Etiology and pattern of zygomatic complex fractures: a retrospective study.
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PURPOSE: To document the etiology and clinical data of patients with fractures of the zygomatic complex seen in two university teaching hospitals in Nigeria and to compare the findings with other studies in the literature. PATIENTS AND METHODS: A six-year retrospective study involving 134 patients with zygomatic complex fractures. These patients were selected from a pool of 960 patients who sustained maxillofacial fractures during the period under review. Recorded were demographic, etiologic and clinical data as well as radiologic findings, treatment and postoperative complications. The Chi-squared test was used to test for significance and p values < 0.05 were regarded as significant. RESULTS: 76.1% were males and 23.9% females. Most (46.3%) patients were aged 21-30 years and road traffic accidents (82.1%) caused the most injuries (p < 0.05). Regarding the site of fracture, 88.8% of the patients had fractures of the zygomatic bone, 8.2% had fractures of the arch, and 3.0% had fractures of both the zygomatic bone and arch. The most frequently associated maxillofacial fracture was mandibular (21.0%). The commonest clinical feature was subconjunctival ecchymosis (63.4%), while the commonest radiologic findings were fractures at the zygomatico-frontal and zygomatico-maxillary sutures (38.8%). The Gillies approach (23.4%) was the commonest method of reduction. CONCLUSION: This study has shown that road traffic accidents are responsible for most zygomatic complex fractures in our environment. Urgent enforcement of road traffic legislation is therefore necessary to minimize zygomatic complex fractures due to road traffic accidents. It also showed a low utilization of technological advances in the imaging and treatment of these fractures. These may play a role in the frequency of postoperative complications. (+info)
Management of facial trauma in children: A case report.
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Children are uniquely susceptible to cranio facial trauma because of their greater cranial mass to body ratio. Below the age of 5, the incidence of pediatric facial fractures in relation to the total is very low ranging from 0.6-1.2%. Maxillo-facial injuries may be quite dramatic causing parents to panic and the child to cry uncontrollably with blood, tooth and soft tissue debris in the mouth. The facial disfigurement caused by trauma can have a deep psychological impact on the tender minds of young children and their parents. This case report documents the trauma and follow up care of a 4-year-old patient with maxillofacial injuries. (+info)
Single transconjunctival incision and two-point fixation for the treatment of noncomminuted zygomatic complex fracture.
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The ultimate goal in treating zygomatic complex fracture is to obtain an accurate, stable reduction while minimizing external scars and functional deformity. The present authors present our experiences with a single transconjunctival incision and two-point (inferior orbital rim and frontozygomatic suture) fixation in 53 patients with zygomatic complex fracture which were not comminuted. All patients had transconjunctival approaches with lateral canthal extensions, and six out of 53 patients also had an additional small (about less than 2 cm) gingivobuccal incision to achieve an accurate reduction. There were 3 minor complications, and the overall esthetics and functional results were satisfactory with a long term follow-up. Our method has the following advantages in the reduction of zygomatic complex fracture; It leaves only an inconspicuous lateral canthal scar. In addition, it provides excellent simultaneous visualization of the inferior orbital rim and frontozygomatic suture area. Hence, two point fixation through a single incision can be performed with a satisfactory stability. (+info)
Kirschner wire as a guide to secondary reconstruction of the deformities of the zygoma. A technical note.
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Mistreated fractures of the zygomatic complex may result in facial enlargement, loss of zygomatic projection, increase of orbitary volume, diplopy, enophthalmy, neuropraxy of the infraorbitary nerve and limited mouth opening. Hence, the treatment of sequelae demands accurate planning, through approaches that evaluate the degree of the existing displacement, bone repositioning and the need of grafts. Surgery is difficult due to lack of anatomical references as guides for bone repositioning. Some techniques have been described in the literature as alternatives for evaluating the degree of bone displacement and necessary correction. We believe that a greater number of anatomical references may contribute to a better final result. The aim of this paper is to present a simple technique using three Kirschner wires as spacial parameters-guides that aid secondary reconstructions of fractures of the zygomatic complex. After osteotomy, it becomes possible to compare and transfer the measures of the non-affected bone for re-establishing an adequate anatomical position for the affected side. This approach is proposed as a useful tool for obtaining 3-D references, helping to obtain a better bone positioning. (+info)
Maxillofacial injuries in a group of Brazilian subjects under 18 years of age.
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