Abstract
Purpose: To present the treatment of zygomaticomaxillary complex (ZMC) fractures with closed-reduction Steinmann-pin fixation and to compare it to the reduction and aesthetic outcomes of open-reduction techniques (ORIF). Materials and Methods: Case series. Charts for 23 patients with ZMC fractures presenting to the Head and Neck Surgery Department at Harbor-UCLA Medical Center from 2005 to 2009 were reviewed. Pre- and post-operative computed tomography (CT) scans were analyzed. Follow up ranged from 3 to 55 months. Interviews were conducted to evaluate the patient’s satisfaction. Patients were placed in two groups: those treated with ORIF and those treated with closed-reduction Steinmann-pin fixation. Results: Twelve patients had complete data for analysis. Average operative time was significantly lower for patients treated with closed-reduction as compared to open-reduction: 65.3 minutes vs. 162.5 minutes (p = 0.02). Bony realignment and aesthetic results were comparable in both groups. Additionally, only one 1cm facial incision was required with this repair system versus several incisions using traditional methods. Conclusions: Closed-reduction Steinmann-pin fixation of ZMC fractures provides adequate bony alignment and aesthetics. Our study supports this system in the repair of ZMC fractures as it requires significantly less operating time, one small incision, and excellent patient outcomes.
Highlights
The etiology of facial fractures differs from one country to another worldwide
Patients were placed in two groups: those treated with open reduction and internal fixation (ORIF) and those treated with closed-reduction Steinmann-pin fixation
Patients were separated into two groups: those treated with open reduction and internal fixation (ORIF), and those treated with closed reduction and transzygomatic external fixation (Steinmann Pin)
Summary
The etiology of facial fractures differs from one country to another worldwide. Earlier studies listed traffic accidents as the major etiological factor of maxillofacial injuries. Recent research has shown that assault has replaced motor vehicle accidents as the most common cause of maxillofacial fractures [5]. Motor vehicle accidents continue to present a fre quent mechanism for facial fractures. It is important for the surgeon to repair both the soft-tissue injury and the bony infrastructure to the patient identity. Technology has allowed for significant improvement in the treatment of these injuries. Resources such as computed tomography, three-dimensional reconstructions, plate-and-screw fixation, and bone grafting give the surgeon a greater ability to restore the bony structures [6]
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