Objective: ZMO fracture indicated for ORIF can be accessed using many approaches, comparison andevaluation of methods was mandatory to reveal the most convenient approach with special attentionto surgical scar appearance and patient's esthetics. Design: Prospective study of the ZMO trauma patients. Participants: Twenty-one patients were operated. Distributed in three groups seven patients in each.Groups represented the three approaches, transconjunctival, subtarsal and subciliary. Additionalhealthy un-operated patients were examined as control. Methods: Patients suffering from ZMO fracture were randomly distributed and operated using thethree mentioned approaches. Patients were evaluated post operatively regarding to esthetic outcome,patient satisfaction, pain, incidence of poor wound healing and the quality of fixation. Results: Modified Vancouver Scar Scale (MVSS) results showed lower values for Transconjunctivalapproach ( 4 ±1.225) followed by Subtarsal approach ( 6 ±2.83) and highest value for Subciliaryapproach ( 7.2 ±1.095). With statistically significant difference between Subciliary andTransconjunctival but there is no statistically significant difference between Subtarsal and the othertwo groups. Conclusions: The transconjunctival approach was associated with lower rates of complications,patient complaints and pain.
The aim of current study was to evaluate the validity of intraoral approach in management of infraorbital rim fracture considering exposure and complications.
MATERIALS AND METHODS
Purpose: Different surgical protocols have been introduced for eminence augmentation for treatment of recurrent temporomandibular joint dislocation, The aim of this study is to assess maximal incisal opening (MIO) using inlay (sandwich osteotomy) autogenous block augmentation harvested from patient’s symphesis for more stable condylar movements . Methods: five patients were treated in this study (10 joints) with bilateral autogenous inlay block bone grafting technique, each autogenous cortico-cancellous bone block was harvested from chin and wedged at the created defect of the eminence through a green stick fracture to increase its height . Results: The follow up period ranged from six months to two years to access the maximal incisal opening (MIO). the mean preoperative maximal incisal opening was 45.8mm and that of the postoperative was 32.3 mm . One patient reported postoperative slight unilateral edema and pain that gradually diminishes after one month postoperative.another patient showed intraoperative condylar dislocation that was treated with masseter scarification. Conclusion: autogenous block interpositional eminoplasty technique is a reliable procedure for management of antero-medial recurrent condylar dislocation.
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