One-piece Craniofacial Bone Fracture Reduction With an Additional Single Osteotomy at the Zygomaticomaxillary Buttress: A Successful Reduction of Frontoorbitozygomaticomaxillary Fracture Associated With a Temporoparietal Bone Fracture

Abstract

A frontoorbitozygomaticomaxillary fracture, also known as a complex midface fracture or “quadripod fracture,” is a type of facial fracture involving multiple midface region bones. This includes the frontal bone (forehead), orbitozygomatic complex (which includes the zygomatic bone or cheekbone and the orbital bones around the eye), and the maxillary bone (upper jaw). These complex midface fractures associated with temporoparietal bone fractures can occur in clinical practice. However, a single-piece fracture of these has not been reported before. This study reports a 44-year-old male patient with a significant frontoorbitozygomaticomaxillary fracture associated with a temporoparietal bone fracture combined with epidural hematoma at the superior aspect of unilateral frontoparietotemporal convexity. Surgical treatment was performed 3 weeks after the traumatic event. Despite craniotomy of the parietal bone fragment, the reduction was not possible. The facial bone reduction was finally achieved following an additional single osteotomy at the unilateral zygomaticomaxillary buttress. The follow-up CT scan taken immediately and 3 weeks postoperatively showed successful realignment of craniofacial bone fracture. In conclusion, a single-piece fracture of frontoorbitozygomaticomaxillary bone connected to a temporoparietal bone can require additional osteotomy to achieve successful outcomes in an acute setting.

Major clinical and surgical approaches to treating orbitozygomatic and zygomatic maxillary complex fractures: a systematic review

“…The facial bone reduction was finally achieved after an additional single osteotomy in unilateral zygomaticomaxillary support. Follow-up CT scan performed immediately and 3 weeks after surgery showed successful realignment of the craniofacial bone fracture [21].…”

Is Gillies Temporal Incision Necessary to Successfully Reduce Zygomaticomaxillary Fracture Combined With Orbital Wall Fracture?

“…T he zygomatic bone gives the lateral projection to the face. 1 Zygomatic bone fractures should be diagnosed and treated promptly because they can affect both the esthetics and function of the face. 2 Multiple fractures of the zygomatic bones are generally reduced using open exploration.…”