Retrospective study about the postoperative stability of zygomaticomaxillary complex fracture

Abstract

Background The aim of this study is to evaluate the postoperative stability of zygomaticomaxillary complex (ZMC) fractures according to the number of fixation sites and to investigate the direction of postoperative displacement of the unfixed part of the fractured segment. Methods This study was retrospectively performed on 38 patients who were treated by open reduction and internal fixation of ZMC fractures and were taken postoperative computed tomography (CT) between February 2012 and July 2019. The patients were classified into 3 groups: 1-point fixation, 2-point fixation, 3-point fixation according to the number of fixations. The postoperative displacement of the fractured segment was evaluated by the superimposition between postoperative CT and follow-up CT, and the postoperative stability according to the fixation sites was investigated through the amount of postoperative displacement. In addition, it was investigated in which direction the location of the fractured segment was changed in the unfixed fractured segment according to the fixation sites. Results The amount of postoperative displacement of the fractured segment was 0.75 ± 1.18 mm on average. In the postoperative displacement of the distal area according to the number of fixation of the fracture, there was no statistically significant difference in the amount of displacement of the fracture (p = 0.574). As for the direction of the change in the location of the fractured segment, 12 patients among 38 patients with the change in the location of the fractured segment were investigated, and the displacement in the medial direction (n = 11, 91.67%) was the most common in all three fixation methods. Conclusion In patients with a ZMC fracture who were treated by open reduction and internal fixation, the number of fixations did not make the difference in the postoperative displacement of the fracture. In addition, the fractured segment mainly changes in the medial direction after surgery, and this fact can be used as a reference for the reduction direction during surgery for the stable prognosis.

Abordagem cirúrgica de fratura blow-out através de acesso transconjuntival

“…Segundo dados epidemiológicos internacionais, o assoalho orbitário é apontado como quarto lugar entre os traumas craniofaciais precedido pelo osso nasal, mandibular e malarmaxilar 4 O terço médio da face pela agregação de variados ossos tem motivado acessos menos invasivos com transformações e resultados estéticos satisfatórios. Mediante os grandes traumas de face e suas repercussões clínicas, novos acessos cirúrgicos e fixações foram-se admitindo pelos cirurgiões, a fim de tornar-se mais acessível e diminuir grandes sequelas ao paciente 5 .…”