫هي‬ ‫ٜٓ٘خ‬ َ٤ِ‫حُو‬‫٣ليع‬‫أ‬‫حُٔؼخُـش‬ ‫ػ٘خء‬‫أ‬ٟٝ‫حُ٤ي‬ ‫حَُى‬ ٝ. ‫أ‬‫األ‬ ٌ‫ه‬‫ػ‬‫و‬ ‫شاض‬‫اىحجاج‬ ‫ىنسش‬ ‫اىؼالٍاخ‬: ‫طلض‬ ‫ِٗف‬ ، ‫حُِٔظلٔش‬ ‫ًٝٓش‬ ، ‫حُلـخؽ‬ ‫طلض‬ ‫ًٝٓش‬، ‫حُِٔظلٔش‬‫ا‬٧‫ح‬ ‫ٓظَهخء‬ٝ ، ٕ‫ؿلخ‬‫حُ٘لغ‬‫ا‬‫ؿئ‬ ، ‫حَُإ٣ش‬ ‫ُىٝحؿ٤ش‬ٖٝ٤‫حُؼ‬ ٍ‫أ‬ٝ ‫ؿلٞظٜخ‬ٝ ٌَُٔ‫ح‬ ْ‫كـ‬ ‫كٔذ‬‫ا‬‫حُلـخؽ‬ َ‫ُيحه‬ ٚٛ‫طـخ‬‫أ‬، ٖ٤‫ُِؼ‬ ‫ًحط٤ش‬ ‫كًَش‬ ، ٚ‫ُوخٍؿ‬ ٝ‫ا‬‫ػ٤٘٤ش‬ ‫هظ٬١خص‬‫أ‬ٍُِ‫ًخ‬ َٟ‫ه‬‫حُٔخء‬ ‫م‬ ٧‫ح‬ ‫حُٔخء‬ ‫ٝحُٔخى‬ ‫حُٔٞىحء‬‫ٍُم‬. ً ‫َُِإ٣ش‬ ٕ‫كويح‬ ‫٣ليع‬‫ب‬١٬‫هظ‬،٧‫ح‬ُ‫حُظخ‬ ٠ٔ‫حُؼ‬ ٞٛ ‫ٗ٤ٞػخ‬ َ‫ًؼ‬٢٩َٜ‫حُز‬ ‫حُؼٜذ‬ ١‫ٗ٠ـخ‬١‫ك٤غ‬‫ا‬َُٞٓ ُْ‫حُؼخ‬ ‫هظَف‬‫أ‬‫٣ليع‬ ‫ػ٘يٓخ‬ ٚٗ ‫ك‬ ، ‫ٝحكي‬ ‫ؿخٗذ‬ ٢‫ك‬ ‫َُِإ٣ش‬ ٕ‫كويح‬‫ب‬‫٣ظٞهغ‬ ٚٗ‫ٝؿٞى‬ٝ ‫حُلـخؽ‬ ‫ؿٞف‬ ‫هٔش‬ َ‫ػز‬ ًَٔٚ‫حُٞؿ‬ ‫ٓ٘ظٜق‬ ًٍٞٔ ‫ٍى‬ ّ‫ػي‬ ‫٣ـذ‬ ‫ػ٘يٛخ‬. ‫حُٜ٘ق‬ ‫ُٞكَٝص‬ ًٍٞٔ ٕ‫كخ‬ ّ‫ػخ‬ ٌَ٘‫ٝر‬3ًٝ٧‫ح‬ ْ‫ػظ‬ ًٍٞٔ ‫ٌُي‬ٝ ‫حُلـخؽ‬ ‫ؿٞف‬ ٢‫ك‬ ًٍٞٔ ‫طٔزذ‬ ‫ٗق‬ٝ ، ٍٚٗ‫ؿيح‬َٜ‫ط‬ ‫هي‬‫ا‬٠ُ ٝ ، ‫حُلـخؽ‬ ‫ًٍٝس‬ٝ ، ٚٗ‫ؿيٍح‬، ‫حُلـخؽ‬ ‫ًٍٝس‬ ٠ُ‫ح‬ َٜ‫ط‬ ‫هي‬‫ف‬15ٝ ٠َُٟٔ‫ح‬ ٖٓ %ٖ٣ٌُ‫ح‬٧‫ح‬ ‫كيٝع‬ ‫ػ٘ي‬ ٠‫ُِٞػ‬ ‫كوي‬ ٖٓ ‫ػخٗٞح‬، ًٟ ‫هي‬‫أ‬‫ٓظ‬ ٌَ٘‫ر‬ ‫ٛ٤زٞح‬‫ؤ‬‫ر‬ َ‫ه‬‫ب‬‫ىٓخ‬ ‫ٟطَحد‬ً ‫ٓخ‬ ٠‫ؿ‬‫خَُٜحع‬‫أ‬، ‫ٗلٔ٤ش‬ ‫طزي٫ص‬ ٝ ٝ‫أ‬٩‫ح‬ ‫ٓخ‬‫حُلي‬ ٢‫ك‬ ‫طليع‬ ٢‫حُظ‬ ‫هظ٬١خص‬‫ك‬ ١ِٞ‫حُؼ‬‫ب‬‫طوغ‬ ‫هِٔخ‬ ‫ٜٗخ‬‫ا‬ِ‫ط‬ ‫ًح‬‫و‬ٝ ‫ٓزٌَس‬ ‫ٓؼخُـش‬ ٚ‫حُٞؿ‬ ‫ٓ٘ظٜق‬ ًٍٞٔ ‫ض‬ٝ ، ‫ًخك٤ش‬‫ط٘ظؾ‬ ٩‫ح‬٩‫ح‬ ٖ‫ػ‬ ‫هظ٬١خص‬ٝ ‫ٗلٜٔخ‬ ‫ٛخرش‬‫هي‬ٌٕٞ‫ط‬‫حُٔظخهَس‬ ‫ُِٔؼخُـش‬ ‫طخُ٤ش‬‫أ‬ٝ ، ‫حُوخ١جش‬ ٝ‫٣ـذ‬‫أ‬ٛ‫ُِٔظخ‬ ‫ٝحػ٤خ‬ ‫حُطز٤ذ‬ ٌٕٞ‫ط‬ ٕ‫حُٔظ‬ َ‫ؤ‬‫هَس‬ ٪ُٛ‫خ‬‫حُيٓخؿ٤ش‬ ‫رخص‬. ‫مسش‬‫قاع‬‫اىحجاج‬‫أ‬‫و‬‫اىنسش‬‫اإل‬‫ّفجاسي‬ : Orbital Blow-out Fracture ‫حُلـخؽ‬ٞٛ‫حُظـَ٣ق‬٢ٔ‫حُؼظ‬٢٤‫حُٔل‬ٖ٤‫رخُؼ‬‫ٝ٣٘ظؾ‬ٖ‫ػ‬ٍٝ٢ٓ‫أٓخ‬‫ٌَُس‬ ٖ٤‫حُؼ‬‫أ‬ٝ‫كخىع‬َ٤ٓ‫أ‬ٝ١‫ح‬‫كخىع‬‫ٗخطؾ‬ٖ‫ػ‬‫ا‬ّ‫ٍططخ‬ٚ‫حُٞؿ‬‫ر٘٠ء‬‫ِٛذ‬ (ٗ‫ٓزخ‬ ّ‫اٍططخ‬ َ‫اػ‬ ‫٣٘خٛي‬ ‫ٓخ‬ ‫ؿخُزخ‬ْ‫رؼظ‬ ‫ٗخرٜٜخ‬ ‫ٓخ‬ ٝ‫أ‬ ْ٘‫حُظ‬ ‫ٌَُس‬ َ ) َٗ‫ٓزخ‬ ٌَ٘‫ر‬ ٝ ‫حُلـخؽ‬ َ‫٣٘ظو‬َُٝ‫ح‬ٌَ٘‫ر‬١ٍ‫اؿزخ‬‫ُوخػيس‬‫حُلـخؽ‬٢ٔ‫حُؼظ‬‫حُ٠ؼ٤لش‬ٌَٔ٘‫كظ‬،
  • 81.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 69 ‫حَُٔ٣َ٣ش‬ ‫حُؼ٬ٓخص‬: -‫حُِٔظلٔش‬ ‫طلض‬ ‫ًيٓش‬ -‫حُٜ٘٤ن‬ ‫ػ٘ي‬ ‫١وطوش‬ ‫ٓٔخع‬ -‫حُليهخص‬ ٟٞ‫ٓٔظ‬ َ‫ط٘خظ‬ ّ‫ػي‬ -‫ٗلغ‬ -ٙٞ‫ه‬ -٢ِ‫حُٔل‬ ٖ‫حُـل‬ ٙٞ٘‫ط‬ -‫ٓظ٬ُٓش‬( ١ِٞ‫حُؼ‬ ٢‫حُلـخؿ‬ ‫حُ٘ن‬‫ِٓ٣ؾ‬َِٖٖٓٗ٤‫حُؼ‬ّ‫حُظخ‬‫ٓغ‬َ٣‫طوي‬،‫حُوَٗ٤ش‬ٖ‫حُـل‬١ِٞ‫حُؼ‬ٝ‫حُٜ٘ق‬ْ‫ر٘ل‬‫حُـخٗذ‬ٖٓ ‫حُـزٜش‬) ‫طؤً٤ي‬ ْ‫٣ظ‬ٚ٤‫ط٘و‬ًٍّٞٔ‫ػظخ‬‫حُلـخؽ‬‫ر‬‫بؿَحء‬‫أ‬‫ٗؼش‬ ‫ٓوطؼ٤ش‬ٝ‫أ‬ٖ٤ٍٗ٢ٔ٤١‫ٓـ٘خ‬٠ِ‫ػ‬‫حُلـخؽ‬‫أ‬ٝ٠‫كظ‬ٍُٜٙٞ‫ح‬ ُ‫ح‬ٚ٤‫٘ؼخػ‬ٚ‫حُزٔ٤ط‬‫ًُي‬٠‫كظ‬‫ٌٗظ٘ق‬ٕ‫ٌٓخ‬‫حَُ٘م‬ٝ‫أ‬ ٌَُٔ‫ح‬٢ٔ‫حُؼظ‬‫ًٌُٝي‬ُ‫ٔؼَكش‬‫ػ٠٬ص‬ٖ٤‫حُؼ‬‫حُٔلٍ٘ٞس‬ َ‫ىحه‬‫ٌٛح‬ٌَُٔ‫ح‬، ٝ١‫طئى‬ٞ‫رؼ‬‫ا‬‫ٛخرخص‬‫حُلـخؽ‬٠ُ‫ا‬‫َٗم‬ٝ‫أ‬ًَٔ٢‫ك‬ٌٙٛ ّ‫حُؼظخ‬َ٘‫كظ٘ل‬‫ػ٠٬ص‬ٖ٤‫حُؼ‬َ‫ىحه‬‫ٌٛح‬‫حَُ٘م‬ٝ‫أ‬ٌَُٔ‫ح‬ ٝ‫طٜزق‬‫ػخؿِس‬ٖ‫ػ‬‫طلَ٣ي‬ٖ٤‫حُؼ‬ٝ‫أ‬َ‫ًؼ‬‫حُؼ٠٬ص‬ً‫ح‬َ‫طؤػ‬ٖٓ ‫ا‬‫ٛخرخص‬ّ‫ػظخ‬‫حُلـخؽ‬٢ٛ‫حُؼ٠٬ص‬‫حُٔلِ٤ش‬ٝ١‫٣ئى‬ ‫ا‬ّ‫كظزخ‬‫حُؼ٠٬ص‬‫حُٔلِ٤ش‬َ‫ىحه‬ٌٍُٞٔ‫ح‬‫حُؼظٔ٤ش‬٠ُ‫ا‬ ّ‫ػي‬‫هيٍس‬ٖ٤‫حُؼ‬٠ُ‫ا‬‫حُلًَش‬٠ُ‫ا‬٠ِ‫أػ‬‫ػِٔ٤ش‬ ٍ٬‫ه‬ ١َٜ‫ه‬ ٌَ٘‫ر‬ ٠ِ‫ُ٨ػ‬ ٖ٤‫حُؼ‬ ‫ًَس‬ َ‫كظ‬ ‫ٓلخُٝش‬ ٟ‫ُي‬ ‫ؿِ٤خ‬ ‫٣٬كع‬ ‫ٓخ‬ ٞٛ ٝ ٚ‫حُلل‬
  • 82.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 70 ‫٣٬كع‬٠ِ‫ػ‬‫ٛئ٫ء‬٠َُٟٔ‫ح‬ْٜٗ‫أ‬‫ػ٘يٓخ‬َٕٝ‫٣٘ظ‬٠ُ‫ا‬٠ِ‫أػ‬ٕ‫كب‬ٖ٤‫حُؼ‬‫حُِٔ٤ٔش‬‫طظلَى‬٠ُ‫ا‬٠ِ‫أػ‬‫ر٤٘ٔخ‬ٖ٤‫حُؼ‬‫حُٜٔخرش‬٬‫ك‬،‫طَطلغ‬ ٝ‫هي‬٢‫٣ٜز‬ٞ‫رؼ‬‫ٌٓٞٗخص‬َ‫حُٔلـ‬ْٝ‫حُ٘ل‬ٝ‫أ‬‫حُؼ٠ِش‬‫حُٔٔظو٤ٔش‬‫حُٔلِ٤ش‬٠ُ‫ا‬‫ؿٞف‬‫حُـ٤ذ‬٢ٌ‫حُل‬ ١‫٣ئى‬ٌَُٔ‫ح‬ٍٝ‫ُـئ‬ٖ٤‫حُؼ‬ٝ‫طليى‬‫كًَخطٜخ‬ٝ‫هي‬‫٣ليع‬‫ٗلغ‬ٍ‫رخ٫رٜخ‬. ‫حُٔؼخُـش‬: ‫اؿَحء‬‫ؿَحكش‬َ٣َ‫ُظل‬‫حُ٘ٔؾ‬‫حُؼخُوش‬ٞ٣ٞ‫ٝطؼ‬‫حُـِء‬٢ٔ‫حُؼظ‬‫حُٔلوٞى‬. ‫هي‬‫٣ليع‬ٍٞ‫حُل‬١ٞٗ‫حُؼخ‬‫أ٣٠خ‬‫رؼي‬‫ػِٔ٤خص‬‫كـخؽ‬ٖ٤‫حُؼ‬،‫حُٔوظِلش‬ٖٓٝ‫أٜٛٔخ‬‫ػِٔ٤ش‬‫طول٤ق‬٢‫حُ٠ـ‬،‫رخُلـخؽ‬ٝ‫ػِٔ٤خص‬‫اٛ٬ف‬ ًٍٞٔ،‫حُلـخؽ‬ٌٕٝٞ٣‫ًُي‬‫ٗظ٤ـش‬١ٞ‫ُٜز‬‫حُؼ٠٬ص‬ٝ‫ح٧ٗٔـش‬‫حَُهٞس‬َ‫ىحه‬‫حُـ٤ٞد‬‫ح٧ٗل٤ش‬‫رطَ٣وش‬َ٤‫ؿ‬،‫ٓ٘ظظٔش‬ٝ‫أ‬‫حُظٜخم‬ ‫حُؼ٠ِش‬‫حُٔٔظو٤ٔش‬‫حُٔلِ٤ش‬‫رخُ٘ٔ٤ؾ‬،‫حٍُِٔٝع‬‫ٝ٣ؼظٔي‬‫كيٝع‬َ‫ٓؼ‬‫ٌٛح‬‫حُ٘ٞع‬ٍٖٓٞ‫حُل‬٠ِ‫ػ‬‫ػيس‬َٓ‫ػٞح‬،‫ٜٓ٘خ‬َٔ‫ػ‬،ٞ٣َُٔ‫ح‬ ‫ٝٝهض‬‫اؿَحء‬‫حُـَحكش‬‫رخُ٘ٔزش‬‫ُليٝع‬،ٌَُٔ‫ح‬‫ٝٗٞع‬‫حُؼِٔ٤ش‬،‫حُٔٔظويٓش‬ٝ‫ٗٞع‬‫حُ٘ٔ٤ؾ‬ّ‫حُٔٔظوي‬٠‫ك‬‫اٛ٬ف‬ٌَُٔ‫ح‬,ٝ٠‫ك‬ ‫أؿِذ‬ٕ‫ح٧ك٤خ‬ْ‫٣ظ‬‫حُ٘لخء‬ٍٖٓٞ‫حُل‬‫طِوخث٤خ‬٠‫ك‬ٕٞ٠‫ؿ‬‫ٓظش‬َٜٗ‫أ‬‫رؼي‬‫حُـَحكش‬.‫ٝػ٬ؽ‬‫ٌٛح‬ٍٞ‫حُل‬ٌٕٞ٣ً‫خ‬٤‫ؿَحك‬‫رٟٞغ‬‫َٗ٣لش‬ ‫ر٬ٓظ٤ٌ٤ش‬َٜ‫طل‬‫حُؼ٠٬ص‬‫حُٔلٍ٘ٞس‬ٖ‫ػ‬ّ‫حُؼظخ‬‫حٌٍُٔٔٞس‬٠‫كظ‬‫طٔظط٤غ‬‫حُظلَى‬‫رلَ٣ش‬.
  • 83.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 71 **‫حُـَحك٤ش‬ َ‫حُٔيحه‬ -‫حُِٔظلٔش‬ َ‫ػز‬Transconjunctival:‫ػوذ‬ ‫ُظـ٘ذ‬ ‫ػخُ٤ش‬ ‫ٜٓخٍس‬ ‫طظطِذ‬ ٝ ‫ىه٤وش‬ ‫ِٓ٤ش‬ ٢ٛ ٝ ٖ‫حُـل‬ َ‫ٗط‬ ‫رؼِٔ٤ش‬ ‫أ٣٠خ‬ ٠‫طيػ‬ ‫حُِٔظلٔش‬ ٝ‫أ‬ ٖ‫حُـل‬ ‫ؿِي‬ -٢ِ‫حُٔل‬ ٖ‫حُـل‬ َ‫ػز‬Subciliary:ٖ‫حُـل‬ ٢ُ‫طي‬ ‫حُؼِٔ٤ش‬ ٌٙٛ ‫اهظ٬١خص‬ ٖٓ -‫حُلـخؽ‬ ‫طلض‬Subtarsal:‫اٗظ٘خٍح‬ َ‫ح٧ًؼ‬ ٝ ‫أٓخٗخ‬ َ‫ح٧ًؼ‬ ‫حُؼِٔ٤ش‬ ٢ٛ ٝ -: ٢ٌ‫حُل‬ ‫حُـ٤ذ‬ َ‫ػز‬ٝ ١‫ؿِي‬ ‫ٗن‬ ٠ُ‫ا‬ ‫حُؼِٔ٤ش‬ ٌٙٛ ‫طلظخؽ‬ ٫ ٝ َ‫ح٧ٓل‬ ّ ‫حُلـخؽ‬ ‫هخع‬ ‫ٗظخ٣خ‬ ْ‫ىػ‬ ٠ُ‫ا‬ ‫حُؼِٔ٤ش‬ ٌٙٛ ‫طٜيف‬ ١ٞٔ‫ك‬ َ‫ىحه‬ ‫ر٘ن‬ ٢‫ٌٗظل‬
  • 84.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 72 : ‫حُلـخؽ‬ ‫هخع‬ ْ٤َٓ‫ط‬ ** ‫طَٓ٤ٔ٤ش‬ ‫ٓٞحى‬ ‫ػيس‬ َٔ‫ٗٔظؼ‬ ‫ٌُُي‬ ٝ ْ٤َٓ‫ط‬ ٠ُ‫ا‬ ‫حُلـخؽ‬ ‫هخع‬ ‫٣لظخؽ‬ 1-ْ‫حُطؼ‬٢‫ًحط‬:-ّ‫حُؼظخ‬(،‫حُـٔـٔش‬،‫ح٧ٟ٬ع‬٢‫حُلَهل‬) -‫ؿ٠َٝف‬ 2-ُ‫ح‬ّٞ‫طؼ‬‫حُٜ٘ؼ٤ش‬:-‫حُـخك٤ش‬‫حُٔـللش‬‫رخُظزَ٣ي‬ 3-: ‫حُٔـخ٣َس‬ ّٞ‫حُطؼ‬-‫٣ٍِع‬SiliasticٝPROPLAST -ِٕٞ‫طل‬ -٢ًٍٔٝ‫ٛ٤ي‬‫أ‬‫رخط٤ض‬ -‫ٗزٌش‬ّٞ٤ٗ‫حُظ٤ظخ‬) ٫‫آظؼٔخ‬ َ‫ح٧ًؼ‬ ٢ٛ ٝ () ‫حٍُٜٞس‬ ( H-َ٤ٛ‫حُظؤ‬: .‫حُٔ٘ظًَش‬ ‫ح٩كظ٤خ١خص‬ ٞ‫رؼ‬ ‫طٔظٞؿذ‬ َ٤ٛ‫طؤ‬ ‫ُلظَس‬ ٚ‫حُٞؿ‬ ًٍٞٔ ‫ؿٔ٤غ‬ ‫طلظخؽ‬ ّ‫ػخ‬ ٌَ٘‫ر‬ ٫ٌٖٔ٣‫ا‬ُ‫ح‬ ِٚ‫حَُٔك‬ ٢‫ك‬ ‫ريٗ٤ش‬ ٖ٣ٍ‫طٔخ‬ ١‫أ‬ ‫ؿَحء‬٩‫ح‬ ٖٓ ٌَٙ‫ٔز‬‫ٝؿٞى‬ ‫ػ٘ي‬ ٚٛ‫هخ‬ ٚ‫ٛخر‬‫ا‬ٝ ْ‫حُظ٘ل‬ ‫ػخهش‬‫ٓخ‬ ‫ؿخُزخ‬ ١ٌُ‫ح‬َٙ‫ُلظ‬ َٔ‫٣ٔظ‬ ‫ٓؼ٤٘ش‬ٚ‫ح٫ٛخر‬ ‫ُ٘يس‬ ‫طزؼخ‬ -ٖ٤ٓٞ٣ ‫ُٔيس‬ ‫ٍحكش‬ ‫رؼي‬ ‫طيٍ٣ـ٤خ‬ ١‫حُ٘٘خ‬ ‫٣زيأ‬ ٩‫ح‬‫أٓخر٤غ‬ ‫ٓظش‬ ‫٣ٔظـَم‬ ً‫خ‬‫ؿخُز‬ ‫ٓظ٘لخء‬,ٝ٩‫ح‬ َ‫٣ؼظز‬٫ ‫ػ٘يٓخ‬ ً٬ٓ‫ًخ‬ ّ‫ُظجخ‬ٝ ٌَُٔ‫ح‬ ٕ‫ٌٓخ‬ ٢‫ك‬ ُْ‫أ‬ ‫ٛ٘خى‬ ٌٕٞ٣‫ح٧ٗؼش‬ َٜ‫طظ‬ ‫ػ٘يٓخ‬ ٩‫ح‬ّ‫ُِؼظخ‬ َٓ‫حٌُخ‬ ّ‫ُظلخ‬. ٝ٩‫ح‬ َ‫هز‬ َٙ‫حُلظ‬ ٍ٬‫ه‬ ‫٣ٜ٘ق‬٢‫٣ؤط‬ ‫رٔخ‬ ّ‫ُظجخ‬: -٢‫حُ٠ـ‬ ٖٓ ٚ‫حُٞؿ‬ ‫ُلٔخ٣ش‬ َٜ‫حُظ‬ ٠ِ‫ػ‬ ُّٞ٘‫ح‬ -ٍٝ‫ط٘خ‬‫أ‬‫حُٔ٠ؾ‬ ‫ِٜٓش‬ ‫ؿٌ٣ش‬‫ط‬ٝ ٖ٤‫حُزَٝط‬ ٖٓ ‫ًز٤َس‬ ‫ًٔ٤خص‬ ٠ِ‫ػ‬ ١ٞ‫لظ‬‫حُلي‬ ‫طؼز٤ض‬ ‫أػ٘خء‬ ّ‫أ٣خ‬ ‫ُؼيس‬ َ‫حُٔٞحث‬ ( ٖٓ َ‫أًؼ‬ ‫ُٔيس‬ ‫ٍَٟٝ٣ش‬ ٌٕٞ‫ٓظ‬ َ‫رخُٔٞحث‬ ‫حُظـٌ٣ش‬8. ‫)أٓخر٤غ‬ -‫أ‬ٚ‫ٝحٌُل‬ ّ‫حُؼطخ‬ َ‫ٓؼ‬ ‫رَكن‬ ٚ‫حُٞؿ‬ ‫كًَخص‬ ‫ىحء‬‫ٝحُظو٤ئ‬.…‫حُن‬
  • 85.
  • 86.
  • 87.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 73 ‫ح٧ٗق‬ ْ‫ػظ‬ ًٍٞٔ٢ُ‫حُـَرخ‬ ٢‫ح٧ٗل‬ ‫حًَُٔذ‬ ٝ A-: ‫ٓويٓش‬ ‫ح٧ٗق‬ ّ‫ػظخ‬ ٟ‫اكي‬ ًَٔ ٞٛ ٌٍُٞٔٔ‫ح‬ ‫ح٧ٗق‬‫ًُي‬ ٝٝ ٚ‫حُٞؿ‬ ٖٓ ‫ح٧ٗق‬ َُٝ‫ر‬ ‫رٔزذ‬ٗ‫ٛ٘خ‬ٚ‫ظ‬ ٝ ً‫خ‬‫ٗ٤ٞػ‬ ‫ح٩ٛخرخص‬ َ‫أًؼ‬ ٖٓ ‫ٝحكي‬ ٌٍُٞٔٔ‫ح‬ ‫ح٧ٗق‬ ٖٝٓ ‫٣وَد‬ ‫ٓخ‬ ْ٠‫ط‬ ٢‫حُظ‬ ٢ٛ40ٚ‫حُٞؿ‬ ٢‫ك‬ ‫ح٩ٛخرخص‬ ‫ؿٔ٤غ‬ ٖٓ ٪. ٚ‫حُٞؿ‬ ٖٓ ٢ٓٝ٨ُ‫ح‬ ‫حُؼِغ‬ ٢‫ك‬ ‫حُٜ٘ش‬ ّ‫حُؼظخ‬ ٖٓ ٢ُ‫حُـَرخ‬ ٢‫ح٧ٗل‬ ‫حًَُٔذ‬ َ‫٣ؼظز‬ ٝ
  • 88.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 74 B-٧‫ح‬: ‫ٓزخد‬ )+ٝ ‫حُؼِٞ٣ش‬ ‫حُظ٘لٔ٤ش‬ ‫ُِطَم‬ ٠ِ‫ح٧ػ‬ ْٔ‫حُو‬ ٢‫ك‬ ‫ح٧ٗق‬ ‫٣وغ‬ٞٛٝ ٍٝ٧‫ح‬ َُٔٔ‫ح‬ٝ ٕ‫ح٩ٗٔخ‬ ‫ػ٘ي‬ ْ‫ُِظ٘ل‬ ٢ٓ‫ح٧ٓخ‬ٞ٠‫حُؼ‬ ٞٛ ٍُ‫حُزخ‬ٝ ‫رخُـش‬ ‫ربٛخرخص‬ َُِٟٝٞ َٝ‫ٓؼ‬ ٞٛ ‫ٌُُي‬ ٚ‫ُِٞؿ‬‫ريٍؿخص‬ٝ ‫ٓوظِلش‬ٝ ‫ح٧ٗق‬ ْ‫ػظ‬ ًَٔ ٠ُ‫ا‬ ١‫طئى‬ ‫ٓظ٘ٞػش‬ ‫١َم‬‫ٗٔزش‬ ‫طزِؾ‬ ٢ُ‫كٞح‬ ٍ‫ٝح٧١لخ‬ ٖ٤‫حُزخُـ‬ ٖ٤‫ر‬ ‫ح٩ٛخرش‬٣٣ٝ ٚ‫حُٞؿ‬ ٍٟٝٞ ٖٓ ٪‫ر٘ٔزش‬ ‫ح٩ٗخع‬ ٖٓ ًٌٍُٞ‫ح‬ ‫ػ٘ي‬ "‫ٗ٤ٞػخ‬ َ‫ح٧ًؼ‬ ٢ٛ٢‫׃‬١ٖٓ ٖ٤‫ر‬ ١١‫ـ‬٢١ًٝ‫خ‬ٜٛٞ‫ه‬ٖ٤٤ٟ‫حَُ٣خ‬ ‫ػ٘ي‬. )+٢‫ك‬ ٚ‫ًٍٝط‬ ‫٣زِؾ‬ ‫ح٧ٗق‬ ًَٔ ٕ‫كب‬ ‫ح٩ٗخع‬ ٠ُ‫ا‬ ‫رخُ٘ٔزش‬ ‫أٓخ‬ٝ ٚ‫حُٞؿ‬ ٠ِ‫ػ‬ ١ٞ‫ُِٔو‬ ‫ٗظ٤ـش‬ ‫ٓ٘ش‬ ٖ٤‫حُٔظ‬ َٔ‫ػ‬‫ح٧ٗق‬ ًٍٞٔ ‫أؿِذ‬ ‫ػ٘ي‬ٝ ٖ٤‫حُٔلظَك‬ ٖٓ ‫حَُ٣خٟش‬ ٍٕٞٓ‫٣ٔخ‬ ٖ٣ٌُِ ٌٕٞ‫ط‬ ‫حُ٘زخد‬ٝ ‫حُٜٞحس‬ً‫خ‬ٜٛٞ‫ه‬‫حُٔ٬ًٔش‬ َ‫ٓؼ‬ ‫حُؼ٘٤لش‬ ‫حَُ٣خٟش‬ ٍٕٞٓ‫٣ٔخ‬ ٖ٣ٌُ‫ح‬ ‫اُن‬ ...‫ٝحُٜٔخٍػش‬ٝ ,ٝ ّ‫حُوي‬ ‫ًَس‬ َ‫ٓؼ‬ ‫حٌَُٝ٣ش‬ ‫حَُ٣خٟش‬ ٠‫كظ‬‫ًَس‬‫حُِٔش....اُن‬‫رخُ٘ٔزش‬ ‫أٓخ‬ ,‫ك٘ٔزش‬ ٍ‫ح٧١لخ‬ ‫ػ٘ي‬ ‫ح٧ٗق‬ ٌٍُٞٔ ٜ‫كيٝػ‬‫خ‬ٜٜ٤‫ط٘و‬ ‫٣ٜؼذ‬ ٚٗ‫أ‬ ‫ك٤غ‬ ٖ٤‫حُزخُـ‬ ٖٓ َ‫أه‬‫خ‬ٝ‫ط‬ٛٞ٘‫ط‬ َ‫أه‬ ٌٕٞ‫خ‬ٖٓ ‫رَُٝح‬ َ‫أه‬ ٌٕٞ٣ ٍ‫ح٧١لخ‬ ‫ػ٘ي‬ ‫ح٧ٗق‬ ٕ٧ ٖ٤‫حُزخُـ‬ ٖٓ ٖ٤‫حُزخُـ‬. )+‫ح٧ٗق‬ ٠ِ‫ػ‬ ١ٞ‫حُٔو‬ ٝ‫أ‬ ‫حٌُِٔش‬ ٖٓ ‫أٗي‬ ‫ح٧ٗق‬ ٠ِ‫ػ‬ ٍٟٝٞ ‫حُٔ٤خٍحص‬ ‫كٞحىع‬ ‫طٔزذ‬ ‫ٓخ‬ ‫ؿخُزخ‬ )+‫٣ِىحى‬ًَٔ َ‫هط‬ْ‫ػظ‬‫ح٧ٗق‬َٓ‫ػٞح‬ ‫ػيس‬ ‫رٔزذ‬ٝٔ٘‫ط‬: َ ٍ‫ح٧ػٔخ‬ *‫ٓظويٓش‬ *‫َٛع‬ *‫ح٧ٗق‬ ‫اٛخرش‬ ٝ‫أ‬ ‫حُٔخرن‬ ‫أٗق‬ ًَٔ *٧‫ح‬‫حَُ٣خٟخص‬ ‫(ٝهخٛش‬ ‫حَُ٣خٟ٤ش‬ ‫ُؼخد‬) ‫حُؼ٘٤لش‬ *ّ‫ػي‬ٍ‫ا‬‫حُٔ٤خٍس‬ ٢‫ك‬ ٕ‫ح٧ٓخ‬ ّ‫كِح‬ ‫طيحء‬ٕ‫ح٧ك٤خ‬ ٞ‫رؼ‬ ٢‫ك‬ ‫أ٣٠خ‬ ٌٖٔ٣ ‫حُٜٞحء‬ ّ‫(أً٤خ‬ٕ‫أ‬‫اٛخرخص‬ ‫طٔزذ‬. ) C-:‫طٜ٘٤ق‬ *ٝ ٙ‫اطـخ‬ ‫رلٔذ‬ ‫ح٧ٗق‬ ًَٔ ‫طٜ٘٤ق‬ ْ‫٣ظ‬ٝ ‫ىٍؿش‬ٝ ‫ح٧ٗق‬ ٠ِ‫ػ‬ ‫حُ٠َرش‬ ِ٤ًَ‫ط‬ٌَُٔ‫ح‬ ْٔ‫٣و‬ٝ ٢‫ؿخٗز‬ ًَٔ ٠ُ‫ا‬٢ٓ‫أٓخ‬ ًَٔ ‫ىٍؿخص‬ ‫ػ٬ع‬ ٠ُ‫ا‬ ‫ٜٓ٘ٔخ‬ ًَ ْٔ‫ٝ٣و‬:-‫هل٤ق‬ -٢ٓٞ‫ٓظ‬ -‫ٗي٣ي‬ ٝٝ‫أ‬ ‫ح٧ٗل٤ش‬ ‫حُـ٤ٞد‬ ٕ‫ؿيٍح‬ ٢‫ك‬ ًَٔ ٝ‫أ‬ ٢‫ح٧ٗل‬ ِ‫حُلخؿ‬ ٢‫ك‬ ‫اٛخرش‬ ‫ح٧ٗق‬ ْ‫ػظ‬ ًَٔ ‫٣َحكن‬ ‫هي‬ًَٔٝ‫أ‬ ‫حُٔن‬ ‫هخع‬ ٢‫ك‬‫طـٞ٣ق‬ ْ‫ػظ‬ .‫ٝحُلي‬ ٚ‫حُٞؿ‬ ْ‫ػظ‬ ٝ‫أ‬ ٖ٤‫حُؼ‬
  • 89.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 75 *ٜ٘٣ ‫ًٔخ‬ًَٔ "‫أ٣٠خ‬ ‫ق‬‫آخ‬ ‫ح٧ٗق‬:-٢‫هخٍؿ‬ ١‫ؿِي‬ ‫ؿَف‬ ‫٫٣ٞؿي‬ ‫ػ٘يٓخ‬ ٢٤ٔ‫ر‬ ًَٔ، -ٌَُٔ‫ح‬ ‫ٓغ‬ ٢‫هخٍؿ‬ ‫ؿَف‬ ‫رٞؿٞى‬ ‫ٓ٠خػق‬ ًَٔ. *‫حُول٤لش‬ ‫حَُٔػش‬ ًٝ َُٝ‫ح‬ ‫ػخىس‬ ‫ٓززٜخ‬ ‫حُٔؼُِٝش‬ ‫ح٧ٗق‬ ًٍٞٔ ٕ‫ا‬. ٌَُٔ‫ح‬ ٌَٗ ٠ِ‫ػ‬ ‫٣ؼظٔي‬ ‫ح٧ٗق‬ ٌٍُٞٔ ّ‫حُؼخ‬ ‫حُظٜ٘٤ق‬ *: ٚ‫حُٞؿ‬ ٢‫ك‬ ٌٍٞٔ‫ر‬ ‫ػخىس‬ ‫٣ظَحكن‬ ‫ح٧ٗق‬ ًَٔ ٕ‫كب‬ ‫ػخُ٤ش‬ ‫َٓػش‬ ًٝ َُٝ ‫ح٧ٗق‬ َٝ‫طؼ‬ ‫اًح‬. ‫ح٧ٗق‬ ًٍٞٔ ‫طٜ٘ق‬) ٢ُ‫حُـَرخ‬ ‫حًَُٔذ‬ ٝ (ٝ ‫حُ٘يس‬ ٢‫ك‬ ‫ٓظيٍؿش‬ ‫أٛ٘خف‬ ‫ػ٬ػش‬ ٠ُ‫ا‬٩‫ح‬ٖٓ ‫ٓظيحى‬1٠ُ‫ا‬3:‫طٜ٘٤ق‬MARCHOWITZ A-‫حُٜ٘ق‬( ْ‫ٍه‬1): ٖٓ ٝ‫أ‬ ّ‫ح٧ٓخ‬ ٖٓ ‫ح٧ٗق‬ ٠ِ‫ػ‬ ٍٝ ‫رٔزذ‬ ‫ػخىس‬ ٌٕٞ٣ٝ ّ‫ح٧ٓخ‬ًَٔ( ‫حُٞطَس‬ ٢‫ك‬ ١‫ػٔٞى‬ ًَٔ ٠ُ‫ا‬ ١‫٣ئى‬ ‫ٓٔخ‬ ‫حُـخٗذ‬Chevallet) ‫ٓغ‬‫ا‬‫ح٧ٗق‬ ّ‫ػظخ‬ ٖٓ ‫حُزؼ٤ي‬ ْٔ‫حُو‬ ٢‫ك‬ ٍ‫طزي‬ ٝ‫أ‬ ‫ٗؤخف‬.
  • 90.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 76 B-( ْ‫ٍه‬ ‫حُٜ٘ق‬2): ٠ِ‫ػ‬ ٢‫ؿخٗز‬ ٍٝ ‫رٔزذ‬ ً‫خ‬‫ؿخُز‬ ٞٛ‫كَف‬ ٌَ٘‫ر‬ ٝ‫أ‬ ٢‫أكو‬ ًَٔ ٠ُ‫ا‬ ١‫٣ئى‬ ‫ٓٔخ‬ ‫ح٧ٗق‬C(ًَٔJavjavay)َٔ٘٣ ‫حُٞطَس‬ ٢‫ك‬ ‫حُٜل٤لش‬٢ٌ‫ُِل‬ ٢ٜ‫حُـز‬ ‫حُ٘خطت‬ ٢‫ك‬ ًَٔ ‫ٓغ‬ ‫حُٞطَس‬ ‫ؿ٠َٝف‬ ‫ٓغ‬ ٢ُ‫حُـَرخ‬ ْ‫ُِؼظ‬ ‫حُوخثٔش‬. C-( ْ‫ٍه‬ ‫حُٜ٘ق‬3): ٝ ‫ٗيس‬ َ‫أًؼ‬ َُٝ‫ح‬ ٕ‫أ‬ ٠ِ‫ػ‬ ٍ‫٣ي‬ٝ َ‫أًز‬ ‫َٓػش‬ ًٝ١‫٣ئى‬٢ُ‫حُـَرخ‬ ٚ٤‫حُظ‬ َٔ٘٤ُ ‫٣ٔظي‬ ‫أٗق‬ ًَٔ ٠ُ‫ا‬٢ُ‫ُِـَرخ‬ ‫حُوخثٔش‬ ‫حُٜل٤لش‬ ، ٝ ‫حُوِق‬ ٠ُ‫ا‬ ٍٝ‫طي‬‫حُلظلخص‬ َُٝ‫ٝر‬ ‫ح٧ٗق‬ ‫ًٍٝس‬ ‫ٍكغ‬ ٠ُ‫ا‬ ‫ٓئى٣ش‬ ٚ‫حُٞؿ‬ َ‫ىحه‬ ‫حُٞطَس‬ ٚٔ‫ط٘و‬.‫ح٧ٗل٤ش‬ٝ‫ٛ٘خى‬‫ا‬٢‫ك‬ ‫ٗي٣ي‬ ‫ٗؤخف‬ ٝ ‫ح٧ٗق‬ ّ‫ػظخ‬ْ‫حُؼظ‬ ‫طلض‬ ‫ُظٜزق‬ 4‫غ‬‫يك‬‫ط‬ ٢‫حُظ‬‫ٝٛ٘خى‬ ،٢ٜ‫حُـز‬‫ا‬ٖ٤٘٤‫حُؼ‬ ٖ٤‫ر‬ ‫ُِٔٔخكش‬ ‫ٝحٟق‬ ‫طٔخع‬Telecanthus
  • 91.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 77 D-ٝ‫ح٧ػَح‬: ‫ح٧ٗق‬ ًَٔ ٝ‫أػَح‬ َٔ٘‫ط‬*:ٝ ‫حٌُيٓخص‬ٍّٞ‫حُظ‬ *ٝ ‫ح٧ٗق‬ ٖٓ ‫ِٗ٣ق‬.ٚ‫حُٞؿ‬ ٖٓ ‫ح٧ٗق‬ ‫ٓ٘طوش‬ *ٙٞ٘‫ط‬ ٝ ُْ‫أ‬:٢‫ك‬ ١ٝ‫طٔخ‬ ّ‫ػي‬ ٝ‫أ‬ ‫ح٧ٗق‬ ‫ٓويٓش‬ ٢‫ك‬ ٝ‫اٗولخ‬ ٝ‫أ‬ ‫ح٧ٗق‬ ْ‫ػظ‬ ٢‫ك‬ ‫طٔطق‬ َٔ٣٧‫ح‬ ٝ‫أ‬ ٖٔ٣٧‫ح‬ ‫حُـخٗذ‬ ٢‫ك‬ ‫ح٧ٗق‬ ٌَٗ، ٖ٤‫حُٔٞه‬ ‫طزخػي‬ * *ْ‫حُظ٘ل‬ ٢‫ك‬ ‫ٛؼٞرش‬ ٞ٣َُٔ‫ح‬ ٚ‫٣ٞحؿ‬ ‫هي‬) ‫ح٧ٗق‬ ‫(اٗٔيحى‬‫طِق‬ ‫كخُش‬ ٢‫(ك‬ ‫ُحثي‬ ‫ٍػخف‬ ٝ‫أ‬ )‫ُ٨ٗق‬ ٢١‫حُٔوخ‬ ‫حُـ٘خء‬ُْ٘‫ح‬ ‫ُلخٓش‬ ٕ‫كويح‬ ٝ‫أ‬ , *ٖ٤٘٤‫حُؼ‬ ٬ً ٝ‫أ‬ ٚ٤٘٤‫ػ‬ ‫أكي‬ ٍٞ‫ك‬ ‫ًيٓخص‬ ٖٓ ً‫خ‬٠٣‫أ‬ ٞ٣َُٔ‫ح‬ ٢ٗ‫٣ؼخ‬ ‫هي‬‫ط٬كع‬ ‫ٓخ‬ ‫ؿخُزخ‬ ( ‫رؼي‬ ‫ؿ٤ي‬ ٌَ٘‫ر‬12) ‫ح٩ٛخرش‬ ‫رؼي‬ ‫ٓخػش‬ ‫ٗلغ‬ ‫ٝؿٞى‬ ‫ٗ٬كع‬ ‫حُ٘ي٣يس‬ ‫ح٩ٛخرخص‬ ٢‫ك‬ * *٠ِ‫ػ‬ ٍ‫٣ي‬ ‫ح٧ٗق‬ ٖٓ ٢‫ٓخث‬ َ‫ٓخث‬ ‫هَٝؽ‬‫حُٔن‬ ‫هخع‬ ْ‫ػظ‬ ٢‫ك‬ ًَٔ ٍ‫حُٔخء‬ ٢‫ك‬ ‫طَٔد‬ ‫ٛ٘خى‬ ٌٕٞ٣ ٕ‫أ‬ َٝ‫٣لظ‬ ٢ُ‫حُـَرخ‬ ‫حًَُٔذ‬ ٝ ‫ح٧ٗق‬ ًٍٞٔ ًَ ٢‫ك‬ ‫حُزيأ‬ ‫٣ـذ‬ ‫ٌُح‬ ٌْ‫حُؼ‬ ‫٣ؼزض‬ ٠‫كظ‬ ‫َٓ٣َ٣خ‬ ‫ٓٞؿٞىح‬ ٌٖ٣ ُْ ٝ ٠‫كظ‬ ٢ًُٞ٘‫ح‬ ٢‫حُيٓخؿ‬ ‫حُٔ٘خٓزش‬ ‫حُيٝحث٤ش‬ ‫رخُٔؼخُـش‬. ٢‫حُيٓخؿ‬ َ‫حُٔخث‬ ‫طَٔد‬ ٝ ‫ح٧ٗل٤ش‬ ‫ح٩كَحُحص‬ ٖ٤‫ر‬ ‫حُظلَ٣ن‬ ٌٖٔ٣‫رؼيس‬ ٢ًُٞ٘‫ح‬ : ‫د‬ ‫ح٩ٓظؼخٗش‬ ٌٖٔ٣ ‫َٓ٣َ٣خ‬ ٌُٖ ٝ ‫ٓوزَ٣ش‬ ‫١َم‬ ‫ُ٪كَحُحص‬ ٢‫حُٜخك‬ ُِٕٞ‫ح‬ ٌْ‫ػ‬ ٢ًُٞ٘‫ح‬ ٢‫حُيٓخؿ‬ َ‫ُِٔخث‬ ٢٘‫حُو‬ ُِٕٞ‫ح‬ *‫ح٧ٗل٤ش‬ ٢‫ح٩٣ـخر‬ ‫حُٜخُش‬ ٍ‫اهظزخ‬ *: ٝ ‫طَٗ٤ق‬ ‫ٍٝهش‬ ٠ِ‫ػ‬ ٚ٘ٓ ‫هطَس‬ ‫ٟٝغ‬ ٌٖٔ٤‫ك‬ ١ٞٓ‫ى‬ ٢‫ح٧ٗل‬ ٕ٬٤ُٔ‫ح‬ ٕ‫ًخ‬ ٍ‫كخ‬ ٢‫ك‬ ًَِٓ ٝ ‫ٗلخكش‬ ‫ٛخُش‬ ‫ك٘٘خٛي‬ ّ‫حُي‬ ٖٓ ‫أَٓع‬ ٢ًُٞ٘‫ح‬ َ‫حُٔخث‬ ٍ‫اٗظ٘خ‬ ٕ‫أ‬ ‫رٔخ‬ ٠ٓ‫ٓي‬. ٢ًُٞ٘‫ح‬ ٢‫حُيٓخؿ‬ َ‫حُٔخث‬ ٖ٤‫ر‬ ًُٞٞ‫حُـ‬ ِ٤ًَ‫ط‬ ٖ٤‫ر‬ ‫ٓوخٍٗش‬ *ّٝ‫ٓؼي‬ ٚ‫(ٗز‬ ٢‫ح٧ٗل‬ َ‫حُٔخث‬ ٝ ) ٢ُ‫ػخ‬ ()
  • 92.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 78 E-ٚ٤‫حُظ٘و‬ *ٝ‫أ‬ ً‫خ‬٣َٜ‫ر‬ ‫ح٧ٗق‬ ًٍٞٔ ‫طلي٣ي‬ ْ‫٣ظ‬ُ‫ح‬ ٚ‫حُلل‬ ٍ٬‫ه‬ ٖٓ١َ٣َٔ *ٝ ٢َُٜٓ‫ح‬ ‫ح٧ٗق‬ ْ‫ػظ‬ ٚ‫كل‬ ‫٣ـذ‬ ٚ‫حُلل‬ ‫ػ٘ي‬ٝ ‫ح٧ٗق‬ ‫ٓويٓش‬ٝ ‫حُوخٍؿ٤ش‬ ‫ح٧ٗق‬ ‫ؿ٠خٍ٣ق‬ ٝ َٓ‫ًخ‬ ٚ‫حُٞؿ‬ ْ‫ػظ‬ ٠ُ‫ا‬ ‫رخ٩ٟخكش‬ ‫ح٧ٗق‬ َ‫ىحه‬ٝ ‫حُـٔـٔش‬ ْ‫ػظ‬ٝ ٖ٤‫حُؼ‬ ‫طـٞ٣ق‬ ْ‫ػظ‬‫٣ـذ‬ ٝ ‫ح٧ٗق‬ ٢‫ك‬ ٙٞ٘‫ط‬ ١‫أ‬ ‫ٓ٬كظش‬ْ‫ػظ‬ ٢‫ك‬ ‫طلَى‬ ١‫أ‬ٝ ‫ح٧ٗق‬ٝ ‫ح٧ٗق‬ ُْٔ ‫ػ٘ي‬ ُْ‫أ‬ ١‫أ‬‫٫ري‬ ٝ ‫حُـِي‬ ٚ‫كل‬ ٖٓٝ ٌَُٔ‫ح‬ ‫ٓغ‬ ‫هخٍؿ٤ش‬ ‫ؿَٝف‬ ‫ٝؿٞى‬ ّ‫ػي‬ ٖٓ ‫حُظؤًي‬‫ح٧ٗق‬ َ‫ىحه‬ ٚ‫كل‬ ‫٣ـذ‬ ْ٤ً ٝ‫أ‬ ‫ػوذ‬ ٝ‫أ‬ ‫حُٔوخ١٤ش‬ ‫رخ٧ؿ٘٤ش‬ ْٜ٘‫ط‬ ‫ٝؿٞى‬ ّ‫ػي‬ ٖٓ ‫ُِظؤًي‬ ‫ح٧ٗق‬ ٍ‫ٓ٘ظخ‬ ‫١َ٣ن‬ ٖ‫ػ‬ ٝ ‫ح٧ٗل٤ش‬ ‫حُوَٗ٤خص‬ ٢‫ك‬ ْٜ٘‫ط‬ ٝ‫أ‬ ٢‫ح٧ٗل‬ ِ‫حُلخؿ‬ ٢‫ك‬ ١ٞٓ‫ى‬َ‫حُٔخث‬ ‫طَٔد‬ ّ‫ػي‬٠ُ‫ا‬ ٢‫حُيٓخؿ‬ ٝ ‫ح٧ٗق‬‫ح٧ٗق‬ َ‫ىحه‬ ٢‫ك‬ ‫طٜذ‬ ٢‫حُظ‬ ‫حُيٓؼ٤ش‬ ‫حُو٘خس‬ ‫اٛخرش‬ ّ‫ػي‬ ٖٓ ‫حُظؤًي‬. *‫ح٧ُٝٞ٣ش‬٢ِٛ٤٤ٔ‫ُِظ‬ٖ٤‫ر‬ٌٍُٞٔ‫ح‬‫حُزٔ٤طش‬‫حُٔظؼِوش‬ّ‫رؼظخ‬‫ح٧ٗق‬(‫ٗٞع‬1)ٌٍُٝٞٔ‫ح‬٢‫حُظ‬ َٔ٘‫ط‬ً‫خ‬٠٣‫أ‬ّ‫ػظخ‬ٚ‫حُٞؿ‬َٟ‫ح٧ه‬ٝ/ٝ‫أ‬ِ‫كخؿ‬‫ح٧ٗق‬(‫أٗٞحع‬2ٝ3.) ٖ٤‫ر‬ ‫حُٔٔخكش‬ ٚ‫كل‬ ٍ‫اؿلخ‬ ‫ػٔي‬ ‫٣ـذ‬ *ُ ٖ٤٘٤‫حُؼ‬ٖ٤٘٤‫حُؼ‬ ‫ٓآم‬ ٢‫ك‬ ‫طزخػي‬ ١‫أ‬ ‫ٔ٬كظش‬ٖٓ َ‫أه‬ ‫١ز٤ؼ٤خ‬ ْ٤‫طو‬ ٢‫حُظ‬ ٝ35ْٓ ‫طؤً٤ي‬ َ‫أؿ‬ ٖٓ‫١َ٣وش‬ ‫ٗظزغ‬ ٢٘٤‫حُؼ‬ ‫حُٔٞم‬ ‫اٛخرش‬‫ح٧ٛخرغ‬ ‫ٟٝغ‬ ‫ٓغ‬ ‫ُِوخٍؽ‬ ‫حُٞك٘٤ش‬ ٚ‫ؿٜظ‬ ٖٓ ٖ‫حُـل‬ ‫رٔلذ‬ ّٞ‫ٗو‬ : َ‫حُٞط‬ ٍ‫اهظزخ‬ ٢‫ك‬ ٝ ٌَُٔ‫ح‬ ‫هطغ‬ ‫كًَش‬ ْٔ‫ٗظل‬ ‫رٌُي‬ ٝ ‫ٗلٜٔخ‬ ٖ٤‫ُِؼ‬ ‫حُيحهِ٤ش‬ ‫حُِحٝ٣ش‬ ٠ِ‫ػ‬٠ِ‫ػ‬ ٍ‫٣ي‬ ‫كٌُي‬ ‫حُٔلذ‬ ٠ِ‫ػ‬ ‫ٓوخٝٓش‬ ١‫أ‬ ‫ؿ٤خد‬ ٌَُٔ‫ح‬ ‫ٝؿٞى‬
  • 93.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 79 ٢ُ‫حُـَرخ‬ ٢‫ح٧ٗل‬ ‫حًَُٔذ‬ ًٍٞٔ ‫كخ٫ص‬ ٢‫ك‬ ‫طٜخد‬ ‫ٓخ‬ ‫ؿخُزخ‬ ٢‫حُظ‬ ٝ ‫حُيٓؼ٤ش‬ ‫حُو٘خس‬ ٝ ‫حُيٓغ‬ َٟ‫ٓـ‬ ْ٤٤‫طو‬ ‫٣ـذ‬ * *‫ٍٝحء‬ ‫ٓخ‬ ‫ٓلخؿجش‬ ‫هِ٤ِش‬ ‫ٓؼِٞٓخص‬ َ‫طٞك‬ ٍٝ٧‫ح‬ ٢٤ٔ‫حُز‬ ‫حُ٘ٞع‬ ٌٍُٞٔ ‫حُٔ٤٘٤ش‬ ‫ح٧ٗؼش‬ ١َ٣َُٔ‫ح‬ ٚ‫حُلل‬‫حُٔ٤٘٤ش‬ ‫رخ٧ٗؼش‬ ٚ٤‫حُظ٘و‬ ‫طؤً٤ي‬ ْ‫٣ظ‬ ‫هي‬ .‫ؿخٗز٤ش‬ ‫ٍٛٞس‬ ( ) ‫ُ٨ٗق‬ٝ ‫حُٔوطؼ٤ش‬ ‫ح٧ٗؼش‬ ٝ‫أ‬٢‫ك‬ َٟ‫أه‬ ‫ربٛخرخص‬ ٙ‫ح٧ٗظزخ‬ ْ‫ط‬ ‫اًح‬ ‫ٓطِٞرش‬ ٌٙٛ ‫ِٓلش‬ َ٤‫ؿ‬ ‫حُزٔ٤طش‬ ‫ح٧ٗق‬ ّ‫ػظخ‬ ًٍٞٔ ‫ػ٬ؽ‬ ٕ‫أ‬ ٖٓ ْ‫حَُؿ‬ ٠ِ‫ػ‬ .ٚ‫حُٞؿ‬٢‫ك‬ ٫‫ا‬ ( ) ٢ُ‫حُـَرخ‬ ‫حًَُٔذ‬ ٢‫ك‬ ‫اٛخرش‬ ‫ٓغ‬ ‫طَحكوٜخ‬ ٍ‫كخ‬ٓ ‫ُؼ٬ؽ‬ ‫ح٩كخُش‬ ْ‫٣ظ‬‫ُٔيس‬ ‫ليى‬5-7 ٢‫ًخك‬ ٌٕٞ٣ ‫ػخىس‬ ّ‫أ٣خ‬. ‫٣ـذ‬ ٢ًُٞ٘‫ح‬ ٢‫حُيٓخؿ‬ َ‫حُٔخث‬ ٢‫ك‬ ‫طَٔد‬ ٝ‫أ‬ ‫ػٜز٤ش‬ ‫ػ٬ٓخص‬ ‫ٝؿٞى‬ ٍ‫كخ‬ ٢‫ك‬ * ‫ح٧رؼخى‬ ‫ػ٬ػ٤ش‬ ٝ ‫ػ٘خث٤ش‬ ‫ٓوطؼ٤ش‬ ٍٞٛ ‫اؿَحء‬ : ‫ٓلٍٞ٣ش‬ ٝ ‫طخؿ٤ش‬ ‫ٓوخ١غ‬ : ‫ح٧رؼخى‬ ‫ػ٬ػ٤ش‬ َ٤ٌ٘‫ط‬ ‫اػخىس‬
  • 94.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 80 *‫ػ٬هش‬ ‫ُٜخ‬ ‫اٛخرش‬ ‫ٛ٘خى‬‫ح٧ٗق‬ ٌٍٞٔ‫ر‬ٝ٢ٛٝ ٢‫ح٧ٗل‬ ِ‫حُلخؿ‬ ٢‫ك‬ ١ٞٓ‫ى‬ ٍّٝ‫ط‬‫ليع‬٢‫ك‬٢ُ‫كٞح‬5ٝ ‫حُلخ٫ص‬ ٖٓ %٫‫ط‬‫ػ٬ؽ‬ ‫لظخؽ‬ ٝ ٍ‫ػخ‬‫٣ـذ‬‫ا‬‫ح٧ٗق‬ ‫اٛخرخص‬ ْ٤٤‫طو‬ ‫ػظٔخى‬. *٤‫ؿ‬ ‫حُزٔ٤طش‬ ٌٍُٞٔ‫ح‬ ْ‫ٓؼظ‬ ٢‫ك‬١٧ َٓ٧‫ح‬ ‫٣لظخؽ‬ ٫ ‫حُٔوظِطش‬ َ‫ا‬‫ٓظوٜخءحص‬‫ك‬ ‫هطٍٞس‬ َ‫ح٧ًؼ‬ َُٟٝٞ‫ح‬ ٢‫ك‬ ٌُٖ ،ٍُٜٞ‫ح‬ ٕ‫ب‬ ٩‫ح‬ َ‫أًؼ‬ ٢ٛ ‫حُ٘ؼخػ٤ش‬.‫أٛٔ٤ش‬ ‫ٓظوٜخءحص‬ ‫٣ـذ‬‫ُِـٔـٔش‬ ‫ٗؼخػ٤ش‬ ‫ٍٛٞح‬ ٖٔ٠‫طظ‬ ٕ‫أ‬ٚ‫،حُٞؿ‬ٝ‫ح٧ٗل٤ش‬ ّ‫حُؼظخ‬‫ا‬٠ِ‫ػ‬ ً‫ح‬‫ػظٔخى‬‫ا‬ٝ ‫ٓظيحى‬ٝ‫ُ٨ؿَح‬ ‫ٛخٓش‬ ٌٕٞ‫ط‬ ‫هي‬ .‫ح٧ً٣ش‬ ‫ٗيس‬ ‫حَُ٘ػ٤ش‬ ‫حُطز٤ش‬. ‫حُ٘ي‬ ‫ٝؿٞى‬ ‫ػ٘ي‬ ‫حُٞؿٜ٤ش‬ ‫حُلٌ٤ش‬ ٌٍُٞٔ‫ح‬ ‫٣ٟٞق‬ ‫هي‬ ْ‫حُؼظ‬ ٠ِ‫ػ‬ ِ٤ًَ‫حُظ‬ ‫ٓغ‬ ١ٍٞ‫حُٔل‬ ٢‫حُطزو‬ َ٣ٜٞ‫حُظ‬ ٕ‫ا‬. F-‫ا‬ٌَُٔ‫ح‬ ‫هظ٬١خص‬: ‫حُو٘خس‬ ‫أً٣ش‬‫حُيٓؼ٤ش‬ٝ‫حُٜٔلٞ٣ش‬ ‫حُٜل٤لش‬ ًَْٔٝٗ ‫كوي‬ٝ٢ًٞٗ ٢‫ىٓخؿ‬ َ‫ٓخث‬ ٕ٬٤َٓ‫ح٧ًؼ‬ ٝ ‫هطٍٞس‬ َ‫ح٧ًؼ‬ َ‫٣ؼظز‬ ١ٌُ‫ح‬ ٝ ‫حُٜٔخد‬ ‫ُل٤خس‬ ‫طٜي٣يح‬٣ ٕ‫أ‬ ‫٣ـذ‬ ١ٌُ‫ح‬ ٝ‫ح٧ٗق‬ ًٍٞٔ ‫ػ٬ؽ‬ َ‫هز‬ ٠‫كظ‬ ‫ؼخُؾ‬ ‫ُِٝؿش‬ َ‫أًؼ‬ ٌٕٞ‫ط‬ ٢‫حُظ‬ ( ‫ُ٨ٗق‬ ‫حُطز٤ؼ٤ش‬ ‫حُٔلَُحص‬ ٝ ٢ًُٞ٘‫ح‬ ٢‫حُيٓخؿ‬ َ‫حُٔخث‬ ٕ٬٤ٓ ٖ٤‫ر‬ ‫حُظلَ٣ن‬ ‫٣ـذ‬‫حُٜؼذ‬ ‫حُ٘٢ء‬ ) َُِٝ ٢ُ‫حُظخ‬ ٢‫ح٧ٗل‬ ‫رخُِ٘ف‬ ٕ‫٣وظِطخ‬ ٖ٣َُ‫حُٔل‬ ٬ً ٕ‫أ‬ ‫ٗظَح‬ ‫ٗٔز٤خ‬ ٠ِ‫ػ‬ ١ٞ‫٣لظ‬ ٢ًُٞ٘‫ح‬ ٢‫حُيٓخؿ‬ َ‫حُٔخث‬ ًٕٞ ‫ٓوزَ٣خ‬ ٝ‫أ‬ ‫حُِِٝؿش‬ ‫ر٘ٔزش‬ ‫َٓ٣َ٣خ‬ ‫ر٤ٜ٘ٔخ‬ ‫حُظلَ٣ن‬ ٌٖٔ٣ًُِٞٞ‫حُـ‬ ٝ ٖ٤‫حُزَٝط‬٠ِ‫ػ‬ . ‫ُ٨ٗق‬ ‫حُطز٤ؼ٤ش‬ ‫حُٔلَُحص‬ ٌْ‫ػ‬ G-‫حُؼ٬ؽ‬: *‫ح٧ٗق‬ ًٍٞٔ ٕ‫ربٌٓخ‬ٝ ‫رِ٤ؾ‬ ٢ِ٤ٔ‫طـ‬ ٙٞ٘‫ط‬ ‫ٛ٘خى‬ ْ٤ِ‫ك‬ ‫ٗلٜٔخ‬ ‫طِوخء‬ ٖٓ ‫حُ٘لخء‬ ‫حُطل٤لش‬‫ػ٬ؽ‬ ‫ٝٛق‬ ٌٖٔ٣‫حُؼِؾ‬ ‫ًٔخىحص‬ ّ‫رؼي‬ ٍٞ‫حُ٘ؼ‬ ‫ُظول٤ق‬ ُْ٨ُ‫حُ٘وخٛش‬ ‫ٝهض‬ ‫أػ٘خء‬ ‫حَُحكش‬. *ْ‫٣ظ‬ٍ ‫ح٧ٗق‬ ٠ِ‫ػ‬ ‫رخٍىس‬ ‫ًٔخىس‬ ٝ‫أ‬ ‫حُؼِؾ‬ ‫ططز٤ن‬15-20‫ىه٤وش‬‫ُؼيس‬ ّٞ٤ُ‫ح‬ ٢‫ك‬ ‫َٓحص‬ ‫ػيس‬ ,‫ٓخػخص‬ُْ٧‫ح‬ َ٤ِ‫طو‬ ٢‫ك‬ ‫٣ٔخػي‬ ‫ٌٛح‬ . ٍّٞ‫ٝحُظ‬. ‫طـِ٤ق‬ ‫٣ـذ‬ٝ‫أ‬ ‫حُؼِؾ‬ُ‫ح‬‫ٌٔخىس‬ُ‫ح‬‫ٓ٘٘لش‬ ٢‫ك‬ ‫زخٍىس‬ٝ٫‫ططز٤ن‬ ْ‫٣ظ‬‫حُـِي‬ ٠ِ‫ػ‬ ‫ٓزخَٗس‬ ‫حُؼِؾ‬. *ٝ ً‫ح‬‫ؿ٤ي‬ ‫حُـَٝف‬ ‫ط٘ظ٤ق‬ ‫٣ـذ‬.‫حُٔٞؿٞىس‬ ‫ح٧ؿ٘ز٤ش‬ ّ‫ح٧ؿٔخ‬ ًَ ‫اُحُش‬ *‫ٓلظٞكش‬ ‫حُٔلـخص‬ ‫طَى‬ َ٠‫٣ل‬ .‫حُٔ٘خٓذ‬ ‫رخُٜخى‬ ٞ٣َُٔ‫ح‬ ‫طـط٤ش‬ ‫ًٌُٝي‬ ُ‫حٌُِح‬ ‫ٓ٠خىحص‬ ‫اػطخء‬ ‫٣ـذ‬. ‫حُـَٝف‬‫ر‬ ‫اؿ٬هٜخ‬ ٌٖٔ٣ ‫حُٜـ٤َس‬‫ب‬٢‫١ز‬ ‫٫ٛن‬ ٍ‫ٓظؼٔخ‬(Steristrips)‫حُٔ٘خٓذ‬ ٢٤‫رخُو‬ ‫ه٤خ١ظٜخ‬ ‫ك٤ـذ‬ ‫حٌُز٤َس‬ ‫حُـَٝف‬ ‫أٓخ‬. *ٞ‫رؼ‬‫حُلخ٫ص‬‫هي‬٫‫طظطِذ‬‫ٓؼخُـش‬‫٧ٜٗخ‬٫‫طظَحكن‬ٙٞ٘‫رظ‬‫ٝحٟق‬ٝ‫أ‬ٚٗ٧٫‫٣ٞؿي‬ًَٔ.‫٣ـذ‬ٖ٤ٔ‫طط‬ٞ٣َُٔ‫ح‬ٝ‫اػخىس‬ٜٚ‫كل‬ ً‫ش‬٤ٗ‫ػخ‬‫رؼي‬ٕ‫أ‬ٌٕٞ‫ط‬‫حًُٞٓش‬‫هي‬‫هلض‬.‫ًٔخ‬ٚٗ‫أ‬‫٣ـذ‬ّ‫ػي‬‫ٓلخُٝش‬‫ٍى‬ًَْٔ٣‫هي‬‫ٌُٜٞٗخ‬‫ٓلخُٝش‬‫ٓلظٞٓش‬َ٘‫حُل‬. *ْ‫٣ظ‬ ٕ‫أ‬ ‫٣ـذ‬ ‫كخى‬ ‫رِ٘٣ق‬ ‫ح٧ٗق‬ ًَٔ ‫طَحكن‬ ‫ٓخ‬ ‫اًح‬‫ٍى‬‫ٓخ‬ ‫رؤَٓع‬ ْ‫حُؼظ‬ٝ ، ٌٖٔ٣ٝ ٍُّٞ‫ح‬ ‫٣وق‬ ٠‫كظ‬ ّ‫أ٣خ‬ ‫ُؼيس‬ َ‫حُٜز‬ ‫٣ـذ‬ ٫‫ا‬ ٝ ٚ‫حُٞؿ‬ ٖ‫ػ‬ ‫ح٩ٍُهخم‬، ‫ح٧ٗق‬‫ر‬ ‫ُِٔٔخف‬ٝ َ٠‫أك‬ ٌَ٘‫ر‬ ٚٗ‫ٌٓخ‬ ٠ُ‫ا‬ ٌٍُٞٔٔ‫ح‬ ْ‫حُؼظ‬ ‫بػخىس‬‫أىم‬ ‫كيٝع‬ ٍ‫كخ‬ ٢‫ك‬ *ٝ ً‫خ‬٣ٝ‫٣ي‬ ِٚ٣‫طؼي‬ ‫ٓلخُٝش‬ ْ‫٣ظ‬ ‫ح٧ٗق‬ ًٍٞٔ ٢‫ك‬ ‫ح٧ٗق‬ ٙٞ٘‫ط‬.‫ؿ٤يس‬ ‫حُ٘ظخثؾ‬ ٌٕٞ‫ط‬ ‫ٓخ‬ ً‫خ‬‫ؿخُز‬ٞ‫رؼ‬ ٍ‫آظؼٔخ‬ ٌٖٔ٣ ٝ‫أ‬ ) ‫هخٛش‬ ‫ٜٓ٘خ‬ ‫(حُٔ٘لَٜس‬ ‫ح٧ٗل٤ش‬ ٌٍُٞٔ‫ح‬ ‫ٍى‬ ٠ِ‫ػ‬ ‫ُِٔٔخػش‬ ‫ح٧ىٝحص‬ ٚ٤‫ط٘و‬ ‫٣ـذ‬ *‫ح٩ٛخرخص‬‫حَُٔحكوش‬٧‫ح‬‫(أٗٞحع‬ َٟ‫ه‬2ٝ3ٝ ‫ػِ٤ٜخ‬ ‫حُظؼَف‬ ‫٣ـذ‬ ٢‫حُظ‬ )ٓ‫حُظؼخ‬‫ؿَحك٤خ‬ ‫ٓؼٜخ‬ َ. : ٖ٤‫رطَ٣وظ‬ ‫ح٧ٗق‬ ًٍٞٔ ‫ٍى‬ ْ‫٣ظ‬ *
  • 95.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 81 ) +‫اىَفرىحح‬ ‫تاىطشٌقح‬ ‫اىنسش‬ ‫سد‬: ُ‫ح‬ )**َ‫ٔيحه‬ُ‫ح‬: ‫ـَحك٤ش‬ 1-: ٢‫هخٍؿ‬ َ‫ٓيه‬ -‫حُظِٔهخص‬‫حَُٟ٤ش‬‫حُٔٞؿٞىس‬: -‫ر‬ ‫ٗن‬ٌَ٘‫كَف‬H: -‫ٗن‬‫ح٫ًِ٤ِ٤ش‬Bicoronal: -‫ٗن‬ٌَ٘‫ر‬‫كَف‬W:
  • 96.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 82 -‫ٗن‬‫ػٔٞى‬: ‫ٜق‬٘ٓ ١ -‫ٗن‬Z: ‫ِٓىٝؽ‬ -‫ٗوٞم‬ٖ‫حُـل‬Eyelid. ‫حُلـخؽ‬ ‫طلض‬ ٝ‫أ‬ ٖ‫حُـل‬ ‫طلض‬ ، ٢٘‫ؿل‬ : -‫ٗن‬ٖ٘٤ُ(Lynch):
  • 97.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 83 2-ٝ‫أ‬ ) ٢١‫ٓوخ‬ ( ٢ِ‫ىحه‬ َ‫ٓيه‬‫ح٧ٗق‬ ‫ٓوخ١٤ش‬ َ‫ػز‬: : ‫حُظؼز٤ض‬ ٝ ‫حَُى‬ ** ) +‫حُٔـِوش‬ ‫رخُطَ٣وش‬ ٌَُٔ‫ح‬ ‫ٍى‬: -)ٖٓ ٢٤ٔ‫ر‬ ًَٔ ‫ٍى‬ ٌُٖٔٔ‫ح‬ ٖٓ‫رؼي‬ ً‫ح‬ًَ‫رخ‬ ٞ٣َُٔ‫ح‬ ‫ٗٞٛي‬ ‫اًح‬ ‫حًُٞٓش‬ ٍٜٞ‫ك‬ َ‫هز‬ ٢‫حُٟٔٞؼ‬ َ٣‫حُظوي‬ ‫طلض‬ ٍٝ٧‫ح‬ ‫حُٜ٘ق‬ َُٝ‫ح‬. ٌٙٛ ‫ٍى‬ ٌٖٔ٣ّ‫ُٝ٘خ‬ ٢‫ِٓو‬ ٍ‫رخٓظؼٔخ‬ ٝ‫أ‬ ٢‫حُـخٗز‬ ٢‫ح٩ٛزؼ‬ ٢‫حُ٠ـ‬ ‫رٞحٓطش‬ ‫ػخىس‬ ٌٍُٞٔ‫ح‬ (Walsham’s Forceps)) ‫حٍُٜٞس‬ (( ٝ‫أ‬ASH Septum Forceps). ِٚ٤‫طؤؿ‬ ‫٣ـذ‬ ٌَُٔ‫ح‬ ‫ٍى‬ ٕ‫كب‬ ‫طٌِ٘ض‬ ‫هي‬ ‫حًُٞٓش‬ ٌٕٞ‫ط‬ ٕ‫أ‬ ‫رؼي‬ ٞ٣َُٔ‫ح‬ ٚ‫كل‬ ْ‫ط‬ ‫اًح‬5-7.ّ‫أ٣خ‬ ٖٓ َ‫أًؼ‬ ٌَُٔ‫ح‬ ‫ٍى‬ ً‫ح‬‫أري‬ َ‫٣ظؤه‬ ٫ ٕ‫أ‬ ‫٣ـذ‬ٝ ‫طؼزظض‬ ‫هي‬ ٌٕٞ‫ط‬ ‫ح٧ٗق‬ ّ‫ػظخ‬ ٕ٧ َُٝ‫ح‬ ‫رؼي‬ ٖ٤‫أٓزٞػ‬ٌٖ٣ ُْ ٕ‫ا‬ ً‫خ‬‫ٛؼز‬ ‫حَُى‬ ‫٣ٜزق‬ ً٬٤‫ٓٔظل‬. ‫٫كن‬ ٍ‫طزي‬ ١‫أ‬ ‫كيٝع‬ ‫ُٔ٘غ‬ ‫ٓؼيٗ٤ش‬ ٝ‫أ‬ ‫ؿزٔ٤ش‬ ‫ؿز٤َس‬ ‫ٟٝغ‬ ٌٖٔ٣
  • 98.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 84 +)ٌٍُٞٔ‫ح‬ ٖٓ ٢ٗ‫حُؼخ‬ ‫حُٜ٘ق‬ ٕ‫ا‬(Class 2)‫حُؼٞىس‬ ٠ُ‫ا‬ ‫حٌٍُٔٔٞس‬ ‫حُوطغ‬ ‫ك٤ٜخ‬ َ٤ٔ‫ط‬ ‫رٔزذ‬ ‫ٍىٛخ‬ ‫رؼي‬ ٌَُٔ‫ح‬ ‫ٟٝؼ٤ش‬ ٠ُ‫ا‬‫حُٞطَس‬ ‫ُـ٠َٝف‬ ‫حٌٍُٔٔٞس‬ ‫حُٜ٘خ٣خص‬ ٖ٤‫ر‬ ‫حُظَحًذ‬ ٝ٢ُ‫ُِـَرخ‬ ‫حُوخثٔش‬ ‫حُٜل٤لش‬ٍ ٕ‫ا‬ .ٚ‫٣َحكو‬ ٕ‫أ‬ ‫٣ـذ‬ ‫ح٧ٗق‬ ّ‫ػظخ‬ ًَٔ ‫ى‬‫ا‬ٍ‫ٓظجٜخ‬ ٝ ‫حٌٍُٔٔٞس‬ ّ‫ح٧هٔخ‬ٕ‫ً٤ِ٤خ‬ ‫ٗن‬ َ‫ػز‬ ‫حُٞطَس‬ ٖٓ ‫حُٔظَحًزش‬(Killian Incision)ٝ‫أ‬ Hemitransfixion Incision. +)‫حُؼخُغ‬ ‫حُٜ٘ق‬ ‫أٓخ‬(Class 3)ً‫ح‬‫ٍى‬ ‫ك٤ظطِذ‬ ٌٍُٞٔ‫ح‬ ًٖٓ‫خ‬‫ٓلظٞك‬ ً‫خ‬٤‫ؿَحك‬. ٝ ‫ٍكغ‬ ٠ُ‫ا‬ ‫حُٔ٘ؤلش‬ ‫ح٧ٗق‬ ّ‫ػظخ‬ ‫طلظخؽ‬‫ٗن‬ َ‫ػز‬ ٢ٗ‫ٓؼي‬ ‫ِٓي‬ ‫رٞحٓطش‬ ‫طؼز٤ض‬ ‫حُـزٜ٤ش‬ ‫ح٧ٗل٤ش‬ ‫حُِحٝ٣ش‬ ‫كٞم‬. :ٖ٤‫حُؼ‬ ‫ٓآم‬ ‫اٗو٬ع‬ ) +‫ٓخ‬ ‫ؿخُزخ‬ٖ٤‫ُِؼ‬ ٢ٔٗ٧‫ح‬ ‫حُٔآم‬ َٜ‫٣٘ل‬ٌَٗ ٠ِ‫ػ‬ ‫ُِللخظ‬ ‫حٌُِٔ٤ش‬ ‫رخُو٤خ١ش‬ ‫ِٗٔش‬ ‫٣ٔظٞؿذ‬ ‫ٓٔخ‬ ٖ٤‫حُؼ‬ ‫كظلش‬‫حُٔآم‬ ‫طؼز٤ض‬ ٞٛ ٝ ‫ٝحكي‬ ‫رٔزيأ‬ ٌُٖ ٝ ) ٍُٜٞ‫رخ‬ ‫ٟٓٞق‬ ٞٛ ‫(ًخ‬ ‫١َم‬ ‫ػيس‬ ٠ِ‫ػ‬ ‫طؼظٔي‬ ٢‫حُظ‬ ٝ ّ‫ح٧ٓخ‬ ٠ُ‫ا‬ ١ٞ‫حُِٔظ‬ ‫حُٞطَس‬ ‫ؿ٠َٝف‬ ‫ٓلذ‬ ْ‫ػ‬ ٕ‫ً٤ِ٤خ‬ ‫ٗن‬ َ‫ػز‬ ‫حُٞطَس‬ ٠ِ‫ػ‬ َ‫حُظيحه‬ ْ‫٣ظ‬.َ‫ح٧ٓل‬ ٩‫ح‬ ‫(ٓٞء‬ ‫حَُى‬ ‫ٓٞء‬ ٕ‫ا‬ّ‫ُظلخ‬)ٝ ‫ح٧ٗق‬ ‫طٜ٘٤غ‬ ٍ‫أٌٗخ‬ ٖٓ ً٬ٌٗ ٚ‫ٓؼخُـظ‬ ‫طظطِذ‬ ‫ٓٞف‬ ‫ح٧ٗق‬ ٍٝ ‫رؼي‬‫حُٞطَس‬ ‫ػيح‬ ( ‫كخُ٤خ‬ ٫‫آظؼٔخ‬ َ‫ح٧ًؼ‬ ٢ٛ ٝ ٌَُٔ‫ح‬ ١ٞ‫هط‬ ‫ُظؼز٤ض‬ َ‫ح٧ٓؼ‬ َ‫حُل‬ ‫حُٜلخثق‬ َ‫طؼظز‬ ‫حُؼخُغ‬ ٝ ٢ٗ‫حُؼخ‬ ‫حُٜ٘ق‬ ٖٓ ‫ح٧ٗق‬ ًٍٞٔ ٢‫ك‬ ) ٖ٤‫ُِؼ‬ ٢ٔٗ٧‫ح‬ ‫حُٔآم‬ ‫طؼز٤ض‬ ٢‫ك‬
  • 99.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 85 )+‫حُيٓؼ٤ش‬ ‫حُو٘خس‬ ‫اٛخرش‬َ‫طؼظز‬ :‫ػيس‬ ‫ٗـي‬ ٝ ٌٍُٞٔ‫ح‬ ٌٙٛ َ‫ٓؼ‬ ٢‫ك‬ ‫ٗخثؼش‬ : ‫ُ٪ٛخرش‬ ‫اكظٔخ٫ص‬ -‫ٓلظض‬ ًَٔ ‫ٗظخ٣خ‬ ‫رٔزذ‬ ٢‫حُيٓؼ‬ ْ٤ٌُ‫ح‬ ‫طِٔم‬ -٢‫حُيٓؼ‬ ُ‫حُـٜخ‬ ٠ِ‫ػ‬ ٢‫ٟـ‬ ُ‫ح‬ ‫اٗٔيحى‬ ٢ٛ ‫حُ٘ظ٤ـش‬ ٝ‫و٘خس‬٧‫ح‬٤‫ٗل‬‫ش‬ُ‫ح‬٤‫يٓؼ‬‫ٗ٘خٛي‬ ٝ ‫ش‬‫ىٓخع‬ٝ‫ا‬‫حُيٓغ‬ ْ٤ً ‫ُظٜخد‬ : ‫ح٩ٛخرش‬ ْ٤َٓ‫ُظ‬-ّ‫حُو٤خ‬ ٌٖٔ٣‫حُ٘يٝد‬ َ‫ػز‬ ‫حُٔٞم‬ ‫ٍأد‬ ‫ٓغ‬ ٚٔ‫ٗل‬ ‫حُٞهض‬ ٢‫ك‬ ٚ‫ر‬ ٢ِ٤ًِ٩‫ح‬ ‫رخُ٘ن‬ ٝ‫أ‬ )ٖ٘٤ُ( ‫ٗن‬ ‫ُ٨ٗق‬ ٢‫حُـخٗز‬ ‫رخُ٘ن‬ ٝ‫أ‬ ‫ح٧ِٛ٤ش‬ -( ‫رخ٧ٗق‬ ‫حُيٓغ‬ ْ٤ً ‫ٓلخؿَس‬Dacryocystorhinostomy):ٕ‫ًخ‬ ‫اًح‬ ‫ح٧ٗق‬ ٢‫ك‬ ٢‫حُيٓؼ‬ َ‫حُٔخث‬ ‫طَٜ٣ق‬ ٠ِ‫ػ‬ َٔ‫ٗؼ‬ ،‫ِٓ٤ٔخ‬ ْ٤ٌُ‫ح‬ -Conjunctivo-rhinostomyٝ ‫حُو٘خس‬ َ‫ٓؼ‬ ٖ٤‫حُزُٞ٤ؼ‬ ‫أٗزٞد‬ ‫ٍُع‬ َ‫ػز‬ : ‫ه٘خس‬ ٍَٟ ‫كيٝع‬ ‫كخُش‬ ٢‫ك‬ ‫ًُي‬ *‫حُٞطَس‬ ٢‫ك‬ ١ٞٓ‫حُي‬ ٍُّٞ‫ح‬Septal Haematoma:‫ح٧ٗل٤ش‬ ‫ُِٞطَس‬ ‫حُـ٠َٝف‬ ‫ٓٔلخم‬ ‫طلض‬ ّ‫حُي‬ ‫طـٔغ‬ ‫رٔزذ‬ ‫٣ليع‬ٌٕٞ٣ ‫هي‬ . َُ‫ح‬ ‫ٓززٜخ‬ً‫خ‬٠٣‫أ‬ ‫طليع‬ ‫هي‬ ‫ٌُٜ٘خ‬ ،٢‫ح٧ٗل‬ ًٝ‫ب‬( ‫حُٞطَس‬ ٠ِ‫ػ‬ ‫ؿَحكش‬ ‫رؼي‬ ١٬‫هظ‬‫ا‬‫حُٔوخ١٤ش‬ ‫طلض‬ ٍ‫ٓظجٜخ‬SMR)ٝ‫ٗظ٤ـش‬ ً‫ح‬ٍ‫ٗخى‬ ‫حُيٓٞ٣ش‬ ٝ‫ح٧َٓح‬ ‫رؤكي‬ ‫ح٩ٛخرش‬‫ػخى‬ ‫٣ٞؿي‬ .‫س‬‫ا‬ٗ‫رٞحٓطش‬ ٖ٤‫رخُـٜظ‬ ‫ُ٨ٗق‬ ّ‫طخ‬ ‫ٔيحى‬‫ا‬١َ١ ‫ٗظلخم‬‫ٓؼخُـش‬ ْ‫طظ‬ ٝ‫أ‬ ٚ‫ط٘و‬ ُْ ‫اًح‬ . ٝ ‫حُـ٠َٝف‬ ٢‫ك‬ َ‫ط٘و‬ ‫ٓغ‬ ‫ٝطَس‬ ‫هَحؽ‬ ٠ُ‫ا‬ ٍٞ‫طظل‬ ‫هي‬ ‫كبٜٗخ‬ ‫ٛل٤ق‬ ٌَ٘‫ر‬ ‫حُلخُش‬٢‫حَُٔؿ‬ ‫ح٧ٗق‬ ٍٜٞ‫ك‬ٍُّٞ‫ح‬ ٟٞ‫ٓلظ‬ ‫ٓلذ‬ ٕ‫ا‬ . ً‫خ‬٤‫ًخك‬ ٌٕٞ٣ ‫هي‬ ‫رخ٩رَس‬ َ٤‫حُٜـ‬ ١ٞٓ‫حُي‬ٝ ‫حُ٘ن‬ َٓ٧‫ح‬ ‫٣ظطِذ‬ ‫هي‬ ٌُْ٘‫ح‬ ٍ‫كخ‬ ٢‫ك‬ ٌُٖ ،‫حُلَحؽ‬ ْٔ‫(ُط‬ ‫حُؼخرَس‬ ‫حُو٤خ١ش‬ ‫ٓغ‬ ‫حُظلَ٣ؾ‬ )‫حُٔ٤ض‬١ُ‫حُـٜخ‬ ٝ‫أ‬ ٢‫حُٟٔٞؼ‬ ٕ‫ح٩ٗظخ‬ ‫كيٝع‬ َ‫هط‬ ٙ‫٩ٗوخ‬ ‫رخُٜخىحص‬ ‫ٓؼخُـش‬ ٞ٣َُٔ‫ح‬ ‫اػطخء‬ ‫٣ـذ‬ .. *‫حُٔخث‬ ٕ٬٤ٓ٢ًُٞ٘‫ح‬ ٢‫حُيٓخؿ‬ َ:َ‫حُٔخث‬ ٕ٬٤ٔ‫ر‬ ‫حُ٘ي‬ َ٤‫٣ؼ‬ ٕ‫أ‬ ‫٣ـذ‬ ٢‫ح٧ٗل‬ َُٝ‫ح‬ ‫رؼي‬ ‫ح٧ٗق‬ ٖٓ ‫ٍحثن‬ ٕ٬٤ٓ ‫ٝؿٞى‬ ٕ‫ا‬ ٝ ً‫ح‬‫ؿي‬ ‫ٍه٤وش‬ ٢ُ‫ُِـَرخ‬ ‫حُٜٔلٞ٣ش‬ ‫حُٜل٤لش‬ ٕ‫ا‬ .٢ًُٞ٘‫ح‬ ٢‫حُيٓخؿ‬ٌَُٔ‫ح‬ ‫ُليٝع‬ ٕ‫ٌٓخ‬ ‫أٗ٤غ‬ ٢ٛٚ٤‫حُظ٘و‬ ٖٓ ‫حُظؤًي‬ ْ‫٣ظ‬ . ٝ َ‫حُٔخث‬ ٚ‫رلل‬ٖٓ ‫هَ٣زش‬ ٚ‫ٗٔزظ‬ ٌٕٞ‫ط‬ ‫ك٤غ‬ ٚ٤‫ك‬ ًُِٞٞ‫حُـ‬ ١َ‫طل‬‫ٓؼخ٣َس‬ ٢ٛ َٟ‫ح٧ه‬ ‫حُطَ٣وش‬ .َُٜٔ‫ح‬ ٢‫ك‬ ًُِٞٞ‫حُـ‬ ‫ٗٔزش‬ B2 Transferrin(ٝٝ َٛ‫حُظخ‬ ‫حُِٔق‬ ٢‫ك‬ ٢‫كو‬ ‫ٓٞؿٞىس‬ ‫رَٝط٤٘٤ش‬ ‫ٓخىس‬ ٢ٖٛ‫كو‬ ٕ‫أ‬ ‫ًٔخ‬ .)٢ًُٞ٘‫ح‬ ٢‫حُيٓخؿ‬ َ‫حُٔخث‬ ٢‫ك‬ ٖ٤ٔ٣ٍِٞ‫حُل‬Fluorescein٢‫ك‬ ٢‫ح٧ٗل‬ ٕ٬٤ُٔ‫ح‬ ٖٓ ‫ؿٔؼٜخ‬ ٌٖٔ٣ ٢٘‫هط‬ ٍِ‫ر‬ ٍ٬‫ه‬ ٖٓ ٢ًُٞ٘‫ح‬ ٢‫حُيٓخؿ‬ َ‫حُٔخث‬ ٢‫ك‬‫ٝؿٞى‬ ٍ‫كخ‬ ٕ٬٤ٓ٢ًُٞ٘‫ح‬ ٢‫حُيٓخؿ‬ َ‫حُٔخث‬. .ًَٔ ‫ٝؿٞى‬ َٜ‫٣ظ‬ ٕ‫أ‬ ٌٖٔ٣ ‫حُيهش‬ ٢ُ‫ػخ‬ ١ٍٞ‫حُٔل‬ ٢‫حُطزو‬ َ٣ٜٞ‫حُظ‬ ٕ‫ا‬
  • 100.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 86 ٝ ،٢ًُٞ٘‫ح‬ ٢‫حُيٓخؿ‬ َ‫ُِٔخث‬ ٕ٬٤ٓ ‫ٛ٘خى‬ ٕ‫أ‬ ‫١خُٔخ‬ ‫رخُٜخىحص‬ ٞ٣َُٔ‫ح‬ ‫طـط٤ش‬ ‫٣ـذ‬٩ ‫حُٔٔززش‬ ْ٤‫حُـَحػ‬ ‫ِٗ٤غ‬‫أ‬ ٕ‫أ‬ ‫رٔخ‬‫ُظٜخد‬ ‫٣ـذ‬ ‫حُظـط٤ش‬ ٕ‫كب‬ ‫حَُثٞ٣ش‬ ‫حٌٍُٔٞحص‬ ٢ٛ ‫حُٔلخ٣خ‬ٝ ٖ٤ِٔ٘‫حُز‬ ٖٔ٠‫طظ‬ ٕ‫أ‬ٖ٣‫حُِٔلخى٣ٔ٤ي‬Sulphadimidine.‫ٝهخث٤ش‬ ‫ًٔؼخُـش‬ *ٌُ ً‫خ‬٣ٞ‫ػل‬ ‫طظٞهق‬ ‫ٓٞف‬ ‫حُٔ٤٬ٗخص‬ ٖٓ ‫حُؼي٣ي‬ ٕ‫ا‬ .‫ٍَٟٝ٣ش‬ ‫ُ٤ٔض‬ ‫رخُٜخىحص‬ ‫حُٞهخث٤ش‬ ‫حُٔؼخُـش‬ ٕ‫أ‬ ٍ‫أٗخ‬ ٞ‫حُزؼ‬٠ُ‫ا‬ ‫٣لظخؽ‬ ‫رؼ٠ٜخ‬ ٖ ‫ر‬ ٢‫ؿَحك‬ ‫اؿ٬م‬‫ب‬ٝ‫أ‬ ‫حُٜيؿ٤ش‬ ‫حُؼ٠ِش‬ ‫ٛلخم‬ ٍ‫ٓظؼٔخ‬Fascia Lateٖٓ ‫ٓوخ١٤ش‬ ‫َٗ٣لش‬ ٝ‫أ‬‫حُٞطَس‬‫ح٩ؿ٬م‬ ْ‫٣ظ‬ ٕ‫أ‬ ٌٖٔ٣ .‫ح٧ٗل٤ش‬ ‫ر‬‫ب‬ٖٔ٠‫٣ظ‬ ٢‫هخٍؿ‬ َ‫ٓيه‬ ٍ‫ٓظؼٔخ‬‫ا‬‫حُـَرخُ٤ش‬ ‫حُو٬٣خ‬ ٍ‫ٓظجٜخ‬External Ethmoidectomy‫رخُطَ٣وش‬ ٝ‫أ‬ ‫حُٞطَس‬ َ‫ػز‬ َ‫رٔيه‬ ٝ‫أ‬ ٢ٜ‫حُـز‬ ‫ػوذ‬ ‫رٞحٓطش‬ ٝ‫أ‬ ‫ح٧ٗق‬ َ‫ػز‬ ‫حُظ٘ظ٤َ٣ش‬Frontal Craniotomْٝ‫حُطؼ‬ ‫ٟٝغ‬ ‫ٓغ‬ ‫حٌٍُٔٔٞس‬ ‫حُؼظٔ٤ش‬ ‫حُوطغ‬ ‫ٍى‬ ‫رؼيٛخ‬ ْ‫٣ظ‬ ‫ح‬‫ُِٔلخ٣خ‬ ‫ُٔ٘خٓذ‬. H-ُ‫ح‬: ‫ٔ٠خػلخص‬ -‫ٓئهض‬ ٝ‫أ‬ ْ‫ىحث‬ ٍ‫هي‬ -٢ًُٞ٘‫ح‬ ٢‫حُيٓخؿ‬ َ‫حُٔخث‬ ٕ٬٤ٓ -‫حُٔلخ٣خ‬ ‫اُظٜخد‬ -‫ٓوخ١٤ش‬ ‫ه٤ِش‬ ٝ‫أ‬ ‫ح٧ٗل٤ش‬ ‫حُـ٤ٞد‬ ‫اُظٜخد‬ -ٕ‫اٗظخ‬ -ُْ٘‫ح‬ ‫كخٓش‬ ‫كوي‬ -١٬‫ًبهظ‬ ٖ٤‫حُٔٞه‬ ‫طزخػي‬ -‫حُِحثق‬ ٖ٤‫حُٔٞه‬ ‫طزخػي‬ -‫هخع‬ ٝ‫أ‬ ٢‫حُلـخؿ‬ ٍ‫حُـيح‬ ْ٤َٓ‫ط‬ َ٘‫ك‬ ‫رٔزذ‬ ٙٞ‫ه‬‫حُلـخؽ‬ -‫حُٔوِش‬ ‫ٟؼق‬ -٠ٔ‫حُؼ‬ -. ‫اٟخك٤ش‬ ‫ؿَحك٤ش‬ ‫ُؼِٔ٤خص‬ ‫حُلخؿش‬ I-‫حُ٘وخٛش‬ ‫ا‬ٖ٤‫ر‬ ‫ٓخ‬ َٜ‫٣ل‬ ٌَُٔ‫ح‬ ‫رؼي‬ ّ‫حُؼظخ‬ ٍ‫ٓظوَح‬3٠ُ‫ا‬4ٝ ‫أٓخر٤غ‬‫رؼي‬ ‫حُوزَحء‬ ٞ‫رؼ‬ ‫٣وظَف‬ّ‫ا‬‫حُ٘ظخٍحص‬ ‫ٍطيحء‬‫أ‬‫حُٞهض‬ ‫ٌٛح‬ ٍ٬‫ه‬ ٢‫حُظٔو‬ ٝ ّ‫حُؼظخ‬ ‫ٓلخًحس‬ ٠ِ‫ػ‬ َ‫٣ئػ‬ ‫هي‬ ٚٗ٧. ‫٣ليع‬‫ا‬ٖ٤‫ر‬ ‫ٓخ‬ َٓ‫حٌُخ‬ ّ‫حُؼظخ‬ ‫ٗيٓخؽ‬4٠ُ‫ا‬8ٝ ‫أٓخر٤غ‬ٝ ٖ٤‫أٓزٞػ‬ ٠ُ‫ا‬ ‫أٓزٞع‬ ‫رؼي‬ ُ‫ٓٔظخ‬ ٌٕٞ٣ ّ‫حُؼخ‬ ١‫حُ٘٘خ‬ٌُٖ:‫د‬ ‫٣ٜ٘ق‬ *٫‫٣ـذ‬‫طظطِذ‬ ٢‫حُظ‬ ‫حَُ٣خٟش‬ ‫ٓٔخٍٓش‬‫ا‬ٝ َ‫ح٧ه‬ ٠ِ‫ػ‬ َٜٗ‫أ‬ ‫ػ٬ػش‬ ٠ُ‫ا‬ ٖ٣َٜٗ ‫ُٔيس‬ ١‫ؿٔي‬ ‫كظٌخى‬ٟ‫ٓي‬ ٠ِ‫ػ‬ ‫٣ؼظٔي‬ ‫ًُي‬ .‫ح٩ٛخرش‬ ‫ٓٞء‬ *‫حُؼو٤ِش‬ ‫ح٧ٗ٤خء‬ َٔ‫ك‬ ّ‫ػي‬ ‫ٓلخُٝش‬. ‫اٍطيحء‬ َ٠‫٣ل‬ *‫ؿ‬‫ز٤َس‬‫أٗل٤ش‬. *‫ُٔيس‬ ‫رخَُ٣خٟش‬ ‫حُٔ٘خًٍش‬ ‫ػ٘ي‬ ٚ‫حُٞؿ‬ ‫هًٞس‬ ‫اٍطيحء‬ ‫٣ـذ‬ ٚٗ‫أ‬ ٠ُٛٞٔ‫ح‬ ٖٓ6ٛ٩‫ح‬ ‫رؼي‬ َ‫ح٧ه‬ ٠ِ‫ػ‬ ‫أٓخر٤غ‬‫خرش‬. K-‫حٌُحط٤ش‬ ‫حُؼ٘خ٣ش‬ *٫‫٣ـذ‬.٢‫١ز‬ ًٕ‫ا‬ ٠ِ‫ػ‬ ٍٜٞ‫حُل‬ ٕٝ‫ى‬ َ‫ؿزخث‬ ١‫أ‬ ‫اُحُش‬ *‫حٌُظٔش‬ ٝ‫أ‬ ‫رخُو٘وش‬ ٍٞ‫حُ٘ؼ‬ ‫ػ٘ي‬َ٠‫٣ل‬ٝ ٍ‫روخ‬ ٢‫ك‬ ْ‫ط٘ل‬ ٝ‫أ‬ ٖ‫ٓخه‬ ّ‫كٔخ‬ ٌ‫رؤه‬ٕ‫أ‬ ٌٖٔ٣ ‫ٌٛح‬٣٢‫ك‬ ‫ٔخػي‬ٝ ١‫حُٔوخ‬ ٞ‫ك‬ّ‫حُي‬ .‫ح٩ٛخرش‬ ٝ‫أ‬ ‫حُـَحكش‬ ‫رؼي‬ ًْ‫٣ظَح‬ ١ٌُ‫ح‬ ‫حُـخف‬ *‫ح٧ٗق‬ ‫أىٝ٣ش‬ ٌ‫أه‬ ٌٖٔ٣) ٕ‫اكظوخ‬ ‫ٓ٠خى‬ ٝ‫أ‬ َّٝ٤ٓ ‫أٗل٤ش‬ ‫هطَس‬ (‫ٓليىس‬ ‫١ز٤ش‬ ‫ٝٛلش‬ ٕٝ‫ى‬ ُْ٧‫ح‬ ‫ُظول٤ق‬
  • 101.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 87 ُ‫ح‬ ٍ‫آظؼٔخ‬ ٌٖٔ٣ *ٝ ‫ٌٔٔ٘خص‬‫ٓ٠خىحص‬٩‫ح‬‫حُٔظ٤َٝ٣ي٣ش‬ َ٤‫حُـ‬ ‫ُظٜخرخص‬‫كٔٞ٣خ‬ L-‫حُٞهخ٣ش‬: ‫ٓ٘غ‬ ٌٖٔ٣ ٫ ‫ؿخُزخ‬ًٍٔٞ‫ح٧ٗق‬ٌُٖ ٝ٩‫ح‬ َ‫هط‬ ٖٓ ‫ُِلي‬‫ٛخرش‬: ‫ا‬ *‫ه٘خع‬ ‫ٓغ‬ ‫حُٞحه٤ش‬ ّ‫حَُأ‬ ‫أؿط٤ش‬ ‫ٍطيحء‬‫ٍ٣خٟخ‬ ٢‫ك‬ ‫ط٘خٍى‬ ‫ػ٘يٓخ‬ ,٩‫ح‬ ‫طظطِذ‬ ‫ص‬ٝ ,١‫حُـٔي‬ ‫كظٌخى‬ٝ‫أ‬ ‫حُيٍحؿخص‬ ‫ًٍٞد‬ ‫ًٌُي‬ ‫حُ٘خٍ٣ش‬ ‫حُيٍحؿخص‬‫رخُؼ٘ق‬ ْٔ‫طظ‬ ٢‫حُظ‬ ‫حَُ٣خٟخص‬ ٝ‫أ‬. ‫ا‬ *‫ٓ٤خٍس‬ ٢‫ك‬ ‫ًٍٞد‬ ‫ػ٘ي‬ ٕ‫ح٧ٓخ‬ ّ‫كِح‬ ‫ٍطيحء‬.
  • 102.
  • 103.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 88 ًٍْٞٔ‫حُؼظ‬٢٘‫حُٞؿ‬ A-: ‫ٓويٓش‬ ( ٢٘‫حُٞؿ‬ ْ‫حُؼظ‬Zygomatic bone):‫ؿخٗذ‬ ًَ ٢‫ك‬ ‫(ٝحكي‬ ‫حُـٔـٔش‬ ّ‫ػظخ‬ ‫أكي‬ ٞٛ‫حُلي‬ ٖٓ ًَ ‫ٓغ‬ ٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ َٜ‫٣ظٔل‬ .) ٝ ١ِٞ‫حُؼ‬ٝ ٢ٜ‫حُـز‬ ْ‫حُؼظ‬ٝ ٢‫حُٜيؿ‬ ْ‫حُؼظ‬١‫حُٞطي‬ ْ‫حُؼظ‬. ٝ ‫حُلـخؽ‬ ٖٓ ً‫ح‬‫ؿِء‬ ٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ٌَ٘٣‫حُوي‬ ْ‫رؼظ‬ ُٚ ٍ‫٣٘خ‬٢‫ك‬ ْ‫حُؼظ‬ ‫٣ظٟٞغ‬ .ٌَ٘٣ ‫ك٤غ‬ ٚ‫حُٞؿ‬ ٖٓ ٢٘‫حُٞك‬ ١ِٞ‫حُؼ‬ ‫حُـِء‬ ٝ ،‫حُوي‬ َُٝ‫ر‬ٝ ٢٘‫حُٞك‬ ‫حُـِء‬ٝ ،‫حُلـخؽ‬ ‫أٍٟ٤ش‬ٝ ‫حُٜيؿ٤ش‬ ٖ٤‫حُللَط‬ ٖٓ ‫أؿِحء‬‫حُٜيؿ٤ش‬ ‫طلض‬. : ‫حُٞؿ٘ش‬ ًٍٞٔ َٔ٘‫ط‬-) ٢ٜ‫حُـز‬ ٝ ٢‫حُٜيؿ‬ ٝ ١ِٞ‫حُؼ‬ ٢ٌ‫حُل‬ ( ‫حُٞؿ٘٤ش‬ ٍُٝ‫حُي‬ -( ‫حُيػخٓش‬buttress‫حُؼِٞ٣ش‬ ‫حُلٌ٤ش‬ ‫حُٞؿ٘٤ش‬ ) -‫حُٞؿ٘٤ش‬ ّٞ‫حُو‬ -١‫حُٞطي‬ ٢٘‫حُٞؿ‬ ٍُ‫حُي‬ -‫ُِلـخؽ‬ ‫حُٔلِ٤ش‬ ‫حُلخكش‬
  • 104.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 89 B-: ‫ح٧ٓزخد‬ ‫ٓغ‬ َٜ‫٣ظٔل‬ ٚٗ‫أ‬ ٫‫ا‬ ٚ‫حُٞؿ‬ ّ‫ػظخ‬ ٠ٔ‫أه‬ ٖٓ ٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ َ‫٣ؼظز‬‫ٗٔز٤خ‬ ‫ٛ٘ش‬ ّ‫ػظخ‬ ٠ِ‫ػ‬ ًٍٞٔ ٌٕٞ‫ط‬ ‫ٓخ‬ ‫ؿخُزخ‬ ٢‫ُظ‬ ٝ ْ‫حُؼظ‬ ‫ٌُٜح‬ ‫حُ٠ج٤ِش‬ ٌٍُٞٔ‫ح‬ ‫ٗٔزش‬ َٔ‫٣ل‬ ‫ٓخ‬ ‫ٌٛح‬ ٝ ) ‫حُٜيؿ٤ش‬ ٝ ‫حُؼِٞ٣ش‬ ‫حُلٌ٤ش‬ ٝ ‫حُـزٜ٤ش‬ ( ‫حُٞؿ٘٤ش‬ ٍُٝ‫حُي‬ ٟٞ‫ٓٔظ‬ ٞ‫رؼ‬ ‫ٜٓ٘خ‬ ٝ ‫حُؼ٘ق‬ ٝ ‫حُٔزخَٗس‬ ‫حُٜيٓخص‬ ٖ‫ػ‬ ٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ًٍٞٔ ‫ط٘ظؾ‬ ‫ٓخ‬ ‫ؿخُزخ‬ ‫ًخُٔ٬ًٔش‬ ‫حُؼ٘٤لش‬ ‫حَُ٣خٟخص‬ C-: ‫حُظٜ٘٤ق‬ : ‫ٜٓ٘خ‬ ًٌَ٘ٓ ٝ ‫حُٞؿ٘٤ش‬ ٌٍُٞٔ‫ح‬ ‫طٜخٗ٤ق‬ ٖٓ َ٤‫ًز‬ ‫ػيى‬ ‫٣ٞؿي‬ ‫طٜ٘٤ق‬ **Knight & North: -‫حُٜ٘ق‬1ٍ‫ٓظزي‬ َ٤‫ؿ‬ ًَٔ : -‫حُٜ٘ق‬2ٍِٝ‫ٓؼ‬ ٍ‫ٓظزي‬ ًَٔ : -‫حُٜ٘ق‬3ٍ‫اٗلظخ‬ ٕٝ‫ى‬ ٍ‫ٓظزي‬ ًَٔ : -‫حُٜ٘ق‬4٢ٔٗ‫أ‬ ٕ‫ىٍٝح‬ ‫ٓغ‬ ًَٔ : ‫ُِوخٍؽ‬ .. ٢٘‫حُٞؿ‬ ٢ٜ‫حُٞؿ‬ ٍُ‫حُي‬ ٖٓ َ‫ُِيحه‬ .. -‫حُٜ٘ق‬5٢٘‫ٝك‬ ٕ‫ىٍٝح‬ ‫ٓغ‬ ًَٔ : ..‫حُلـخؽ‬ ‫طلض‬ ‫حُلخكش‬ ٖٓ ٠ِ‫ُ٨ػ‬ ..ُِ‫وخٍؽ‬ٍُٖٓ‫حُي‬٢ٜ‫حُٞؿ‬٢٘‫حُٞؿ‬ -‫حُٜ٘ق‬6ٌَُٔ‫ح‬ ١ٞ‫هط‬ ‫ٓظؼيى‬ :
  • 105.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 90 ‫طٜ٘٤ق‬ **Killey`s: 1)-‫ٓغ‬ ٢٘‫حُٞؿ‬ ْٔ‫ؿ‬ ًَٔ: ‫كـخؿ٤ش‬ ‫اٛخرش‬ -٢٤ٔ‫ر‬ ٍ‫طزي‬ -َ‫ح٧ٓل‬ ٝ َ‫ُِيحه‬ ٍ‫طزي‬ -‫حُوِق‬ ٝ َ‫ُِيحه‬ ٍ‫طزي‬ -‫ُِوخٍؽ‬ ٍ‫طزي‬ -‫ٓلظض‬ 2)-‫كـخؿ٤ش‬ ‫اٛخرش‬ ٕٝ‫ى‬ ٢٘‫حُٞؿ‬ ّٞ‫حُو‬ ًَٔ **‫طٜ٘٤ق‬Özyazganٝ ٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ًٍٞٔ ٖ٤‫ر‬ ‫حُِٔؽ‬ ٠ِ‫ػ‬ ‫٣ؼظٔي‬ ١ٌُ‫ح‬ ٝ ‫حُٞؿ٘٤ش‬ ّٞ‫حُو‬ 1)-‫حُٜ٘ق‬1ٍِ‫ٓ٘ؼ‬ ‫ٝؿ٘٤ش‬ ّٞ‫ه‬ ًَٔ : A-ٍِ‫ٓ٘ؼ‬ ٢٘‫ٝؿ‬ ّٞ‫ه‬ ًَٔ B-ٖ٣ًَٔ ٖٓ َ‫أًؼ‬ B-V–‫كَف‬ ٌَ٘‫ر‬ ًَٔV B-D–ٍ‫ٓظزي‬ ًَٔ 2)-‫حُٜ٘ق‬2‫ٓ٘ظًَش‬ ‫ٝؿ٘٤ش‬ ّٞ‫ه‬ ٝ ْ‫ػظ‬ ًَٔ : A-‫ٓلَى‬ ًَٔ B-‫ٓظؼيىس‬ ًٍٞٔ B-R-ٍ‫ٓظزي‬ َ٤‫ؿ‬ ًَٔ B-D–ٍ‫ٓظزي‬ ًَٔ : ٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ًٍٞٔ ‫طٜ٘٤ق‬ ** ‫ٗٞع‬1:ًٍَٔ‫ٓظزي‬ َ٤‫ؿ‬. ‫ٗٞع‬2:٢‫كو‬ ّٞ‫حُو‬ ًَٔ. ‫ٗٞع‬3:ًَٔ٢٘‫ٝؿ‬ْ‫حُوٞحث‬ ٢‫ػ٬ػ‬٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ (ْ٤ِٓ) ‫ٗٞع‬4:ًَٔ٢٘‫ٝؿ‬ْ‫حُوٞحث‬ ٢‫ػ٬ػ‬) ‫ٓ٘لِٜش‬ ٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ( ‫ٗٞع‬5:ًَٔ١ٍ‫اٗلـخ‬.. ‫ٗٞع‬6:‫كخكش‬ ًَٔ٢‫حُلـخؿ‬. ‫ٗٞع‬7ًٍٞٔ :َٟ‫أه‬ ًٍٞٔٝ ‫ٓلظظش‬
  • 106.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 91 D-ٝ‫ح٧ػَح‬: ‫حُٞؿ‬ ّ‫ػظخ‬ ًٍٞٔ ‫ػ٘ي‬‫٘ش‬٧‫ح‬ ٌٕٞ‫ط‬ٝ ٌَُٔ‫ح‬ ‫رٔ٘طوش‬ ‫ؿخُزخ‬ ٚ‫َٓطزط‬ ٝ‫ػَح‬ٝ ٚ‫ٗيط‬‫أ‬‫ٜٛٔخ‬: -ٝ ‫ح٩ٛخرش‬ ٕ‫ٌٓخ‬ ُْٔ ‫ػ٘ي‬ ُْ‫أ‬‫ح٩ٛخرش‬ ٕ‫ٌٓخ‬ ٢‫ك‬ ‫كخى‬ ُْ‫أ‬. -٢ِ‫حُٔل‬ ‫حُلي‬ ًٍٞٔ ‫ػ٘ي‬ ‫حُلي‬ ‫طلَ٣ي‬ ٢‫ك‬ ٚ‫حُٜؼٞر‬ َ‫ٓؼ‬ ٚ‫حُٞظ٤ل‬ ٕ‫كويح‬‫حُ٘خطت‬ ‫ٓغ‬ ‫حٌٍُٔٔٞس‬ ‫حُٞؿ٘ش‬ ‫طَحًذ‬ ‫رٔزذ‬ ‫ؿخُزخ‬ ( ٢ِ‫حُٔل‬ ‫ُِلي‬ ١ٍ‫حُٔ٘وخ‬‫اٗلٜخ‬ ‫رٔزذ‬ ٝ‫أ‬‫حُٔخٟـش‬ ٝ‫أ‬ ‫حُـ٘خك٤ش‬ ٝ‫أ‬ ‫حُٜيؿ٤ش‬ ‫حُؼ٠ِش‬ ٍ)‫ا‬٧‫ح‬ ٠ُ‫ح‬ ‫ٟخكش‬ُْ -‫حُٔوِش‬ ‫كًَش‬ ‫طليى‬ ‫ٓغ‬ ٖ٤‫حُؼ‬ ٢‫ك‬ ‫ٗلغ‬ -ٝ ٕ‫ح٧ٓ٘خ‬ ‫طلَى‬ ‫ٓغ‬ ُْ٧‫ح‬ ‫ٝ٣ليع‬ ٚ‫حُ٘ل‬ ٢‫ك‬ ٍ‫هي‬ ‫٣ليع‬ ‫هي‬ٝ ّ‫طخ‬ ٌَ٘‫ر‬ ‫ا١زخهٜخ‬ ‫آٌخٗ٤ش‬ ّ‫ػي‬٧‫ح‬، ‫ح٧١زخم‬ ‫ػ٘ي‬ ‫حُ٘ي٣ي‬ ُْ -٧‫ح‬ ٍّٞ‫ط‬ٚ‫حُٔل٤ط‬ ٚ‫ٗٔـ‬ٖ٤‫حُؼ‬ ٍٞ‫ك‬ ‫ًيٓش‬ ٕٝ‫ح٧ؿلخ‬ ‫كظلش‬ ٌَٗ ٢‫ك‬ َ٤‫طـ‬ ‫ٓ٘خٛيس‬ ٌٖٔ٣ ‫ًٔخ‬ -١ِٞ‫حُؼ‬ ‫ُِلي‬ ١ِ٤ِٛ‫حُي‬ ‫حُٔ٤ِحد‬ ‫هخع‬ ٢‫ك‬ ‫ًيٓش‬ -‫ٝحٟق‬ ٙٞ٘‫ط‬‫حُٞؿ٘٤ش‬ ّٞ‫حُو‬ ‫اٗؤخف‬ ٝ‫أ‬ ‫حُلـخؽ‬ ‫كٞحف‬ ٝ‫أ‬ ٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ٢‫ك‬ٝ ً٬ٓ‫ًخ‬ ٌَُٔ‫ح‬ ٕ‫ًخ‬ ‫اًح‬‫حٌٍُٔٔٞس‬ ّ‫حُؼظخ‬ ‫أؿِحء‬ ٝ ‫ٌٓخٜٗخ‬ ٖٓ ‫طلًَض‬ٖ٤‫حُؼ‬ َ‫ٓلـ‬ ّ‫ػظخ‬ ًَٔ ‫ػ٘ي‬ ٚ‫حُٞؿ‬ ٢‫ك‬ ٙٞ٘‫ط‬ٝ٧‫ح‬ ّ‫ػظخ‬ٝ ٍّٞ‫حُظ‬ ٖ‫ػ‬ ٬٠‫ك‬ ‫ٗق‬ٝ ‫حٌُيٓخص‬‫حُِ٘ف‬ -.. ٖ٤‫حُؼ‬ ‫ٓوِش‬ ٍٝ‫ؿئ‬ ، ‫حُِٔظلٔش‬ ‫ًيٓش‬ , ‫ٍػخف‬ ‫ٗ٘خٛي‬ ‫ٓخ‬ ‫ٗخىٍح‬ E-١َ٣َُٔ‫ح‬ ٚ‫حُلل‬: ٚ٤‫حُظ٘و‬ ٝ : ‫أٓخٓ٤ش‬ ٍٝ‫ٓلخ‬ ‫ػ٬ع‬ ٠ِ‫ػ‬ ٚ٤‫حُظ٘و‬ ‫٣ؼظٔي‬ 1-: ‫حَُٔ٣َ٣ش‬ ‫حُوٜش‬ ‫اٍطٌخُٛخ‬ ‫ٗوطش‬ ٝ‫ح‬ ٟٞ‫حُو‬ ٙ‫اطـخ‬ ٠ِ‫ػ‬ ٝ َُٝ‫ح‬ ‫١ز٤ؼش‬ ٠ِ‫ػ‬ ‫٣ؼظٔي‬‫حُٞؿٜ٤ش‬ 2-: ١َ٣َُٔ‫ح‬ ٚ‫حُلل‬ ‫ؿخٗز٤ش‬ ‫اهظ٬١خص‬ ١‫أ‬ ‫ٓ٘غ‬ ٝ ٢ٔ‫حُؼظ‬ ‫ح٩ِٗ٣خف‬ ‫ٗيس‬ ْ‫طلخه‬ ‫ُٔ٘غ‬ ‫ُط٤لخ‬ ١َ٣َُٔ‫ح‬ ٚ‫حُلل‬ ٌٕٞ٣ ٕ‫أ‬ ‫٣ـذ‬ ٢‫حُٜيؿ‬ ٝ ١ِٞ‫حُؼ‬ ٢ٌ‫حُل‬ ٝ ٢ٜ‫حُـز‬ ْ‫حُؼظ‬ ‫ٓغ‬ ‫حُٞؿ٘٤ش‬ ٍُٝ‫حُي‬ ْ‫رـ‬ ّٞ‫ٗو‬
  • 107.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 92 ٝ ١ٞ‫حُؼل‬ ٖ٤‫حُؼ‬ ‫كًَخص‬ ٚ‫رلل‬ ١َ٣َُٔ‫ح‬ ٚ‫حُلل‬ ّ‫اطٔخ‬ ‫٣ـذ‬ ١َٔ‫حُو‬: 3-ٚ‫حُلل‬٢‫حُ٘ؼخػ‬: ‫حُوخػي٣ش‬ ‫حٍُٜٞس‬ ٠ِ‫ػ‬ ٌِ‫٣َط‬: Submentovertex viewُ‫ٓٔظخ‬ ٌَ٘‫ر‬ ‫حُٞؿ٘٤ش‬ ّٞ‫حُو‬ َٜ‫طظ‬ ٢‫حُظ‬ ٝ ‫أٓخٓ٤ش‬ ‫هِل٤ش‬ ‫ؿٔـٔش‬ ‫رٍٜٞس‬ ‫ح٩ٓظؼخٗش‬ ٌٖٔ٣ ٝ‫رٟٞؼ٤ش‬Water’s:
  • 108.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 93 ٍِ‫ٓ٘ؼ‬ ٢٘‫ٝؿ‬ ْ‫ػظ‬ ًَٔ ‫ٝؿٞى‬ ٍ‫كخ‬ ٢‫ك‬ ‫طٔظطذ‬ ٢‫حُظ‬ ٝ ‫هٔ٤ش‬ ‫ًه٘٤ش‬ ‫ٍٛٞس‬ ٝ‫أ‬ ‫ٝؿٞى‬ ٍ‫كخ‬ ٢‫ك‬‫ح٧رؼخى‬ ‫ػ٬ػ٤ش‬ ‫ٓوخٍرش‬ ‫ٓغ‬ ٢‫ٓوطؼ‬ َ٣ٜٞ‫ط‬ ‫اؿَحء‬ َ٠‫٣ل‬ ‫ٗي‬ F-‫حُٔ٠خػلخص‬ -‫حُِ٘ف‬ ‫ٗيس‬ ‫رٔزذ‬ ٚٓ‫حُٜي‬ -‫ا‬ٖ٤‫حُؼ‬ ‫ٛخرش‬ٝ‫أ‬ ‫حُوَ٣زش‬ ‫ح٧ػٜخد‬ ٝ‫أ‬ ‫ح٧ٗق‬ ,ٝ ‫ح٧ٍرطش‬ ( ٚ‫حُٔل٤ط‬ ‫حُظَحً٤ذ‬ٝ ٍ‫ح٧ٝطخ‬‫حُٔل٤طش‬ ‫ح٧ٗٔـش‬ ٝ‫أ‬ ‫حُيٓٞ٣ش‬ ‫ح٧ٝػ٤ش‬. )
  • 109.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 94 -٢‫ك‬ ٍ‫هي‬ ٝ ‫حُلـخؽ‬ ‫طلض‬ ‫حُؼٜذ‬ ‫اٛخرش‬‫حُؼِٞ٣ش‬ ‫حُ٘لش‬ ٝ ٢ِ‫حُٔل‬ ٖ‫حُـل‬ -َٓ‫ًخ‬ ٌَ٘‫ر‬ ٢ِ‫حُٔل‬ ٖ‫حُـل‬ ‫اؿ٬م‬ ٠ِ‫ػ‬ ‫حُويٍس‬ ّ‫ػي‬ ٢ُ‫رخُظخ‬ ٝ ٢ٜ‫حُٞؿ‬ ‫ُِؼٜذ‬ ٢٘‫حُٞؿ‬ ‫حُلَع‬ ‫اٛخرش‬ -ْ‫حُظ٘ل‬ ٢‫ك‬ ‫اػخهش‬) ‫ٗخىٍح‬ (. -ٝ‫ٓخ‬ ‫ٓ٠خػلخص‬ َٜ‫طل‬ ‫هي‬٣‫حُ٘ي‬ ‫ًخُِ٘ف‬ ٚ‫حُـَحك‬ ‫رؼي‬ٝ‫أ‬ ‫ي‬‫حُظِٞع‬ ‫ٗظ٤ـش‬‫أ‬ٝ‫ط‬‫ٔٞص‬٢ٔ‫ػظ‬‫حُظ‬ ‫هطغ‬ ‫رٔزذ‬‫َٝ٣ش‬ٚ٣ٞٓ‫حُي‬. G-‫حُؼ٬ؽ‬: : ١‫ٗوخ‬ ‫ػيس‬ ٢‫ك‬ ‫حُؼ٬ؽ‬ ٚ٤‫طِو‬ ٌٖٔ٣ 1-‫ػ٬ؽ‬ ٕٝ‫ى‬ 2-: ‫ٓغ‬ َٗ‫ٓزخ‬ َ٤‫ؿ‬ ‫ٍى‬-. ‫طؼز٤ض‬ ٕٝ‫ى‬ -. ‫ٓئهض‬ ْ‫ىػ‬ -. َٗ‫ٓزخ‬ ‫طؼز٤ض‬ -. َٗ‫ٓزخ‬ َ٤‫ؿ‬ ‫طؼز٤ض‬ 3-. َٗ‫ٓزخ‬ ‫طؼز٤ض‬ ٝ ‫ٍى‬ َ٣‫ٓـخ‬ ٌَ٘‫ر‬ ٌُٖ ٝ ١‫حُ٘وخ‬ ٌٙٛ َ٤ٜ‫طل‬ ْ‫ٓ٤ظ‬ a)-: ‫اىَحافظ‬ ‫اىؼالج‬ ٠ُ‫ا‬ ‫حُؼ٬ؽ‬ ‫٣ٜيف‬:-‫اػخىس‬‫طؼز٤ظٜخ‬ ٝ ‫حٌٍُٔٔٞس‬ ‫حُوطغ‬ ‫طٟٔٞغ‬ -‫اػخىس‬‫حُٞؿٜ٤ش‬ ّٞ‫ُِو‬ ٢‫حُطز٤ؼ‬ ٌَُ٘‫ح‬ -ُْ٧‫ح‬ ‫اُحُش‬ -٢ِ‫حُٔل‬ ‫حُلي‬ ‫ُلًَش‬ ‫اػخهش‬ ١‫أ‬ ‫اُحُش‬ -‫حُلـخؿ٤ش‬ ‫حُلخكش‬ َ٤ٌ٘‫ط‬ ‫اػخىس‬ -‫ٝؿيص‬ ٕ‫ا‬ ‫حُِٔىٝؿش‬ ‫حَُإ٣ش‬ ‫طٜل٤ق‬ ‫ط‬ ١‫أ‬ ‫ؿ٤خد‬ ‫ٓغ‬ ٌَُٔ‫ح‬ ٢‫ه‬ ٢‫ك‬ ٍ‫طزي‬ ١‫أ‬ ‫ؿ٤خد‬ ٍ‫كخ‬ ٢‫ك‬ ‫ًُي‬ ٝ ‫ػ٬ؽ‬ ١٧ ‫ٗلظخؽ‬ ٫ ‫حُلخ٫ص‬ ٞ‫رؼ‬ ٢‫ك‬ٙٞ٘‫حَُإ٣ش‬ ‫اٟطَحد‬ ٝ‫أ‬ٍ‫هي‬ ٝ‫أ‬ ٢ِ‫حُٔل‬ ‫حُلي‬ ‫كًَش‬ ٢‫ك‬ ‫اػخهش‬ ٝ‫أ‬ ‫ٟٓٞؼ٤ش‬ ‫ػٜز٤ش‬ ‫اهظ٬١خص‬ ١‫أ‬ ‫ؿ٤خد‬ ٝ ٙٞ٘‫ط‬ ‫ٝؿٞى‬ ّ‫ػي‬ ٍ‫كخ‬ ٢‫ك‬ ٢‫حُ٬ؿَحك‬ ‫حُؼ٬ؽ‬ ‫طؼظٔي‬٢‫هخٍؿ‬ ‫ٓؼزض‬ ٍ‫آظؼٔخ‬ ٌٖٔ٣ ٝ (‫٫كن‬ ٍ‫طزي‬ ١‫أ‬ ‫ُٔ٘غ‬ ‫حُٜٔخرش‬ ‫حُٔ٘طوش‬ ‫كٞم‬ ٚ‫ه٤خ١ظ‬ ْ‫طظ‬ ) ‫ِٛزش‬ ‫أىحس‬ ١‫أ‬ ٝ‫أ‬ ٕ‫ُٔخ‬ ‫هخكع‬
  • 110.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 95 b)-: ً‫اىجشاح‬ ‫اىؼالج‬ : ‫حُظخُ٤ش‬ ‫حُلخ٫ص‬ ٢‫ك‬ ٢‫حُـَحك‬ ‫حُؼ٬ؽ‬ ‫٣ٔظطذ‬ -‫حَُإ٣ش‬ َ‫طؤػ‬ -ٖ٤‫ُِؼ‬ ‫حُٔلًَش‬ ‫حُؼ٠٬ص‬ ٍ‫اٗلٜخ‬ -‫حُلـخؽ‬ ‫هخع‬ ًٍٞٔ -‫ٓظزيُش‬ ًٍٞٔ -‫ٓوظِطش‬ ًٍٞٔ -٢ِ‫حُٔل‬ ‫حُلي‬ ‫كًَش‬ ‫اٟطَحد‬ -٢‫حُٟٔٞؼ‬ ‫ح٧ػٜخد‬ ‫اٟطَحد‬ ُ‫ح‬‫ٜيف‬٢ٔ٤‫حَُث‬‫ُؼ٬ؽ‬ًَّٔٞ‫حُو‬٢٘‫حُٞؿ‬ْٝ‫ػظ‬‫حُٞؿ٘ش‬ٞٛ‫اػخىس‬‫طٟٔٞغ‬‫حُـَحك٤ش‬. ‫حَُى‬ )* ‫ٛ٘خى‬‫ػيس‬‫أٓخُ٤ذ‬‫ٓوظِلش‬: 1-ْ‫حُل‬ َ‫ىحه‬ ٖٓ(Keen 1909): ‫حُؼِٞ٣ش‬ ‫ح٧ٍكخء‬ ٟٞ‫ٓٔظ‬ ٠ِ‫ػ‬ ١ِ٤ِٛ‫ى‬ ‫ٗن‬ ‫اؿَحء‬ ٝ ْ٤‫حُظؼو‬ ‫رؼي‬َ‫ر‬ ّٞ‫ٗو‬ ‫حَُ٘٣لش‬ ‫ٍكغ‬ ٝ٢٘‫حُٞؿ‬ ّٞ‫حُو‬ ًَٔ ‫ى‬‫ٍحكغ‬ ‫١َ٣ن‬ ٖ‫ػ‬ ‫ٓٔظو٤ٔش‬ ‫أىحس‬ ١‫أ‬ ٝ‫أ‬ ‫ٓٔلخم‬٫ٞٛ‫أ‬ ‫حُ٘ن‬ ‫ه٤خ١ش‬ ‫رؼيٛخ‬ ْ‫٣ظ‬ ٝ.
  • 111.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 96 2-‫حُٜيؿ٤ش‬‫١َ٣وش‬ (Gillies1927): ٍٞ‫رط‬ ‫حُ٘ن‬ َٟ‫٣ـ‬2ّٞ‫حُو‬ ٠‫كظ‬ ‫حُٜيؿ٤ش‬ ‫حُؼ٠ِش‬ ‫ٛلخم‬ ‫طلض‬ ‫حُظِٔ٤ن‬ ْ‫٣ظ‬ ٝ ‫حُٜيؿ٤ش‬ ‫حُٔ٘طوش‬ ٢‫ك‬ َ‫حُ٘ؼ‬ ‫كخكش‬ ٠ِ‫ػ‬ ْٓ ‫حُؼٌحٍ٣ش‬ ‫ػزخص‬ ‫ٝؿٞى‬ ‫ٓغ‬ ‫حُٔؼُِٝش‬ ٌٍُٞٔ‫ح‬ ‫كخ٫ص‬ ٢‫ك‬ ‫حُطَ٣وش‬ ٌٙٛ ‫طٔظطذ‬‫َُِى‬ ٢ُ‫طخ‬ ْ‫ػ‬ ‫حُ٘ٔؾ‬ ٍٝ ّ‫ػي‬ ٝ ْ‫ُِيػ‬ ‫حَُحكؼش‬ ‫طلض‬ ‫طٟٞغ‬ ٕ‫ٗخ‬ ‫هطؼش‬ ٠ِ‫ػ‬ ‫رخ٩ػظٔخى‬ ‫حُٔ٘ـَُس‬ ّٞ‫حُو‬ ‫ٍكغ‬ ٝ ِ٤٤ِ٤‫ؿ‬ ‫ٍحكؼش‬ ٍ‫اىهخ‬ ْ‫٣ظ‬ ٝ ‫حُٔ٘خٓذ‬ ٢٤‫رخُو‬ ‫حُ٘ن‬ ‫ه٤خ١ش‬ ْ‫٣ظ‬ ٌٖٔ٣‫ح٩ٓظؼخٗش‬‫رَحكؼش‬Rowe: 43 2 1
  • 112.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 97 3-( ‫حُوطخف‬ ‫١َ٣ن‬ ٖ‫ػ‬Hock): ‫حُوطخف‬ ّ‫ٍأ‬ ‫طؼز٤ض‬ ْ‫٣ظ‬ ‫ىحثَ٣ش‬ ‫ٜٗق‬ ‫رلًَش‬ ٝ ‫ٓزخَٗس‬ ‫حُٞؿ٘٤ش‬ ّٞ‫حُو‬ ٟٞ‫ٓٔظ‬ ‫طلض‬ ‫حُوطخف‬ ٖٓ ‫حُٔٔظيم‬ ‫حُـِء‬ َُ‫ؿ‬ ْ‫٣ظ‬ ٝ ٍٞ‫حُيه‬ ‫ٗوطش‬ ‫ُو٤خ١ش‬ ‫ٛ٘خ‬ ‫كخؿش‬ ٫ ٝ ٢ٜ‫حُٞؿ‬ ْ‫حُؼظ‬ ٝ‫أ‬ ّٞ‫حُو‬ ‫ٍى‬ ْ‫٣ظ‬ ‫طٞؿ٤ٜ٤ش‬ ‫رلًَخص‬ ٝ ٢٘‫حُٞؿ‬ ْ‫ُِؼظ‬ ٢‫حُوِل‬ ٚ‫حُٞؿ‬ ٠ِ‫ػ‬ 4-‫١َ٣وش‬Dingman`s: ٢‫حُلخؿز‬ ‫حُ٘ن‬ ٝ‫أ‬ ‫حُظِٔ٤ن‬ ْ‫ػ‬ ‫ُِلخؿذ‬ ‫حُٞك٘٤ش‬ ٝ ‫حُؼِٞ٣ش‬ ‫حُلخكش‬ ٟٞ‫ٓٔظ‬ ٠ِ‫ػ‬ ‫حُ٘ن‬ ٌٕٞ٣٠ُ‫ا‬ ٫ٞٛٝ ٝ ‫ح٧ٓخٓ٤ش‬ ‫حُـزٜ٤ش‬ ‫حُؼ٠ِش‬ ‫ٛلخم‬ ‫كٞم‬ ‫ٓٔظو٤ٔش‬ ‫رؤىحس‬ ٌَُٔ‫ح‬ ‫ٍكغ‬ ْ‫ػ‬ ٖٓ ٝ ‫حُٜيؿ٤ش‬ ‫حُؼ٠ِش‬ ‫ٛلخم‬ َّٛ ‫كيٝع‬ ‫ُٔ٘غ‬ ‫اٍطٌخُٛخ‬ ‫ٗوطش‬ ٟٞ‫ٓٔظ‬ ٠ِ‫ػ‬ ٠ِٔ‫حُٔٔظؼ‬ ‫ح٧ىحس‬ ‫طلض‬ ٕ‫ٗخ‬ ‫هطؼش‬ ‫ٟٝغ‬ ‫حُلخ٫ص‬ ٌٙٛ َ‫ٓؼ‬ ٢‫ك‬ َ٠‫٣ل‬‫ُِ٘ٔؾ‬ 5-: ٢‫حُزَحؿ‬ ٍ‫ربٓظؼٔخ‬ ‫حُٔ٘خٓزش‬ ‫حُٟٞؼ٤ش‬ ٠ُ‫ا‬ ٍُٞٛٞ‫ح‬ ٠‫كظ‬ ‫حُٞؿ٘ش‬ ‫رظلَى‬ ٌْ‫حُظل‬ ٌٖٔ٣ ‫رٌُي‬ ٝ ٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ‫ٓ٘ظٜق‬ ٢‫ك‬ ٢‫رَؿ‬ ‫طؼز٤ض‬ ٠ِ‫ػ‬ ‫طؼظٔي‬ ُ‫ح‬ ٍ‫آظزيح‬ ٌٖٔ٣‫ز‬‫رؤىحس‬ ٢‫َؿ‬Carroll-Girard)‫(حٍُٜٞس‬
  • 113.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 98 5-ّ‫ربٓظويح‬ ‫حَُى‬Towel Clip: )*‫حُ٘ن‬٢‫حُـَحك‬: ٕ‫أ‬ ‫آخ‬ *ٌَُٔ‫ح‬ ٢‫ه‬ ٠ِ‫ػ‬ َٗ‫ٓزخ‬ ٌَ٘‫ر‬ ٌٕٞ٣ ٢‫حُزَحؿ‬ ٝ ‫حُٜلخثق‬ ‫رٞحٓطش‬ ٝ‫أ‬ ‫رخ٧ٓ٬ى‬ ‫آخ‬ َٗ‫ٓزخ‬ ٌَ٘‫ر‬ ‫حُظؼز٤ض‬ ٝ ‫حَُى‬ ْ‫٣ظ‬ ٝ ٌَُٔ‫ح‬ ٢‫ه‬ ‫كٞم‬ ‫حُٜٔخد‬ ‫حُـخٗذ‬ ٠ِ‫ػ‬ ُّٞ٘‫ح‬ ٖ‫ػ‬ ‫ح٩ٓظ٘خع‬ ٝ َُٟٝٞ‫ح‬ ٖٓ ‫ٗٞع‬ ١‫أ‬ ‫طـ٘ذ‬ ‫٣ـذ‬ ‫حُ٘لخء‬ ‫كظَس‬ ٍ٬‫ه‬
  • 114.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 99 : ٢‫ؿخٗز‬ ٢‫كـخؿ‬ ‫ٗن‬ * ١ِٞ‫ػ‬ ٢٘‫ؿل‬ ‫ٗن‬ * ٢‫كـخؿ‬ ‫طلض‬ ‫ٗن‬ * : ‫حُِٔظلٔش‬ َ‫ػز‬ ‫ٗن‬ *
  • 115.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 100 :٢‫طخؿ‬ ‫ٗن‬ * : ‫حُظؼز٤ض‬ )* -: ‫حٌُِٔ٤ش‬ ‫حُو٤خ١ش‬ ‫١َ٣ن‬ ٖ‫ػ‬ ‫آخ‬ ‫ٓزخَٗس‬ ٌَُٔ‫ح‬ ٢‫ه‬ ‫كٞم‬ ‫ُ٘ن‬ ٢ٓ‫أٓخ‬ ٌَ٘‫ر‬ ‫طلظخؽ‬ ٝ ‫حُلـخؽ‬ ‫طلض‬ ‫حُلخكش‬ ٝ ٢٘‫حُٞؿ‬ ٢ٜ‫حُـز‬ ٍُ‫ُِي‬ ‫حُو٤خ١ش‬ ٌٕٞ‫ط‬ ‫ٓخ‬ ‫ؿخُزخ‬ -: ‫حُٜلخثق‬ ٝ ٢‫حُزَحؿ‬ ٍ‫آظؼٔخ‬ ٝ ٫‫آظؼٔخ‬ َ‫ح٧ًؼ‬ ‫حُطَ٣وش‬ ٢ٛ ٝ٢٘‫حُٞؿ‬ ْ‫حُؼظ‬ ْٔ‫ؿ‬ ٝ ‫حُلـخؽ‬ ‫طلض‬ ‫حُلخكش‬ ٝ ٢ٜ‫حُـز‬ ٢٘‫حُٞؿ‬ ٍُ‫حُي‬ ًٍَٔ ٢‫ك‬ ‫طٔظطذ‬ ‫ٌُٜ٘خ‬ : ‫حُٜلخثق‬ ٍ‫آظؼٔخ‬ ‫ٓغ‬ ‫اطزخػخ‬ َ‫ح٧ًؼ‬ ‫حُـَحك٤ش‬ َ‫حُٔيحه‬-‫ُِلـخؽ‬ ‫حُـخٗز٤ش‬ ‫حُلخكش‬ ‫ٗن‬ -‫حُلـخؽ‬ ‫طلض‬ َ‫حُٔيحه‬ -ٖ‫حُـل‬ َ‫ػز‬ َ‫حُٔيه‬ -‫حُِٔظلٔش‬ َ‫ػز‬ َ‫حُٔيه‬ -‫حُل‬ َ‫ىحه‬ ‫حُ٘ن‬١ٞٔ ‫ٓظلَهش‬ ٝ‫أ‬ ‫ٓـظٔؼش‬ ٌٕٞ‫ط‬ ‫هي‬ ‫ُِظؼز٤ض‬ ١‫ٗوخ‬ ‫ػيس‬ ‫ًٌُي‬ ‫ٗؼظٔي‬
  • 116.
    ‫الوجه‬ ‫عظام‬ ‫كسور‬ Dr.firas Kassab Page 101 ًٖ‫أٓخ‬ ‫ػ٬ع‬ ٝ‫أ‬ ٖ٤ٗ‫ٌٓخ‬ ٝ‫أ‬ ‫ٝحكي‬ ٕ‫رٌٔخ‬ ‫آخ‬ ‫حُظؼز٤ض‬ ٌٕٞ٣ ٝ ‫طؼز٤ض‬ ١‫ٗوخ‬ ‫أٍرغ‬ ٠‫كظ‬ ٝ‫أ‬ H-‫حُٔ٠خػلخص‬: 1-ْ‫حُؼظ‬ ٠ِ‫ػ‬ ‫حَُهٞس‬ ‫حُ٘ٔؾ‬ ‫طٟٞغ‬ ‫ٓٞء‬ 2-: ‫ػ٤٘٤ش‬ ‫ٓ٠خػلخص‬-‫حُٔوِش‬ ‫هِق‬ ‫ِٗف‬ -‫حُٔ٠خػلش‬ ‫حَُإ٣ش‬ ٍ‫آظَٔح‬ -ٖ٤‫حُؼ‬ ٍٝ‫ؿئ‬ -‫حُلـخؽ‬ ‫طلض‬ ‫حُؼٜذ‬ ٕٞ٘‫ط‬ -٠ٔ‫ػ‬ 3-‫كٌ٤ش‬ ‫ؿ٤ٞد‬ ‫اُظٜخد‬ 4-٢ِ‫حُٔل‬ ‫ُِلي‬ ١ٍ‫حُٔ٘وخ‬ ‫حُ٘خطت‬ ‫ٓغ‬ ‫حُٞؿ٘ش‬ ‫اُظٜخم‬ 5-ٕ‫ح٩ٗظخ‬
  • 117.
  • 118.
  • 119.
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