Advantages of intraoral and transconjunctival approaches for posterior displacement of a fractured zygomaticomaxillary complex

• Published in: Maxillofacial plastic and reconstructive surgery Vol. 38; no. 1; p. 36
• Main Authors: Yoo, Ji Yong, Lee, Jang Won, Paek, Seung Jae, Park, Won Jong, Choi, Eun Joo, Kwon, Kyung-Hwan, Choi, Moon-Gi
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.12.2016; 대한악안면성형재건외과학회
• Subjects: Dentistry; Medicine; Oral and Maxillofacial Surgery; Plastic Surgery; 치의학; Zygomaticomaxillary complex (ZMC) fracture; Displacement direction; Surgical approach
• ISSN: 2288-8101; 2288-8586; 2288-8586
• DOI: 10.1186/s40902-016-0085-x

Background Fracture of the zygomaticomaxillary complex (ZMC) is one of the most common facial injuries. A previous study has performed 3D analyses of the parallel and rotational displacements that occur in a fractured ZMC. However, few studies have investigated adequate fixation methods according to these displacements. Here, we assessed whether specific approaches and fixation methods for displacement of ZMC fractures produce esthetic results. Methods Hospital records and pre- and post-surgical computed tomographic scans of patients treated for ZMC fractures at the Department of Oral and Maxillofacial Surgery, College of Dentistry, Wonkwang University, between January 2010 and December 2015, were selected. Data were analyzed according to the direction of displacement and post-reduction prognosis using a 3D software. Results With ZMC fractures, displacement in the posterior direction occurred most frequently, while displacement in the superior-inferior direction was rare. A reduction using a transconjunctival approach and an intraoral approach was statistically better than that using an intraoral approach, Gillies approach, and lateral canthotomy approach for a posterior displacement ( P  < 0.05). Conclusions When posterior displacement of a fractured ZMC occurs, use of an intraoral approach and transconjunctival approach simultaneously is recommended for reducing and fixing the displaced fragment accurately.