Management of zygomatic complex fractures / 实用口腔医学杂志

ABSTRACT

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. ConclsionsA 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.