Does initial reduction at infra-orbital rim first improve malar height and vertical dystopia in ZMC fractures?
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ORIGINAL ARTICLE
Does initial reduction at infra-orbital rim first improve malar height and vertical dystopia in ZMC fractures? Rupshikha Choudhury 1 & Sanjay Rastogi 1 & Dharmendra Kumar 2 & Shanthi Prasad Indra 3 & Ankur Joshi 4 & Shreya Jawalkar 2 Received: 17 July 2020 / Accepted: 3 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To estimate the clinical and functional results of patients who underwent distinctive types of open reduction and internal fixation of ZMC fractures, with particular emphasis on malar height and vertical dystopia. Materials and methods A randomized clinical trial was conducted from August 2016 to October 2019 in which 40 adult patients with ZMC fractures of maxillofacial region were included. Patients were randomly allocated to group A (n = 20; frontozygomatic (F-Z) first 3-point reduction and fixation) or group B (n = 20; group B infra-orbital first 3-point reduction and fixation). All patients were evaluated objectively for malar height and vertical dystopia pre- and post-operatively at 3 months. The data were scrutinized by applying mean and standard deviation and unpaired t test. Results Mean values of the malar height and vertical dystopia were statistically significant (P < .05) for group B compared with group A at all intervals. Data analyzed for other secondary variables showed a statistically non-significant difference between the groups (P > 0.05). Conclusion The results showed improvement in the malar height and vertical dystopia for infra-orbital first three-point fixation (group B) compared with F-Z first approach for initial reduction and fixation (group A). Furthermore, group B was better in terms of malar width and antero-posterior projection of the zygomaticomaxillary complex. Keywords ZMC fracture . Traditional three-point fixation . Infra-orbital first approach . Malar height . Vertical dystopia
Introduction The traditional treatment of zygomatic bone fracture varies from none to open reduction and internal fixation at three or four sites depending upon type of fracture. Open reduction and internal fixation of simple displaced fractures of the zygoma is an attempt to define the simplest method of achieving post reduction stability. The preference for open reduction and internal fixation of zygomatic fractures using traditional three-point fixation has continued
to grow in response to observations of inadequate results from two point fixation technique, with the exception of management of isolated fractures of the zygomatic arch. In a report, the threepoint fixation (frontozygomatic (F-Z) suture, inferior orbital rim, and zygomaticomaxillary buttress) using either miniplates alone or interfragmentary wiring conferred the greatest stability [1–10]. However, traditional three-point fixation starting from F-Z, zygomatic buttress, and infra-orbital rim might result in vertical dystopia and inadequate malar height post-operatively [8–10].
* Sanjay Rastogi [email protected] Rupshikha Choudhury [email protected]
Shreya Jawa
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