Purpose To evaluate the efficacy of two point rigid internal fixation in the immobilization of zygomatic complex fractures. Patients and methods 30 patients with zygomatic complex fractures were managed by open reduction and internal fixation using titanium mini bone plate screws at the frontozygomatic and zygomatic buttress region. This prospective study was carried out at the Department of Oral & Maxillofacial Surgery, Armed Forces Medical College (AFMC), Pune, India between 1st August 2005 to 1st August 2007. Isolated unilateral zygomatic complex fractures of less than six weeks duration were included in the study. Result Clinically and radiologically satisfactory results were achieved in all 30 patients using two point rigid internal fixation at the frontozygomatic and zygomatic buttress region of zygomatic complex fracture. Conclusions Stable fixation and immobilization of isolated zygomatic complex can be achieved with two point fixation using titanium mini bone plate and screws at the frontozygomatic and zygomatic buttress region of zygomatic complex fracture. Postoperative complications like scarring, ectropion and neurological deficit can be avoided by not using infraorbital rim as the third point of fixation.
Aim This retrospective study was done to analyse the management of zygomatic complex fractures necessitating surgical intervention in a tertiary care hospital in a 8 year period in terms of incidence, cause, pattern and treatment. Materials and Methods Two hundred and thirteen cases of zygomatic complex fractures treated during this period were analysed. Results One hundred and eighty three cases of zygomatic complex fractures were treated by a two point fixation while additional fixation was used in 25 cases and single point fixation in five cases. The main etiology in zygomatic complex fractures was Road traffic accidents (RTA) (83.56 %-178 cases) followed by sport injuries (10 cases-4.65%), accidental falls (19 cases-8.9%) and domestic violence (2.81%-6 cases). The average age at the time of injury was 34.36 years with the age range being 7 years to 75 years. The highest incidence of fractures was seen in the third decade of life (102 cases) (47.88 %) followed by the second decade (44 cases) (20.65%), 41 cases (19.24 %) in the 4th decade, 8 cases each (3.75%) in the 5th and 6th decades, six cases (2.81%) in the 7th decade and four cases (1.87%) in the 8th decade. Conclusion The protocol of two point fixation was found to be adequate in most cases of zygomatic complex fractures in terms of stability and restoration of contour and function.
Various local flaps have been used for reconstruction of developmental and post surgical soft tissue defects of maxillofacial region. They include nasolabial flap, palatal pedicled flap, buccal fat pad, temporalis muscle and fascia flap. An ideal flap for all indications is yet to be found. Our experience with free dermal fat graft in the correction of deformities associated with Parry Romberg syndrome and oral submucous fibrosis is presented.
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