Internal Fixation for the Treatment of Zygomatic Maxillary Complex Fractures

doi:10.3969/j.issn.1005-4979.2017.06.005

Abstract

Abstract: Objective: To summarize the clinical experience of buccal maxillary vestibular groove incision for fixation of the infraorbital rim and combined with ear-temporal incision and eyebrow incision for the treatment of zygomatic maxillary complex(ZMC) fractures. Methods: The clinical data of 58 patients with ZMC fractures during January 2014 and January 2016 were analyzed retrospectively. All cases were confirmed by CT examination. Here we summarized the experiences of clinical manifestations, surgical approaches, prognosis and recovery status (6 months after operation). Results: All patients in this group had satisfactory outcomes after surgical treatment via buccal maxillary vestibular groove incision combined with ear-temporal incision and eyebrow incision. During the followed up of 6 months, only two cases had their wound infected after surgery, but recovered after dressing. Temporal branch of facial nerve temporary paralysis were damaged in three cases, but all restored at three months after surgery. All patients' faces were symmetrical without trismus. Conclusion: The method of buccal maxillary vestibular groove incision for fixation of the infraorbital rim and combined with ear-temporal incision and eyebrow incision is a good way to treat ZMC fractures. It can not only achieve good therapeutic outcome but also avoids ectropion of eyelids and scar and other complications caused by subciliary incision, which could be recommended for clinical use.

Key words: zygomatic maxillary complex fracture, buccal maxillary vestibular groove incision, minimal incision, minimally invasive surgery

摘要： 目的：总结经上颌前庭沟入路进行眶下缘固定同时联合眉弓外侧、耳颞切口入路治疗颧上颌骨复合体骨折的临床经验。方法：回顾性分析2014-01—2016-01期间福建医科大学附属第一医院口腔颌面外科经CT检查确诊为颧上颌复合体骨折的病例资料，共58例。分析临床表现、手术入路、预后及随访6个月的愈合情况。结果：本组中所有病例经过上颌前庭沟、眉弓外侧切口、耳颞切口联合入路进行手术治疗后，均获得满意的治疗效果。随访6个月，2例出现伤口感染，换药后痊愈；3例出现面神经颞支暂时性损伤，术后3个月左右全部恢复正常。所有患者面部外形对称，无张口受限。结论：经上颌前庭沟切口进行眶下缘内固定并联合眉弓外侧、耳颞切口治疗颧上颌复合体骨折的方法是治疗此类疾病的良好方法，在达到良好治疗效果的同时，又可避免睑缘下切口导致的睑外翻和瘢痕等并发症，值得在临床上推广。

关键词: , , 颧上颌骨复合体骨折； , , 上颌前庭沟切口； , , 小切口； , , 微小侵袭外科

CLC Number:

R782.4

ZHU Xiao-Feng1, LIAO Yun-Yang1, HUANG Yue1, SHI-Bin1, LIN Li-Song1, ZHANG Bin2. Internal Fixation for the Treatment of Zygomatic Maxillary Complex Fractures[J]. 《Journal of Oral and Maxillofacial Surgery》, doi: 10.3969/j.issn.1005-4979.2017.06.005.

朱小峰1，廖云阳1，黄跃 1，施斌1，林李嵩1,张斌2. 颧上颌骨复合体骨折内固定58例临床总结[J]. 《口腔颌面外科杂志》, doi: 10.3969/j.issn.1005-4979.2017.06.005.

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URL: https://journal06.magtech.org.cn/Jweb_joms/EN/10.3969/j.issn.1005-4979.2017.06.005

https://journal06.magtech.org.cn/Jweb_joms/EN/Y2017/V27/I6/401

References

[1] Birgfeld CB, Mundinger GS, Gruss J S. Evidence-based medicine: evaluation and treatment of zygoma fractures[J]. Plast Reconstr Surg, 2017, 139(1):168-180.

[2] Chowdhury SR, Menon PS. Etiology and management of zygomaticomaxillary complex fractures in the Armed Forces[J]. Med J Armed Forces India, 2005, 61(3):238-240.

[3] Armin T, Kimble FW. Fractured zygomas[J]. ANZ J Surg, 2003, 73(1-2):49-54.

[4] van Hout WM, Van Cann EM, Koole R, et al. Surgical treatment of unilateral zygomaticomaxillary complex fractures: a 7-year observational study assessing treatment outcome in 153 cases[J]. J Craniomaxillofac Surg, 2016, 44(11):1859-1865.

[5] Zingg M, Laedrach K, Chen J, et al. Classification and treatment of zygomatic fractures; a review of 1025 case[J]. J Oral Maxillofac Surg, 1992, 50(8):778-790.

[6] Knight JS, North JF. The classification of malar fractures: an analysis of displacement as a guide to treatment[J]. Br J Plast Surg, 1961, 13(13):325-339.

[7] Manson PN, Clark N, Robertson B, et al. Subunit principles in midface fractures: the importance of sagittal buttresses, soft-tissue reductions, and sequencing treatment of segmental fractures[J]. Plast Reconstr Surg, 1999, 103(4):1287-1290.

[8] 何冬梅, 张益, 张震康, 等. 颧骨复合体骨折的分类研究和治疗[J]. 中华口腔医学杂志, 2004, 39(3):211-213.

[9] Chakranarayan A, Thapliyal GK, Sinha R, et al. Efficacy of two two points rigid internal fixation in the management of zygomatic complex fracture[J]. J Oral Maxillofac Surg,2009, 8(3):265-269.

[10] Boffano P, Roccia F, Gallesio C, et al. Infraorbital nerve posttraumatic deficit and displaced zygomatic fractures: a double-center study [J]. J Craniofac Surg, 2013, 24(6):2044-2046.

[11] 刘璐, 陈明, 苏志彩, 等. 眼眶骨折中眶下神经损伤和治疗的研究现状[J]. 国际眼科杂志, 2012, 12(4):681-683.

[12] Ellis E, El-Attar A, Moos KF. An analysis of 2,067 cases of zygomatico-orbital fracture[J]. J Oral Maxillofac Surg, 1985, 43(6):417-428.

[13] Salentijn E, Boverhoff J, Heymans M, et al. The clinical and radiographical characteristics of zygomatic complex fractures: a comparison between the surgically and non-surgically treated patients[J]. J Craniomaxillofac Surg, 2013, 42(10):1233-1234.

[14] Zhuang QW, Zhang XP, Wang X, et al. Coronal approach to zygomaticomaxillary complex fractures[J]. Eur Rev Med Pharmacol Sci, 2015, 19(5):703-711.

[15] 徐兵, 史俊, 唐友盛,等. 小切口、三维固定治疗颧骨复合体骨折43例临床评价[J]. 中国口腔颌面外科杂志, 2004, 2(3):199-201.

[16] Sharma R, Chhabra N, Sharma P, et al. Evaluation of intra ocular pressure in zygomatico maxillary complex fractures[J]. Br J Oral Maxillofac Surg, 2015, 14(2):226-356.

[17] El-Anwar MW, Elsheikh E, Hussein AM, et al. Transconjunctival versus subciliary approach to the infraorbital margin for open reduction of zygomaticomaxillary complex fractures: a randomized feasibility study[J]. Oral Maxillofac Surg, 2017, 21(2):187-192.

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