Contemporary Management of Zygomaticomaxillary Complex Fractures

Contemporary Management ◽

AbstractZygomaticomaxillary complex fracture is one of the most commonly treated facial fractures. Accurate reduction and stable fixation of the zygoma are required to restore facial symmetry and projection and avoid functional sequalae from changes in orbital volume. Achieving optimal outcome is challenging due to the complex three-dimensional anatomy and limited visualization of all affected articulations of the zygoma. This article provides an updated overview of the evaluation and management of zygomaticomaxillary complex fractures based on available evidence and clinical experience at our center. The importance of soft tissue management is emphasized, and approaches to internal orbital reconstruction are discussed. While evidence remain limited, intraoperative imaging and navigation may prove to be useful adjuncts in the treatment of zygomaticomaxillary fractures.

Virtual surgical planning and three-dimensional printing for the treatment of comminuted zygomaticomaxillary complex fracture

Journal of Stomatology Oral and Maxillofacial Surgery ◽

10.1016/j.jormas.2020.05.009 ◽

2020 ◽

Cited By ~ 1

Author(s):

M. Longeac ◽

A. Depeyre ◽

B. Pereira ◽

I. Barthelemy ◽

N. Pham Dang

Keyword(s):

Surgical Planning ◽

Three Dimensional ◽

Three Dimensional Printing ◽

Complex Fracture ◽

Virtual Surgical Planning ◽

Dimensional Printing ◽

Evaluation of one-point fixation for zygomaticomaxillary complex fractures using a three-dimensional photogrammetric analysis

Journal of Otolaryngology - Head and Neck Surgery ◽

10.1186/s40463-019-0359-2 ◽

2019 ◽

Vol 48 (1) ◽

Author(s):

Se Young Kim ◽

Seung Min Nam ◽

Eun Soo Park ◽

Yong Bae Kim

Keyword(s):

Three Dimensional ◽

Complex Fractures ◽

Use of C-Arm to Assess Reduction of Zygomatic Complex Fractures: A Comparative Study

Craniomaxillofacial Trauma & Reconstruction ◽

10.1055/s-0036-1592085 ◽

2017 ◽

Vol 10 (1) ◽

pp. 35-43 ◽

Cited By ~ 6

Author(s):

AtmakuruVenkata Maheedhar ◽

C. Ravindran ◽

Emmanuel D. S. Azariah

Keyword(s):

Comparative Study ◽

Intraoperative Imaging ◽

Maxillofacial Surgery ◽

T Test ◽

Oral And Maxillofacial Surgery ◽

Orbital Volume ◽

Complex Fractures ◽

The aim of this study was to analyze the use of C-arm and its significance in accurate reduction of zygomaticomaxillary complex (ZMC) fractures. Orbital volume is used as parameter to compared pre- and postoperative volumes of injured orbit. Differences in orbital volume calculated in cases done with intraoperative imaging and in controls treated without the use of intraoperative imaging were evaluated using Student t-test. C-arm is definitively an effective tool in the armamentarium of oral and maxillofacial surgery in assessment of reduction of ZMC fracture.

Tetrapod Fracture: Surgical Anatomy Revisited As A Guide For 3D Reduction Using Carroll Girard T-Bar Screw

Jurnal Plastik Rekonstruksi ◽

10.14228/jpr.v4i1.219 ◽

2018 ◽

Vol 4 (1) ◽

pp. 82-87

Author(s):

Prasetyanugraheni Kreshanti ◽

Livia Faranita Gianni

Keyword(s):

Three Dimensional ◽

Lower Eyelid ◽

Surgical Anatomy ◽

Facial Skeleton ◽

Lateral Aspect ◽

Reference Axis ◽

Aesthetic Appearance ◽

Vestibular Approach ◽

Background: Zygomaticomaxillary complex plays a key role in the structure, function, and aesthetic appearance of the facial skeleton. Using Carroll Girard T-bar screw allows easy manipulation of the zygomaticomaxillary complex fracture. The goal of the treatment is three dimensional (3-D) restoration of the disturbed anatomy. Methods: After exposing the fracture sites using technique such as lower eyelid, Dingman (lateral brow) or maxillary vestibular approach, the Carroll Girard T-bar screw is then attached to the lateral aspect of the malar eminence to freely move the zygoma according to the x,y, and z axis. Zygomaticosphenoid suture acts as the anatomical landmark for adequate reduction. Conclusion: Open reduction and internal fixation is the principle of management in displaced ZMC fractures, aided by the use of Carroll Girard T-bar screw which allows easy manipulation and rotation for the zygomatic bone using the reference axis x, y and z.

Management of Unilateral Zygomaticomaxillary Complex Fracture - A Case Report

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/626 ◽

2021 ◽

Vol 10 (35) ◽

pp. 3070-3073

Author(s):

Vybhavi M. K. ◽

Prashanth V. ◽

Srinivas V.

Keyword(s):

Surgical Intervention ◽

Bone Fractures ◽

Nasal Bone ◽

Surgical Approaches ◽

Complex Fracture ◽

Complex Fractures ◽

Maxillofacial Fractures ◽

Comminuted Fractures ◽

Zygomaticomaxillary complex (ZMC) fractures are relatively common. Zygomatic complex fractures with functional or aesthetic impairments often require surgical intervention. Treatment of ZMC fractures consists of reduction and fixation of the dislocated bone fragments to their original location. The zygomaticomaxillary complex functions as a major buttress for the face and because of its prominent convex shape, is frequently involved in facial trauma.1 ZMC fractures are also called tripod, tetrapod, quadripod, malar or trimalar fractures. They account for approximately 15 % - 23.5 % of maxillofacial fractures.2,3 The aetiology of zygomatic complex fractures primarily includes road traffic accidents (RTA), violent assaults, falls and sports injuries. They are the second most common facial fracture after nasal bone fractures.3-6 ZMC fractures are more common in men than women, and most commonly occur in the third decade of life.7-10 The main clinical features of zygomatic complex fractures include diplopia, enophthalmos, subconjunctival ecchymosis, extraocular muscle entrapment, cosmetic deformity, malocclusion and neurosensory disturbances of the infra-orbital nerve.10 The gold standard radiological investigation for evaluation of ZMC fractures is computed tomography (CT) scan. Surgical intervention is effective in cases of displaced and comminuted fractures involving functional and aesthetic defects, whereas a nonsurgical approach is often used for non-displaced fractures.11 Various surgical approaches and treatment strategies have been proposed to obtain a successful treatment outcome. Based on review of literature, it has been observed that the open reduction with internal fixation using mini plates and screws is the most commonly preferred treatment for displaced and comminuted fractures.10-12 Here, we report a clinical case of right zygomaticomaxillary complex fracture and its management.

Intraoperative use of C-Arm as an Aid in Reduction of Zygomatic Complex Fractures

World Journal of Dentistry ◽

10.5005/jp-journals-10015-1003 ◽

2010 ◽

Vol 1 (1) ◽

pp. 13-16 ◽

Cited By ~ 2

Author(s):

Tejraj Pundalik Kale ◽

Abhishek Balani ◽

SM Kotrashetty ◽

SD Baliga

Keyword(s):

Image Intensifier ◽

Functional Results ◽

Acceptable Limit ◽

Complex Fracture ◽

Complex Fractures ◽

Zygomaticomaxillary Complex ◽

Maximum Discrepancy

ABSTRACT To monitor the efficacy of C-Arm as a intraoperative tool in reduction of zygomatic complex fractures. 15 patients with isolated zygomaticomaxillary complex fracture, were selected for reduction of the same. C-Arm (image intensifier) images were taken intraoperatively. Standardization of all postoperative radiographs were done to evaluate the discrepancy in reduction. The maximum discrepancy after analysis of postoperative radiographs was within 2 mm, which was considered as acceptable limit. Thus, C-Arm is considered a useful tool for reduction of zygomatico-maxillary complex fractures with enhanced postoperative esthetics and functional results.