scholarly journals Treatment of Zygomatic Complex Fractures with Surgical or Nonsurgical Intervention: A Retrospective Study

2018 ◽  
Vol 12 (1) ◽  
pp. 377-387 ◽  
Author(s):  
Thomas Starch-Jensen ◽  
Linda Busk Linnebjerg ◽  
Janek Dalsgaard Jensen
Keyword(s):  
Surgical Intervention ◽  
Mouth Opening ◽  
Orbital Floor ◽  
Radiographic Examination ◽  
Rigid Fixation ◽  
Ocular Motility ◽  
Facial Contour ◽  
Complex Fractures ◽  
Intraoral Approach ◽  
Ocular Movement

Objective:Evaluate the 1-year treatment outcome of zygomatic complex fractures with surgical or nonsurgical intervention.Materials and Methods:One hundred and forty-two consecutive patients with a zygomatic complex fracture were enrolled. Sixty-eight patients underwent surgical intervention and 74 patients nonsurgical intervention. The 1-year examination evaluated cosmetic and functional outcome including malar symmetry, ocular motility, occlusion, mouth opening, neurosensory disturbances, and complications.Results:Forty-six patients allocated to surgical intervention responded to the 1-year follow-up examination. Satisfying facial contour and malar alignment was observed in 45 patients. All patients presented with identical position of the eye globe without enophthalmos and normal ocular movement. A habitual occlusion was seen in all patients with a mean interincisal mouth opening without pain of 49 mm. One patient presented with minor ectropion. Wound infection occurred in five patients. Persistent infraorbital neurosensory disturbance was described by 19 patients. The 1-year radiographic examination showed adequate fracture alignment in all patients with satisfying facial contour. However, dissimilar position of the orbital floor was seen in three patients having orbital reconstruction. None of the patients were re-operated or needed secondary correction of the zygomatic complex or orbital floor.Conclusion:Surgical intervention is an effective treatment modality of depressed zygomatic complex fractures, whereas a nonsurgical approach is often used for nondisplaced fractures. Most zygomatic complex fractures can be treated solely by an intraoral approach and rigid fixation at the zygomaticomaxillary buttress. Further exposure of the zygomaticofrontal junction or inferior orbital rim is necessary for severely displaced fractures, which require additional fixation.

Management of Orbital Floor Fractures

2019 ◽  
Vol 35 (06) ◽  
pp. 633-639 ◽  
Author(s):  
Tom Shokri ◽  
Mark Alford ◽  
Matthew Hammons ◽  
Yadranko Ducic ◽  
Mofiyinfolu Sokoya
Keyword(s):  
Decision Making ◽  
Surgical Repair ◽  
Operative Intervention ◽  
Orbital Floor ◽  
Ocular Motility ◽  
Orbital Volume ◽  
Facial Contour ◽  
Orbital Floor Fractures ◽  
Craniomaxillofacial Trauma

AbstractFractures of the orbital floor represent a common yet difficult to manage sequelae of craniomaxillofacial trauma. Repair of these injuries should be carried out with the goal of restoring normal orbital volume, facial contour, and ocular motility. Precise surgical repair is imperative to reduce the risk of long-term debilitating morbidity. This article aims to review concepts on the management of orbital floor fractures in the hope of further elucidating perioperative evaluation and decision-making regarding operative intervention.

scholarly journals Correction of severe facial asymmetry: A case with fractured condyle

2019 ◽  
Vol 9 ◽  
pp. 59-64
Author(s):  
Ramesh Agrawal ◽  
Dolly P. Patel ◽  
Bhagyashree B. Desai
Keyword(s):  
Facial Asymmetry ◽  
Post Treatment ◽  
Radiographic Examination ◽  
Rigid Fixation ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
History Of ◽  
Condylar Head ◽  
The Stability ◽  
The Right

The current paper depicts the challenges faced during the treatment of a complicated case of mandibular condylar head fracture, facial asymmetry, and centric relation-centric occlusion (CR-CO) discrepancy along with Class III malocclusion. A 20-year-old female reported with the chief complaint of difficulty in chewing and concern with her appearance due to deviated jaw and had a history of trauma over chin region. The clinical and radiographic examination revealed significant facial asymmetry with long face, right-sided deviation of the mandible, fractured condyle, CR-CO discrepancy, cross- bite with Class III malocclusion, and a missing mandibular single incisor along with non-vital 21 and 22. She was treated with 0.022 MBT appliance along with guiding plane for CR-CO correction followed by asymmetric bilateral sagittal split osteotomy and differential set back on the right and left sides and finally rigid fixation. A good facial profile and functional occlusion were achieved and non-vital 21 and 22 were esthetically rehabilitated with PFM crowns. The stability of surgical as well as orthodontic corrections was excellent and appreciable in the records obtained 2-year post-treatment. When faced with mutilated malocclusion, with multiple problems, sequential correction of functional malocclusion with dental decompensation followed by skeletal correction with surgical approach has yielded a appreciable facial correction with good stability showing 2-year post-treatment follow-up.

Assessment of Infraorbital Hypesthesia Following Orbital Floor and Zygomaticomaxillary Complex Fractures Using a Novel Sensory Grading System

2019 ◽  
Vol 35 (1) ◽  
pp. 53-55 ◽  
Author(s):  
Natalie Homer ◽  
Lora R. Glass ◽  
N. Grace Lee ◽  
Daniel R. Lefebvre ◽  
Francis C. Sutula ◽  
...  
Keyword(s):  
Orbital Floor ◽  
Grading System ◽  
Complex Fractures ◽  
Zygomaticomaxillary Complex

scholarly journals Forced Duction Test: Is It Necessary after the Scleral Buckling Procedure?

2020 ◽  
Vol 11 (2) ◽  
pp. 282-286
Author(s):  
Mohammad Sharifi ◽  
Mohammad Reza Ansari Astaneh
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Scleral Buckling ◽  
Motility Disorder ◽  
Ocular Motility ◽  
Ocular Movement ◽  
Scleral Buckling Procedure ◽  
Movement Limitation ◽  
Restrictive Strabismus

A 14-year-old boy who had ocular motility disorder which started 2 weeks following retinal surgery (scleral buckling) secondary to rhegmatogenous retinal detachment, was referred to the strabismus clinic. He had significant ocular movement limitations in adduction and elevation under general anesthesia. The forced duction test (FDT) was positive in both adduction and elevation. After buckle removal, FDT was negative. The eye was orthotropic without ocular movement limitation at final follow-up. In conclusion, FDT at the end of the scleral buckling procedure needs to be performed. It may prevent restrictive strabismus after scleral buckling surgery.

Using Activities of Daily Living to Evaluate the Design and Placement of a Proximal Radius Fracture Fixation Device

2009 ◽  
Author(s):  
David W. Wagner ◽  
Alejandro Vallejo
Keyword(s):  
Boundary Conditions ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Design Space ◽  
Surgical Intervention ◽  
Element Model ◽  
Rigid Fixation ◽  
New Device ◽  
Everyday Activities ◽  
Active Lifestyles

The return of a patient to activities of daily living following a surgical intervention (i.e. joint replacement, rigid fixation, etc.) involving an implantable device is often used as one component to measure the success of the surgery [1]. The longevity of the implant subject to the forces imposed when performing those normal daily activities is another. As people are living longer and continuing to maintain active lifestyles, the paradigm of everyday activities that are used to evaluate implant longevity must also evolve. Although physiological boundary conditions during pre-clinical implant evaluations have been used for simulating the life span of a new device, only a small number of everyday activities used for deriving those forces have been widely characterized. The purpose of this paper is to demonstrate how musculoskeletal simulation can be used for providing the boundary conditions of a finite element model used to evaluate the design space of an implant subject to specific activities of daily living (Figure 1).

Current methods, outcomes and challenges for the treatment of hand fractures

2020 ◽  
Vol 45 (6) ◽  
pp. 547-559
Author(s):  
Michel E. H. Boeckstyns
Keyword(s):  
Conservative Treatment ◽  
Outcome Measures ◽  
Surgical Intervention ◽  
Metacarpal Fractures ◽  
Complex Fractures ◽  
Hand Fractures ◽  
Surgical Methods ◽  
Technical Advances ◽  
Phalangeal Fractures

In treating hand fractures, we have to make a proper decision about conservative treatment versus surgical intervention and decide on individual surgical methods. This article reviews recent publications, technical advances, and outcome measures in treating metacarpal fractures, phalangeal fractures, complex fractures of the proximal interphalangeal joints, bony mallet fingers, and fractures of the thumb. My personal preferences and considerations are presented. At the end, the current challenges that hand surgeons are facing in treating frequent phalangeal and metacarpal fractures are discussed.

scholarly journals Bioresorbable Material in Secondary Orbital Reconstruction Surgery

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Hui Pan ◽  
Zhenzhen Zhang ◽  
Weiwei Tang ◽  
Zhengkang Li ◽  
Yuan Deng
Keyword(s):  
Retrospective Chart Review ◽  
Fracture Repair ◽  
Orbital Fracture ◽  
Ocular Motility ◽  
Orbital Fractures ◽  
Orbital Reconstruction ◽  
Primary Surgery ◽  
Ocular Movement ◽  
Bioresorbable Material ◽  
Secondary Orbital Reconstruction

Purpose. To validate the potential of bioresorbable implantation in secondary revisional reconstruction after inadequate primary orbital fracture repair, with assessment of pre- and postoperative clinical characteristics and computed tomography image findings. Methods. A retrospective chart review was conducted on 16 consecutive patients treated for orbital fractures at Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, with inadequate prior surgeries between July 2010 and June 2017; patients who had suffered orbital blowout fractures had undergone primary surgeries elsewhere. Secondary repair of orbital fractures used bioresorbable material following unsatisfactory primary orbital repair. Patients’ demographics, degree of enophthalmos, ocular motility, diplopia test results, primary implants, and surgical complications were reviewed. Results. All 16 patients had primary orbital implants consisting of Medpor, titanium mesh, hydroxyapatite, or poly-L-lactide. Of the 16 cases, 14 had malpositioned implants posteriorly and two had implant infections. Findings following primary surgery included enophthalmos (12/16), diplopia (9/16), intraorbital abscess (2/16), and ocular movement pain (1/16). Mean preoperative enophthalmos was 3.8 ± 0.8 mm. Secondary reconstruction resulted in a mean reduction of enophthalmos by 3.1 ± 0.9 mm (P<0.01). Nine in ten patients experienced improvements in postoperative ocular motility and diplopia following secondary surgery. Intraorbital abscesses and eyeball movement-associated pain were cured. Conclusions. This study demonstrates that secondary orbital reconstruction of previously repaired orbital fractures using bioresorbable material can achieve excellent functional and aesthetic results with minimal complications. Bioresorbable material should be considered in secondary orbital reconstruction when clinically indicated.

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