An evaluation of the clinical application of three different biodegradable osteosynthesis materials for the fixation of zygomatic fractures

Abstract

The aim of this prospective study was to compare the clinical handling of 3 different biodegradable osteosynthesis materials and to determine whether they can be used for the fixation of all types of zygomatic fractures. A total of 54 consecutive patients who presented with displaced fractures of the zygomatic bone between October 2001 and May 2003 were randomly allocated to 3 biodegradable material groups for the fixation of the fractures. A titanium fixation system was used as rescue osteosynthesis whenever biodegradable materials failed. Seventy-one (75.5%) of 94 fracture sites were fixed with biodegradable osteosynthesis; 23 (24.5%) had to be fixed with titanium plates and screws. No statistically significant difference was found between the 3 biodegradable materials with regard to their suitability for zygomatic fracture fixation (P = .16). Nonstable fixation (n = 7) or the need to fix small fragments (n = 16) were the reasons for using the titanium fixation system as rescue osteosynthesis at these sites. Biodegradable materials were most frequently unfeasible for use at the infraorbital rim and in the zygomaticomaxillary/anterior sinus wall area. It was possible to stabilize 3 of 4 zygomatic fractures with 1.5- or 1.7-mm biodegradable osteosynthesis. Insufficient fracture stabilization, especially at the infraorbital rim and the zygomaticomaxillary crest/anterior sinus wall, was the main reason to switch to titanium osteosynthesis. The biodegradable screw design is possibly too bulky for these particular bony structures.