Evaluation of one-point fixation for zygomaticomaxillary complex fractures using a three-dimensional photogrammetric analysis

Se Young Kim,Eun Soo Park,Seung Min Nam,Yong Bae Kim

doi:10.1186/s40463-019-0359-2

Abstract

BackgroundThe goal of treatment for zygomaticomaxillary (ZM) complex (ZMC) fractures is to achieve stability and restore aesthetic appearance through three-dimensional reduction and rigid fixation. The purpose of this study was to evaluate the stability and aesthetic appearance outcomes of one-point fixation using a three-dimensional photogrammetric analysis.MethodsFrom March 2014 to December 2014, 34 patients with ZMC fractures were treated by one-point fixation in the ZM buttress using unsintered hydroxyapatite (u-HA)/poly-L-lactide (PLLA) plates. Differences in soft tissue inter-malar height between the fractured side and unfractured sides were evaluated using photogrammetric analysis with a three-dimensional camera (Morphius®) at the preoperative and 1 week, 1 and 3 months after surgery. The differences in bony inter-malar height between the fractured and unfractured sides were evaluated using computer tomography at the pre-operative and 6 months after surgery. The paired t-test was used to compare differences in malar height.ResultsSix months after surgery, 34 patients achieved satisfactory bony stability and symmetric malar appearances. Comparisons of differences in soft-tissue inter-malar height revealed statistically significant differences between the pre-operative period and 1 week and 1 month after surgery (p < .01). There was no statistically significant difference between 1 and 3 months after surgery. Comparison of differences in bony inter-malar height revealed a statistically significant difference between before and 6 months after surgery (p < .01).ConclusionsWhen we conducted a three-dimensional photogrammetric analysis, although it has restricted surgical indications, one-point fixation of the ZM buttress using an u-HA / PLLA plate yielded reliable, satisfactory, and safe clinical results in patients with ZMC fractures.Clinical question / level of evidenceTherapeutic, III.

Highlights

Zygomaticomaxillary (ZM) complex (ZMC) fractures are common facial fractures [1, 2]
Open reduction and internal fixation has been used as the standard method for treating Zygomaticomaxillary complex (ZMC) fractures [4]
Of the patients who underwent open reduction and rigid fixation for ZMC fractures using unsintered hydroxyapatite (u-HA)/PLLA composites between March 2014 to December 2014, 34 who could be observed and followed for longer than 6 months were enrolled in this study

Summary

Introduction

Zygomaticomaxillary (ZM) complex (ZMC) fractures are common facial fractures [1, 2]. The ZMC projects anterolaterally to form the malar eminence and establishes the midfacial width and contour of the orbital rim; it plays an important role in terms of aesthetic appearance [3]. The goal of treating ZMC fractures is to achieve stability and restore aesthetic appearance through three-dimensional reduction and rigid fixation. After adequate reduction of the fracture has been achieved, it is important to maintain stability and rigid fixation to prevent functional impairment and aesthetic sequelae. Open reduction and internal fixation has been used as the standard method for treating ZMC fractures [4]. The goal of treatment for zygomaticomaxillary (ZM) complex (ZMC) fractures is to achieve stability and restore aesthetic appearance through three-dimensional reduction and rigid fixation. The purpose of this study was to evaluate the stability and aesthetic appearance outcomes of one-point fixation using a three-dimensional photogrammetric analysis

Objectives

Methods

Results

Discussion

Conclusion