Comparative evaluation of 2-point vs 3-point fixation in the treatment of zygomaticomaxillary complex fractures – A systematic review

Gadkari, Nishtha; Bawane, Shilpa; Chopra, Ratima; Bhate, Kalyani; Kulkarni, Deepak

doi:10.1016/j.jcms.2019.07.009

Cited by 29 publications

(30 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…21 Nishta and Gadkari in their systematic review proved that 5 out 8 studies support three point fixation. 22 Na and Lim et al had found no difference in stability between two point and three point fixation however he found difference in the facial projection. 23 Wail et al compared two and three point fixation in two groups and evaluated surgical outcomes with CT scans.…”

Section: Discussionmentioning

confidence: 94%

Management of Zygomatico maxillary complex fractures with two-point fixation-A retrospective study for 5 years

Shanmugam¹,

Thanasekaran²,

Biradar³

et al. 2021

Asian J Med Sci

View full text Add to dashboard Cite

Background: The Zygomatico maxillary complex fractures (ZMC) are commonly encountered in the practice of the maxillofacial surgeon. Perfect management of the fracture is absolutely essential as the revision surgeries are tedious. Surgical management of ZMC is done at two or three points depending on the clinical displacement. Aims and Objectives: Zygomatico maxillary complex is the second most common fractures next to nasal bone fracture in the face worldwide. ZMC fractures are frequently seen and they were managed in great volumes throughout the country. The aim of our study is to prove the surgical outcomes of two-point fixation in the management of ZMC fractures. Materials and Methods: The inpatient records follow up records, radiographic records and photographs of 55 patients who underwent management of ZMC with two point fixations (one at zygomatic buttress and one at the fronto zygomatic region) were retrieved and analysed for the surgical outcomes. The evaluation was done preoperatively and postoperatively at 4weeks, 8 weeks and 12 weeks. Result: Two-point fixations give stable results both aesthetically and functionally in the management of Zygomatico maxillary complex fractures. Conclusion: Rigid internal fixation with titanium miniplates at two points in zygomatic buttress and in the fronto zygomatic region can be adopted with confidence as it gives excellent results. The scar formed in the infraorbital region or the unsightly ectropion can be avoided by not including the infra orbital region.

show abstract

Section: Discussionmentioning

confidence: 94%

Management of Zygomatico maxillary complex fractures with two-point fixation-A retrospective study for 5 years

Shanmugam¹,

Thanasekaran²,

Biradar³

et al. 2021

Asian J Med Sci

View full text Add to dashboard Cite

show abstract

“…Gadkari N et al, 2019 did a comprehensive systematic review, aiming to find the best method of fixation with the least incidence of malar asymmetry in the treatment of ZMC fractures. Five articles out of eight showed the superiority of 3 point fixation over the 2 point fixation for these fractures [23].…”

Section: Discussionmentioning

confidence: 97%

Combined Traumatic Facial Nerve Repair and Maxillofacial Fractures: Long Term Follow-Up

Saleh

Ghanem

Shanab

2020

The Egyptian Journal of Plastic and Reconstructive Surgery

View full text Add to dashboard Cite

Maxillofacial fractures management is considered a great challenge to facial plastic and reconstructive surgeons. They inquire adequate and systematic patient assessment to exclude involvement of facial neurovascular structures and the airway injuries. Types of fixation differ whether rigid or semi rigid fixation is used according to the degree of comminusion, site and shape of the fracture. The etiology of facial nerve palsy include: Idiopathic, post traumatic, neoplastic, etc... The traumatic injuries are the second most common, caused by personnel assaults, accidental at work or due to road traffic accidents. Searching in the English written literature it is not mentioned the outcome of primary traumatic facial nerve repair combined with complex maxillofacial injuries. The aim of the study is to investigate the long term functional outcome of traumatic facial nerve and maxillofacial fractures reconstruction. The study reviewed 16 patients with nerve injury and varies types of maxillofacial fractures, at El Demerdash Ain Shams University Hospital between June 2015 and October 2019. Only patients diagnosed with facial nerve main trunk or its branches after examination were included in the study. Only patients with followed-up data for at least 18 months were included. All patients was examined in the post-operative period and assessment was done using the House-Brackmann classification 11 and CT facial bone Patients demographic, history, physical and clinical examination, clinical photographs and surgical procedures (number and type) and complications were collected. This study revealed that the long term follow-up for patients with repaired facial nerve and varies maxillofacial fractures had promising esthetic and functional with a mean the post-operative objective House-Brackmann score analysis was 2.56 (±0.51). Further multi centric study is suggested to investigate the relation between the type of trauma, results and different nerves involved and this could be achieved by increasing the number of patients to be included in the future study.

show abstract

“…11 There have been numerous studies analyzing how mechanism of injuries, approaches, fixation points, and implant materials affect ZMC reconstruction. 3,8,[12][13][14][15][16][17] Our study builds upon the prior studies by extensively analyzing multiple variables and presenting a novel classification system in order to elicit potential relationships between fracture patterns and patient outcomes. We sought to test the clinical application of a comminution-based scoring method against what many consider to be the gold standard in the Zingg classification schematic.…”

Section: Discussionmentioning

confidence: 99%

A Novel Classification Method of Zygomaticomaxillary Complex Fractures by Suture Comminution to Better Predict Clinical Outcomes

Prabhu

Rudolph

Hemal

et al. 2020

FACE

View full text Add to dashboard Cite

Purpose: To assess a novel technique for classifying zygomaticomaxillary complex (ZMC) fractures by its ability to predict clinical outcomes and reoperations when compared to a well-established classification method. Methods: The investigators conducted a retrospective cohort study over a 7-year period composed of patients with unilateral and bilateral fractures of the ZMC. Fractures were graded according to the Zingg method and a CT-based comminution method. Outcomes were classified into 3 groups: orbital complications, facial complications, and reoperation. Orbital complications consisted of enophthalmos and diplopia. Facial complications consisted of lagophthalmos, ectropion, ptosis, facial motor weakness, trismus, and malar depression. Other variables included demographics, mechanism of injury, and preoperative symptoms. Results: A total of 159 patients were identified producing a total of 204 ZMC fractures. The mean age was 40.2 ± 16.5 years and the most common mechanism of injury was motor vehicle accidents in 49.7% of patients. By the Zingg classification, B-type fractures were the most common in 46% of patients. The average total comminution score was 2.9 ± 2.4. Univariate analysis showed an association between increased age and reoperation ( P = .01). After adjusting for demographic and clinical variables on multivariate analysis, total comminution score was a significant predictor of facial complications and reoperation. The Zingg method did not demonstrate significance as a predictor for facial complications or reoperation. Neither classification method was predictive of orbital complications. Conclusion: The results of this study suggest that total comminution scoring is a viable method for categorizing ZMC fractures to better predict clinical outcomes.

show abstract

Comparative evaluation of 2-point vs 3-point fixation in the treatment of zygomaticomaxillary complex fractures – A systematic review

Cited by 29 publications

References 19 publications

Management of Zygomatico maxillary complex fractures with two-point fixation-A retrospective study for 5 years

Management of Zygomatico maxillary complex fractures with two-point fixation-A retrospective study for 5 years

Combined Traumatic Facial Nerve Repair and Maxillofacial Fractures: Long Term Follow-Up

A Novel Classification Method of Zygomaticomaxillary Complex Fractures by Suture Comminution to Better Predict Clinical Outcomes

Contact Info

Product

Resources

About