Zygomatico-orbital Complex Fractures Research Articles

Titanium Nickelide in Midface Fractures Treatment.

Background: The question of reconstruction of human tissues and organs with the use of medical materials is still open, because of the accurate requirements for their biological and physical features. The aim of this study was to prove the efficiency of titanium nickelide constructors in treatment of isolated orbital floor fractures or combination with zygomatico-orbital complex fractures. Methods: Patients with a fracture of zygomatico-orbital complex and/or low orbital floor (n = 44) carried out different treatments: in the first group, osteosynthesis and endoprosthesis with titanium nickelide structures; in the second group, titan mini-plates osteosynthesis; in the third group (‘blow-out’), endoprosthesis with a titanium nickelide mesh; and in the fourth group (‘blow-out’), conservative treatment and monitoring (archive data) (p > 0.05). The paraesthesia, diplopia, enophthalmos and exophthalmos degree were measured in points. Results: In one year, the first and second groups had no differences in level of paraesthesia (p > 0.05). The absence of exophthalmos and differences between first and second groups, and between the third and the fourth groups with positive dynamics inside the groups were proved (p < 0.05). In the first and third groups, enophthalmos was absent, and it increased in the second and fourth groups (p < 0.01, p < 0.11). Diplopia in the first and third groups was absent, and it increased in the second and fourth groups (p < 0.05, p < 0.01). Conclusion: The elasticity and biocompatibility of titanium nickelide make the implant insertion and restoration of the lower orbital wall anatomy easier, with good postoperative clinical results.

Short- and long-term results of orbital floor fractures treatment

The objective of this research was to study complications of orbital floor reconstruction by making analysis of early and late follow up treatment results of patients with orbital floor fractures. We summerized the experience in surgery of 215 victims with zygomatico-orbital complex fractures, who underwent treatment in teaching hospitals of the oral and maxillo-facial surgery department of Privolzhsky Research Medical University from 2011 to 2017. The orbital wall fractures which required reconstruction and restorative treatment were diagnosed in 78 (36.3%) patients. The amount of surgical intervention included transconjuctive approach and orbital floor reconstruction with polymeric and metal implants. In most cases we obtained good and satisfactory results during the period of early and late follow up. We made the analysis of developed early and late complications from orbital floor reconstruction. Post-operative enophthalmos and implant displacement are noted to be the most adverse events in the late follow up period and they require re-surgery. Our experience suggests that it is possible to avoid complications and receive good esthetic and functional results in case a surgeon is highly qualified and carefully plans an operation, namely calculation of anatomical and topometrical orbit parameters by CT and a right choice of operation methods and implants.

Role of Intraoperative Computerized Tomographic Scan in the Management of Zygomatico-Orbital Complex Fractures

Role of Intraoperative Computerized Tomographic Scan in the Management of Zygomatico-Orbital Complex Fractures

Nickel-Titanium Shape Memory Alloy in Reconstructive Osteosynthesis in Patients With Zygomatico-Orbital Complex Fractures

At the Department of Maxillofacial Surgery I.M. Sechenov First Moscow State Medical University 120 patients with zygomatico-orbital complex fractures were treated during the period from 2011 to 2015. Different methods of the osteosynthesis are presented and discussed. Successful application experience of superelastic nickelid titanium mesh and porous nickelid titanium implants for the lower orbital wall reconstruction was reviewed.

Intraoperative Imaging With a 3D C-Arm System After Zygomatico-Orbital Complex Fracture Reduction

During the repair of zygomatico-orbital complex (ZMC) fractures, the lateral orbital wall and/or the orbital floor is often reduced by merely reducing the zygoma. Intraoperative 3D imaging can help surgeons decide whether the orbit must be reconstructed as well. The purpose of this study was therefore to assess the usefulness of intraoperative 3D C-arm imaging in evaluating the adequacy of fracture reduction. A total of 21 patients with unilateral ZMC fractures were enrolled in this retrospective study. Four fractures were treated with a closed reduction technique. Seventeen fractures were repaired with open reduction and internal fixation of the zygomaticomaxillary buttress area. Intraoperative 3D C-arm imaging was performed in all cases. All patients underwent postoperative computed tomography and a clinical examination no earlier than 5 months after the procedure. After reduction of the ZMC fractures, intraoperative 3D scans showed inadequate repair of the orbital floor in 2 patients and inadequate repair of the lateral orbit in 1 patient. Zygoma and zygomatic arch fracture reduction had to be corrected in 1 further case. The other 17 patients did not need an additional procedure. Postoperative imaging showed that no patient required a secondary operation. No postoperative diplopia or enophthalmos developed in any patient. Intraoperative 3D C-arm imaging appears to be an effective tool for evaluating ZMC fracture reduction. It helps avoid additional procedures and thus helps reduce morbidity. In addition, there appears to be no need for postoperative imaging.

A survey of maxillofacial surgeons and a prospective study on driving advice for patients with diplopia following zygomatico-orbital complex fractures

A survey of maxillofacial surgeons and a prospective study on driving advice for patients with diplopia following zygomatico-orbital complex fractures

Continuing Medical Education in Emergency Plastic Surgery for Referring Physicians: A Prospective Assessment of Educational Needs

Continuing medical education for referring physicians is an essential part of raising the profile of plastic surgery and improving patient care. The authors conducted a prospective cohort study to assess the educational needs of emergency and primary care physicians who refer patients to the on-call plastic surgeon. The following information was collected for telephone referrals from emergency and primary care physicians over a 1-year period: date, location of referral center, population of referral center, distance between referral center and tertiary care hospital, patient age, presenting problem, anatomical location of the problem, and treatment plan proposed by the plastic surgeon. In addition, the 50 physicians who most frequently referred patients were surveyed to identify which topics they perceived to be of the highest educational utility and which were frequently encountered. There were a total of 1077 referrals to on-call plastic surgeons, mostly for trauma (83 percent) and injuries involved primarily the upper extremity (65 percent) or head and neck regions (26 percent). Five percent or more of all referrals involved mandible, phalangeal, metacarpal, or zygomatico-orbital complex fractures, minor burns, flexor tendon injuries, single digits requiring revision of an amputation, and extensor tendon injuries. Referring physicians reported that the topics of most educational utility were management of hand infections, minor burns, nasal fractures, boxer's fractures, complex facial lacerations, frostbite, metacarpal fractures, and scaphoid fractures. To have the greatest potential affect on changing physicians' behavior and improving patient care, continuing medical education should focus on traumatic injuries to the upper extremity and head and neck regions. A prioritized list of topics should include management of minor burns, hand fractures, hand infections, nasal infections, and complex facial lacerations.

Changing trends in the treatment of zygomaticomaxillary complex fractures: a 12-year evaluation of methods used.

The efficacy of the current methods for the treatment of fractures of the zygomaticomaxillary complex was evaluated. One thousand two hundred seventy-seven patients with fracture of the zygomaticomaxillary complex and 196 patients with fractures of the zygomatic arch that were admitted between 1984 and 1995 were evaluated. One thousand one hundred fifty surgical procedures were performed, and in 401 cases, no operative treatment was considered necessary. The Gillie's approach was used in 514 cases, intraosseous wiring in 89 cases, bone plate osteosynthesis in 322 cases, Roger-Anderson pins in 180 cases, antral packing in 17 cases, and elevation with a hook in 28 cases. The best results were achieved with the use of semirigid fixation with miniplates applied at one or more sites of the fractured complex, occasionally used in combination with other methods such as Roger-Anderson pins. Semirigid fixation with miniplates offers the most reliable method available today for the treatment of zygomatico-orbital complex fractures and has practically replaced every other method in our institution. The increased cost and occasionally the necessity to remove the hardware are the main disadvantages of the method.

Changing trends in the treatment of zygomatico-orbital complex fractures. A 12-year evaluation of the methods we used

Changing trends in the treatment of zygomatico-orbital complex fractures. A 12-year evaluation of the methods we used