Feasibility of 4-Point Fixation Using the Preauricular Approach in a Zygomaticomaxillary Complex Fracture

Choi, Kang Young; Ryu, Dong Wan; Yang, Jung Dug; Chung, Ho Yun; Cho, Byung Chae

doi:10.1097/scs.0b013e3182700d23

Cited by 16 publications

(19 citation statements)

References 18 publications

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“…Standard treatment mostly involves internal fixation with plates and screws, but there is much debate regarding what qualifies as adequate fixation. Three-point fixation for treatment of ZMC fractures is traditionally recommended; however, there are varying opinions on what is truly necessary for adequate reconstruction 6891011…”

mentioning

confidence: 99%

Current Management of Zygomaticomaxillary Complex Fractures: A Multidisciplinary Survey and Literature Review

Farber

Nguyen

Skolnick

et al. 2016

Craniomaxillofacial Trauma & Reconstruction

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The prominence of the zygomaticomaxillary complex (ZMC) convexity along the anterolateral portions of the face makes it vulnerable to traumatic injury. While there is debate as to what part of the facial skeleton is most commonly injured, ZMC fractures comprise up to 40% of facial fractures. 1,2Common etiologies include motor vehicle accidents, assault, falls, and sports-related injuries.1,3 The complex three-dimensional aspect of the zygoma contributes both to facial aesthetics and function. It forms the malar eminence, providing cheek projection, and the lateral and inferior portions of the orbit. Reestablishing preinjury form is the goal of all ZMC fracture treatments, regardless of the approach utilized.As surgical technique and technology have improved through the past century, management opinions have evolved.4-7 Standard treatment mostly involves internal fixation with plates and screws, but there is much debate Keywords ► orbital fractures ► zygomatic fractures ► facial injuries AbstractDespite the prevalence of zygomaticomaxillary complex (ZMC) fractures, there is no consensus regarding the best approach to management. The aim of this study is to determine differences in ZMC fracture treatment among various surgical specialties. A survey was conducted regarding treatment of patients with different ZMC fractures that included a minimally displaced fracture (Case 1), a displaced fracture without diplopia (Case 2), a displaced fracture with diplopia (Case 3), and a complex comminuted fracture (Case 4). The survey was distributed to members of plastic surgery, oral maxillofacial surgery, and otolaryngology societies. The rates of surgical treatment, exploration of the orbital floor, and plating three or more buttresses were analyzed among the specialties. A total of 173 surgeons participated (46 plastic and reconstructive surgeons, 25 oral and maxillofacial surgeons, and 102 otolaryngologists). In Case 1, a significantly higher percentage of plastic surgeons recommend an operation (p < 0.01) compared with other specialties. More than 90% of surgeons would perform an operation on Case 2. Plastic surgeons explored the orbital floor (p < 0.01) and also fixated three or more buttresses more frequently (p < 0.01). More than 93% of surgeons would operate on Case 3, with plastic surgeons having the greatest proportion who fixed three or more buttresses (p < 0.01). In Case 4, there was no difference in treatment patterns between specialties. Across the specialties, more fixation was placed by surgeons with fewer years in practice (<10 years). Conclusion There is no consensus on standard treatment of ZMC fractures, as made evident by the survey. Significant variability in fracture type warrants an individualized approach to management. A thorough review on ZMC fracture management is provided.

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confidence: 99%

Current Management of Zygomaticomaxillary Complex Fractures: A Multidisciplinary Survey and Literature Review

Farber

Nguyen

Skolnick

et al. 2016

Craniomaxillofacial Trauma & Reconstruction

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“…Three-point fixation for treatment of ZMC fractures is traditionally recommended; however, there are varying opinions on what is truly necessary for adequate reconstruction [17,[19][20][21][22][23]. Despite the prevalence of ZMC fractures, there is no consensus in the literature concerning the best approach to management and when repair is indicated.…”

mentioning

confidence: 99%

Biomaterials used in Reduction and Fixation of Unstable Fractures of the Zygomaticomaxillary Complex

Budacu¹,

Nemtoi²,

Craiu³

et al. 2017

Mat.Plast.

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This study evaluated a series of cases of fracture in the zygomaticomaxillary complex with displacement of the fractured segment which were evaluated before and after treatment with cone beam CT. The treatment perfomed was represented by titanium micro-plates and screws. The study sample which consist of 25 patients of both genders with fractures in the zygomaticomaxillary bones. After clinical examination to arrive at correct diagnosis and treatment plan, each patient was subjected to 2D and 3D reconstruction using cone beam CT. Reffering to the type of treatment was evaluated the procces of bone remodelling and also the osseointegration process of the titanium micro-plates and screws used for reduction and fixation of the fractures. The treatment performed for all patients was reduction and fixation with titanium micro-plates which were osseointegrated partially in 45 % of patients and 3 screws were not osseointegrated.

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“…[1][2][3][4] Despite the relative frequency of these injuries, there remains debate regarding management, including number of approaches and points of fixation and the decision to explore the orbital floor. [5][6][7][8][9][10][11][12][13][14] Recent studies have attempted to resolve these controversies using large cohorts to derive algorithms for management. 2,3 At many institutions, facial trauma management is divided across several services, such as oral and maxillofacial surgery, plastic and reconstructive surgery, and otolaryngology (ORL).…”

mentioning

confidence: 99%

Does Training Background Influence Decision-Making in the Management of Zygomaticomaxillary Complex Fractures?

Susarla

Mundinger

O’Brien-Coon

et al. 2016

Journal of Oral and Maxillofacial Surgery

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Feasibility of 4-Point Fixation Using the Preauricular Approach in a Zygomaticomaxillary Complex Fracture

Cited by 16 publications

References 18 publications

Current Management of Zygomaticomaxillary Complex Fractures: A Multidisciplinary Survey and Literature Review

Current Management of Zygomaticomaxillary Complex Fractures: A Multidisciplinary Survey and Literature Review

Biomaterials used in Reduction and Fixation of Unstable Fractures of the Zygomaticomaxillary Complex

Does Training Background Influence Decision-Making in the Management of Zygomaticomaxillary Complex Fractures?

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