Michael Bezuhly1, Janice Lalonde, Moraya Alqahtani, Gerald Sparkes, Donald H Lalonde. 1. Halifax, Nova Scotia, and Saint John, New Brunswick, Canada From the Division of Plastic Surgery, Dalhousie University, Queen Elizabeth II Health Sciences Center, and Division of Plastic Surgery, Dalhousie University, Saint John Regional Hospital.
Abstract
BACKGROUND: The objective of zygoma fracture repair is to restore preinjury function and appearance. The optimal surgical technique represents a balance between accurate fracture reduction and soft-tissue morbidity. METHODS: Fifty patients were eligible for review after treatment for isolated simple zygoma fractures using a combination of Gillies elevation and percutaneous Kirschner wire fixation between 1992 and 2003. Fourteen patients were available for examination at a mean follow-up of 8.7 years. Quantifiable parameters, including orbitozygomatic complex position, ocular globe projection, and infraorbital nerve function, were measured. All patients underwent qualitative assessment by independent, blinded observers. Negative soft-tissue sequelae were recorded. RESULTS: The mean differences between injured and uninjured sides of the face for malar eminence projection, height, and lateral position were 2.5, 2.7, and 2.3 mm, respectively. The mean difference in ocular globe projection was 1.23 mm. When these results were compared with those previously published for open reduction and internal fixation, no statistically significant difference was noted. The qualitative observers were able to identify the affected side 12 percent of the time. Other than a small punctate scar noted in one patient at the Kirschner wire insertion site, no other negative cutaneous or eyelid sequelae were noted. CONCLUSIONS: This study objectively shows that Gillies elevation combined with percutaneous Kirschner wire fixation provides facial contour restoration that is not significantly different from that of open reduction and internal fixation, with less soft-tissue morbidity. The technique is safe, easy to learn, and easy to perform, and should be considered in cases of isolated simple zygoma fractures.
BACKGROUND: The objective of zygoma fracture repair is to restore preinjury function and appearance. The optimal surgical technique represents a balance between accurate fracture reduction and soft-tissue morbidity. METHODS: Fifty patients were eligible for review after treatment for isolated simple zygoma fractures using a combination of Gillies elevation and percutaneous Kirschner wire fixation between 1992 and 2003. Fourteen patients were available for examination at a mean follow-up of 8.7 years. Quantifiable parameters, including orbitozygomatic complex position, ocular globe projection, and infraorbital nerve function, were measured. All patients underwent qualitative assessment by independent, blinded observers. Negative soft-tissue sequelae were recorded. RESULTS: The mean differences between injured and uninjured sides of the face for malar eminence projection, height, and lateral position were 2.5, 2.7, and 2.3 mm, respectively. The mean difference in ocular globe projection was 1.23 mm. When these results were compared with those previously published for open reduction and internal fixation, no statistically significant difference was noted. The qualitative observers were able to identify the affected side 12 percent of the time. Other than a small punctate scar noted in one patient at the Kirschner wire insertion site, no other negative cutaneous or eyelid sequelae were noted. CONCLUSIONS: This study objectively shows that Gillies elevation combined with percutaneous Kirschner wire fixation provides facial contour restoration that is not significantly different from that of open reduction and internal fixation, with less soft-tissue morbidity. The technique is safe, easy to learn, and easy to perform, and should be considered in cases of isolated simple zygoma fractures.
Authors: Jason E Cohn; Sammy Othman; Samuel Bosco; Tom Shokri; Marissa Evarts; Paul Papajohn; Seth Zwillenberg Journal: Craniomaxillofac Trauma Reconstr Date: 2020-03-17
Authors: Jun Hyeok Kim; Ye Sol Kim; Deuk Young Oh; Young Joon Jun; Jong Won Rhie; Suk-Ho Moon Journal: Biomed Res Int Date: 2020-03-18 Impact factor: 3.411