Application of computer-assisted surgery techniques in the management of zygomatic complex fractures

Patients suffering from zygomatic complex fractures always present facial deformity and dyslunctions, and thereafter develop psychological and physiological problems. It is really hard to get an ideal prog- nosis for the zygomatic complex fractures because of the complicated anatomical structures. Computer- assisted surgery techniques, as the new emerging auxiliary methods, can optimize the surgical protocol, predict operation outcomes, and improve the accuracy and quality of the operation. Meanwhile the postoperative complications can be reduced effectively. This review aims to provide a comprehensive overview of the application of computer-assisted surgery techniques in the management of zygomatic complex fractures.

Surgical management of zygomatic complex fractures in a major trauma centre

Aim: To analyse the epidemiology, aetiology, and surgical management of zygomatic complex (ZMC) fractures in our major trauma centre, and to compare the number and location of fixation points and surgical access in our patient cohort with the literature. Methods: Retrospective analysis of all operative cases (Open Reduction and Internal Fixation) of zygomatic complex fractures over a one year period (2016). Results: A greater proportion of patients in our cohort (54%) were treated with one-point fixation compared to the literature, with the zygomaticomaxillary (ZM) buttress being the most popular fixation point (90%). ZM buttress and frontozygomatic (FZ) suture were the commonest choices for two-point fixations (70%). Buccal sulcus incision was used for ZM access in all cases. For FZ access, upper blepharoplasty incision was the most common (56%). For infra-orbital margin access, transconjunctival incision was the most common (75%). There was no significant association between number of fixation points and presence of associated injuries, impact of injury, or time to operation. There were no post-operative complications. Conclusion: A greater proportion of patients in our cohort were successfully treated with one point fixation compared to the literature, and fewer patients underwent orbital floor exploration and repair in our cohort compared to the literature. This study highlights the ongoing variation in the surgical management of ZMC fractures.

Management of isolated zygomaticomaxillary complex fractures with an individualized approach: a retrospective study

Aim:Fractures of the zygomatico maxillary complex(ZMC)are commonly seen after traumatic injuries to the facial skeleton.The aim of the study was to review the outcome of individualized treatment approach in the management of isolated ZMC fractures.Methods:A retrospective analysis of 25 patients was conducted to assess the outcomes of isolated ZMC(iZMC)fracture treatment at a multi specialty hospital(Punjab,India)over a 3–year period.Results:Out of the 25 patients reviewed,4 patients required no surgical intervention and 21 patients underwent surgical reduction via the buccal sulcus approach.An individualized treatment plan was formulated for each patient to decide mini plate fixation at one–two–or three–point with or without orbital rim exploration.Two patients required removal of mini plates from the buttress area on postoperative follow up.Conclusion:Our review shows that an individualized treatment approach produces the most favorable results in the management of iZMC fractures.