ABSTRACT
Dentre as fraturas maxilofaciais, o complexo zigomático é o mais acometido, seguido das fraturas nasais e das fraturas Mandibulares O objetivo deste trabalho é apresentar um relato de caso de fratura de complexo zigomático tratada pelo serviço de Cirurgia e Traumatologia Bucomaxilofacial, como também descrever as formas de diagnóstico e tratamento clínico e cirúrgico.
Among the maxillofacial fractures, the zygomatic complex is most affected followed by nasal fractures and mandibular fractures. The objective of this work is to present a case report of a zygomatic complex fracture treated by the bucomaxillofacial Surgery and Traumatology service, as well as to describe the forms of diagnosis, clinical and surgical treatment.
Subject(s)
Humans , Male , Female , Zygomatic Fractures , Fracture FixationABSTRACT
Background:Isolated zygomatic or malar bone fractures are second most common fracture among facial skeletal injuries. It has been reported that three point fixation is appropriate for isolated zygomaticbone fracture. The objective of current study was to compare the mean difference in terms of malar height outcome by using different fixation techniques (two point and three point)in patients with zygomatic complex fracture.Methods:This randomized controlled trial was conducted at Department of Oral and Maxillofacial Surgery, MMDC, Multan, during a period of six months from 1st June 2017 to 30th November 2017. A total 182 patients of both genders were included in this study. Two point fixation techniques were used in Group-A patients. While 3 point fixation was used in Group-B patients. After 6 weeks follow-up, patients were assessed for malar height. Outcome was measured by comparing the mean difference of pre and postoperative malar height of both techniques. Data were analyzed using computer program SPSS-21. P≤0.05 was taken as significant in all analysis.Results:Among patients in two pointfixation group, the mean malar height was 67.55±2.98 mm and in three pointfixation group, meansmalar height was 71.55±2.36 mm. The difference of malar height among two treatments was highly significant with p<0.01. Conclusions: Using three point fixation results better as compared to two point fixations in terms of malar height outcome
ABSTRACT
Patients suffering from zygomatic complex fractures always present facial deformity and dysfunctions, and thereafter develop psychological and physiological problems. It is really hard to get an ideal prognosis for the zygomatic complex fractures because of the complicated anatomical structures. Computer-assisted surgery techniques, as the new emerging auxiliary methods, can optimize the surgical protocol, predict operation outcomes, and improve the accuracy and quality of the operation. Meanwhile the postoperative complications can be reduced effectively. This review aims to provide a comprehensive overview of the application of computer-assisted surgery techniques in the management of zygomatic complex fractures.
ABSTRACT
Background Zygomatico-maxillary complex fractures are one of the most frequently occurring injuries of the facial skeleton due to its position and also the facial contour. The principal aetiologic factors that may result in zygomatic bone fracture include assaults, road traffic accidents and also falls. There are many methods of fixation that have been applied for treatment of zygomatic arch fractures. Aim To reduce and fix the zygomatic complex fracture using miniplates at the fronto-zygomatic suture and zygomatic buttress area. Material and method The present study includes five cases of zygomatic complex fractures who visited the Department of Oral and Maxillofacial Surgery in Government Dental College and Hospital, Hyderabad. The operative procedure adopted was the lateral bow incision for exposure of fronto-zygomatic suture, the Gillie temporal approach for reducing the zygoma and intra-oral incision for exposure of zygomatic buttress fracture. Fixation was done with miniplates at the fronto-zygomatic suture and the zygomatic maxillary buttress suture. Result All the cases were successfully treated without any post-operative complications and with uneventful restoration of aesthetics and function.
ABSTRACT
Zygomatic bone forms major buttress of the facial skeleton and plays an important role in facial contour. Fractures of zygomatic complex are second most common only next to nasal bone fractures. Motor vehicle accidents and interpersonal violence are common causes. Bilateral fractures of zygomatic complex and zygomatic arch are very rare. We present a case report of isolated fractures involving bilateral zygomatic complex and zygomatic arch with oral submucous fibrosis, which is unique and first of its kind to be reported.
Subject(s)
Adult , Male , Oral Submucous Fibrosis/etiology , Zygoma/injuries , Zygomatic Fractures/complications , Zygomatic Fractures/diagnosisABSTRACT
Avulsion injuries of facial bones are rare, as well as accounts regarding the management of these lesions. This study describes a facial trauma that resulted from a bull gore, which caused the avulsion of the zygomatic bone, which was left hanging by only a small pedicle. The case study involved a 36 year old male leukoderma patient who sought the Maxillo-Facial Surgery and Trauma Department at the Emergency Unit in Pelotas-RS (Brazil). Clinical examination showed extensive laceration of the face in the middle third area on the left side, with the avulsion of the zygomatic body, causing the displacement of the eyeball towards the maxillary sinus. Treatment included bone and eyeball repositioning, zygoma fixation and suture, yielding good aesthetic and functional results. The peculiarity of the etiology and the particular features of the trauma are highlighted... (AU)
Lesões avulsivas dos ossos faciais são raras, assim como descrições quanto ao manejo dessas injúrias. Este estudo descreve um traumatismo facial decorrente de uma chifrada de um boi, que ocasionou a avulsão do osso zigomático, restando preso apenas por um pequeno pedículo. Trata-se de um paciente gênero masculino, 36 anos, leucoderma, que procurou o serviço de Cirurgia e Traumatologia Buco-Maxilo-Facial do Hospital de Pronto-Socorro da cidade de Pelotas-RS (Brasil). Ao exame clínico observava-se extensa laceração na face, em área de terço médio, lado esquerdo, com avulsão do corpo do zigoma, determinando o deslocamento do globo ocular em direção ao seio maxilar. O tratamento constou de reposicionamento ósseo e do globo ocular, fixação do zigoma e sutura, obtendo-se um bom resultado estético e funcional. Destaca-se a peculiaridade da etiologia e características únicas deste trauma... (AU)
Subject(s)
Humans , Male , Adult , Zygoma , Zygomatic Fractures , Facial Bones , Facial Bones/injuries , Maxillary SinusABSTRACT
RESUMEN Introducción: las fracturas maxilofaciales exigen un diagnóstico certero, preciso y oportuno. La variabilidad del tratamiento dependerá de la edad del paciente, tipo de fractura y complicaciones asociadas. Objetivo: determinar las características clínicas de fracturas maxilofaciales. Material y métodos: diseño observacional descriptivo retrospectivo realizado en pacientes que fueron atendidos en el Hospital Nacional (Itauguá) en los años 2007 al 2011. Se tuvieron en cuenta la etiología, edad, género y tipo de fracturas. Resultados: ingresaron al estudio 195 casos de pacientes ingresados por traumatismos maxilofaciales. La causa más frecuente (57,44%) correspondió a accidentes de motocicleta. Predominó el sexo masculino (90%). El rango etario de mayor prevalencia fue entre 20-40 años (69%). La fractura del complejo cigomático orbitario ocupó el primer lugar (46%). El año 2009 fue el más concurrido por pacientes con traumatismos maxilofaciales (29%). Conclusión: las fracturas maxilofaciales predominaron sobre todo a varones, de edad media, fueron originados en su mayoría por accidentes en motocicleta y afectaron sobre todo el complejo cigomático.
ABSTRACT Introduction: maxillofacial fractures require accurate diagnosis, precise and timely. The variability of treatment will depend on the patient's age, type of fracture and associated complications. Objective: To determine the clinical characteristics of maxillofacial fractures. Methods: retrospective observational design conducted in patients who were treated at the National Hospital (Itauguá) during the years 2007 to 2011. We took in account the etiology, age, gender and type of fracture. Results: 195 cases were admitted to the study of patients admitted for maxillofacial trauma. The most frequent cause (57.44%) corresponded to motorcycle accidents. Predominance of male gender (90%). The most prevalent age range was between 20-40 years (69%). Orbital zygomatic complex fracture ranked first (46%). The year 2009 was the busiest for facial trauma patients (29%). Conclusion: maxillofacial fractures predominated mostly in middle-aged males, were mainly caused by motorcycle accidents and affected above all the zygomatic complex.
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Introduction: We decided to study the prevalence of zygomatic fracture among the population which presented one variation of facial fractures has been occurred more often from traffic accidents, sports trauma and other injures with high-impact. There were the quantity of patients with zygomatic fractures has been treated at in-patients and out-patients.In 1998,Gerhard S., Joseph A. (USA) reviewed 259 patients with zygomatic fractures and found that ZMC (zygomaticomaxillary complex) fractures occurred in 78.8% of patients, arch fractures occurred in 10.8% and 10.4 % of patients, respectively. Of note, displaced or comminuted fractures were found in 59.3% of patients with isolated zygomatic arch fractures.Goal: The main purposes of this study are to determine cause of zygomatic fractures, the occasion and form of fractural lines.Specific objectives:1. To reveal the occurance of zygomatic fracture2. To identify etiology of zygomatic fracture3. To classify the configuration of zygomatic fractureMaterials and Methods: The study of the science discussion be provide necessity which faced on medical science. Therefore: In-patients with zygomatic fracture treated in State of central hospital. The data of this study composed 13314 in-patients records who treated 480 patients at maxillofacial department of State hospital between 1996-2011. Objectives representative expecting is 8-10%.Result: There were 3.61% 480 patients with zygomatic fractures of total patients 13314 treated in Maxilla facial-oral surgery clinic from 1996-2011. The zygomatic fractures have been occurred mostly in the everyday life injures and traffic accidents 61.25% have resulted from beginning fight. There were arch fractures 17,53%, zygomatic fractures 18.31%. There were the main fractures 64.16% in the zygomatic have occurred in the maxillary sinusitis.
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Objective To compare the three-dimensional eephalometric and three-dimensional CT measurements of adult zygomatic complex among a Sanjiang population.Methods 120 female natives of Sanjiang region from Chinese Han between 19 to 23 years of age (mean 21.4 years),were randomly selected from students of Jiamusi University.Three-dimensional cephalometric and CT measurements of the face and skull were taken,with reference to zygomatic size measurement by Prof.Qi Zuo-liang,for the comparative study, which included the upper,mid and lower facial width followed by the length,width and angle of malar process,and width of the facial bone.Statistical analysis was done with the obtained measurements.Results Three-dimensional CT analysis showed facial width ratio of 0.83 and 0.79 and skeletal facial profile width ratio of 0.81 and 0.77,respectively,when compared with three-dimensional cephalometric analysis that showed facial width ratio of 0.84 and 0.77.Both values showed no statistical significance (P>0.05).Conclusion Three-dimensional CT measurement as the same to three-dimensional cephalometric can be used in the diagnosis of prominent malar complex.
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Objective To investigate the application of subciliary incision combined with preauricular temporal approach in the treatment of zygomatic complex fracture. Methods Fifty-three patients with zygomatic complex fracture including 41 males and 12 females were selected. Subciliary incision combined with preauricular temporal incision was employed to exp the site of fracture. After reduction of the fractures, rigid internal fixation was applied to fix the fractured bones. The facial profile, mouth opening, occlusion, view sight, movement of eye ball and local scar were evaluated postoperatively. Results The wounds of all the cases healed by first intension. All the cases had been recovered with normal face profile, mouth opening, occlusion, view-sight and eye ball movement. Facial nerve function of one case among the three cases with facial nerve trauma preoperatively was recovered totally after surgical treatment. And one case with suborbital nerve dysfunction preoperatively was not recovered. There was no case with the complications of entropion and ectropion, visible scar and temporal amyotrophia. Permanent trauma of temporal branch of facial nerve and supraorbital nerve was not observed after surgical therapy, but temporary facial nerve dysfunction occurred in 18 cases postoperative 1-3 months. Conclusion It is suggested that the approach of subciliary incision combined with preatrricular temporal incision could be employed to treat zygomatic complex fracture.
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Objetive:To analyze the fixation methods and sites in treatment of zygomatic complex fractures of 152 patients. Methods:The clinical data of 152 patients from 1990 to 2004 were investigated and analyzed, which focused on the changing trend of etiology and treatment methods. Results:Traffic accident was the primary reason for zygomatic complex fractures in China.152 patients received primary, timely reduction and fixation; Scalp coronal incision in combination with other incisions or alone was applied in 108 patients, the rest were treated by single local incisions. Rigid internal fixation was applied in 123 cases, and the single application of transosseous wire fixation was performed in 22 patients. 328 Ti plates were used. As to the fixation sites, 96 were applied at the zygomatic-frontal suture, 45 plates at zygomatic-maxillary suture and zygomatic crest, 92 plates at zygomatic-temporal suture, and 95 plates across the fracture line. Conclusion:Scalp coronal incision in combination with other incisions or alone can provide satisfactory outcome. Early, timely reduction and rigid internal fixation may result in better treatment results. The sites are focused at zygomatic-frontal suture, zygomatic-maxillary suture and zygomatic crest, zygomatic-temporal suture and the fracture line which restore the horizontal and vertical force route.
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Objective:To study the indications, surgical technique and complications of the coronal approach in the treatment of zygomatic complex fractures.Methods:Eighty-four patients with zygomatic complex fracture underwent coronal incisions for surgery. Micro or mini titanium bone plates were used to stabilize the fractured bones.In patients with endophthalmos orbital wall fractures were treated with hydroxyapatite.Follow-up was conducted for 3 months to 2 years.Results:All patients had no wound infection after operation. There was no permanent facial nerve motor function deficit. All of the patients with malocclusion regained their functional occlusion after treatment. The patients with restriction of mouth opening recovered after training. Eight patients had observable asymmetry characterized by widening of the face on the side of the injury. One patient sustained the postoperative endophthalmos beyond 3 mm.Conclusion:Coronal approach is feasible in the surgical treatment of zogomatic complex fracture.
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砄bjective: To study the cause,clinical characteristics and treatment of zygomatic complex fractres(ZCF). Methods: Medical records of 79 cases with ZCF and followed up for 3 months to 2 years were reviwed and analysed. Reduction and cosmatic outcome were assessed by clinical evaluation and postoperative images. Results: Of the 79 patients, 87.3% were male, with the peak incidence in the age group from 20 to 40 years old(73.5%). 58.2% were due to traffic accidents, 15.2% to assalts. Incidence of malar asymmetry, enophthalmos, diplopia,limited mandiblar movement and malocclusion were 83.5%,24.1%,19.0%, 60.8% and 35.4% respectively. Of the nerve disturbances, 41.8% of the infraorbital and 13.9% of the facial nerve were involved. For the treatment the most freqently used approach was the coronal incision in combination with the maxillary vestibular incision(30.4%), followed by coronal incision alone(22.8%). 40.5% of the patients were treated by rigid internal fixation with titanium miniplates alone or combined with wire fixition(20.3%). All patients but five regained satisfactary facial appearance. Three patients still showed slightly post surgical enophthalmos and diplopia at a 6 month follow up. All of the patients with malocclusion regained their functional occlusion after treatment. Conclsions:A variety of techniques can be used in the treatment of ZCF. Among them the coronal incision in combination with other incisions or alone and rigid internal fixation can produce a satisfactary outcome.
ABSTRACT
During 1993 to 1994, 30 cases of minimally-displaced fracture of the zygomatic complex were treated with open reduction and rigid internal fixation with single 4-hole mini-dynamic compression plates (DCP) and screws at the zygomatico-frontal fracture site. The open reduction was done wth the aid of a bone hook inserted through a tiny stab incision at the zygomatic arch prominence. When good alignment was achieved, the zygomatico-frontal fracture site was fixed with only one 4-hole mini-DCP. The one-point fixation with this type of plate for minimally displaced zygomatic complex fractures reduces morbidity, operative time, and costs.