كسور عظام الوجه

1. ٚ‫حُٞؿ‬ ّ‫ػظخ‬ ًٍٞٔ
ّ‫كَح‬ .‫ى‬‫ؿٞىص‬‫ًٔخد‬

2. ‫الوجه‬ ‫عظام‬ ‫كسور‬
‫كساب‬ ‫جودت‬ ‫فراس‬ .‫د‬

3. ّ‫انٕخ‬ ‫عظاو‬ ‫كغٕس‬
‫كساب‬ ‫جودت‬ ‫فراس‬
ّ‫انٕخ‬ ‫عظاو‬ ‫كغٕس‬

4. ّ‫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

5. ّ‫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

6. ّ‫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

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. ‫الوجه‬ ‫عظام‬ ‫كسور‬
Dr. firas Kassab Page 6

14. ‫الوجه‬ ‫عظام‬ ‫كسور‬
‫كساب‬ ‫جودت‬ ‫فراس‬ .‫د‬

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. ‫الوجه‬ ‫عظام‬ ‫كسور‬
‫كساب‬ ‫جودت‬ ‫فراس‬ .‫د‬

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. ‫الوجه‬ ‫عظام‬ ‫كسور‬
‫كساب‬ ‫جودت‬ ‫فراس‬ .‫د‬

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