Two-Point versus Three-Point Fixation in the Management of Zygomaticomaxillary Complex Fractures

Gawande, MayurJanardan; Lambade, PravinN; Bande, Chandrashekhar; Gupta, Mithilesh Kumar; Mahajan, Monica; Dehankar, Tejaswini

doi:10.4103/ams.ams_75_20

Cited by 12 publications

(12 citation statements)

References 33 publications

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“…They noted that treating ZMC complicated fractures with approach involving three-point fixation and tolerant rigid fixation of fractured sections of bone leads to a reduced frequency of complications that are proportionate to the intensity of traumatic injury. [ 25 , 26 ] Gadkari et al [ 16 ] study strongly suggested, however, that three-point fixation offers superior outcomes and upholds stability of site of fracture in all three dimensional planes . Three-point visualization and fixation led to undesirable consequences in the trial, like postoperative visible scars.…”

Section: Discussionmentioning

confidence: 99%

Management of zygomatico maxillary complex fractures among Indian patients

Makkad¹

2023

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Zygomatic bone fractures should be effectively diagnosed and treated because they affect how the face is shaped for both aesthetically and functional reasons. It is possible to compare different surgical techniques and their comorbidities objectively through using outcome quantitative assessments, which call for a treatment programme and long-term follow-up. The purpose of this study was to compare the outcomes of two procedures and the effectiveness of the zygomatic bone following open reduction internal fixation (ORIF) employing two-point fixation and ORIF employing three-point fixation. Two groups of twenty patients each were randomly assigned to. Twenty patients in Group A had ORIF treatment using two-point miniplate fixation technique, and twenty patients in Group B received three-point miniplate fixation treatment. Differences between the two categories were ascertained after they had been evaluated in terms of their advantages and disadvantages. We discovered that the two-point fixation group had the fewest facial complications and neurological side effects. At 1 month follow up, Group B's average radiological evaluation score was 2.47ą 0.30, and then at 6 months follow up, it was found out to be 1.87ą0.47. A significant statistical distinction between the average radiological evaluations was observed in study participants of Group A at follow up done after one month and six months of procedure. Student's paired t- statistical test was utilized from this statistical analysis. (t = 6.54, P < 0.01). On carrying out follow up after one month of surgery, average neurological assessment score in study participants of group A was found out to be 0.22ą 0.42, and then at 6 months follow up, it was 0.61ą0.63. The average neurological evaluation score in study participants of Group A on carrying out follow up after one month of surgical procedure and and after six months of surgical procedure months showed a significant statistical distinction when utilizing Student's paired t- statistical test (t = 2.51, P = 0.021).It was determined that the best available rehabilitation for the treatment of zygomaticomaxillary complex fractures is open reduction and internal fixation employing two-point fixation by miniplates.

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Section: Discussionmentioning

confidence: 99%

Management of zygomatico maxillary complex fractures among Indian patients

Makkad¹

2023

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“…In contrast, there are complications that occur less frequently with fewer fixation points. Studies have reported that postoperative facial and neurological complications were less common in patients who underwent two-point fixation than three-point fixation [ 7 ]. and that scar formation occurred more frequently in two-point fixation than one-point fixation [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, multiple studies have compared two-point versus three-point fixation [6][7][8]. One study, which compared onepoint and two-point fixation using X-rays, argued that twopoint fixation was superior for bone stability to one-point fixation [9].…”

Section: Introductionmentioning

confidence: 99%

One-point versus two-point fixation in the management of zygoma complex fractures

Lee

Cheol

Shin

et al. 2022

Arch Craniofac Surg

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Background: The treatment of zygoma complex fractures is of crucial importance in the field of plastic surgery. However, surgical methods to correct zygoma complex fractures, including the number of fixation sites, differ among operators. Although several studies have compared two-point and three-point fixation, no comparative research has yet been conducted on one-point versus two-point fixation using computed tomography scans of surgical results. Therefore, the present study aimed to address this gap in the literature by comparing surgical results between one-point and two-point fixation procedures.Methods: In this study, we randomly selected patients to undergo surgery using one of two surgical methods. We analyzed patients with unilateral zygoma complex fractures unaccompanied by other fractures according to whether they underwent one-point fixation of the zygomaticomaxillary buttress or two-point fixation of the zygomaticomaxillary buttress and the zygomaticofrontal suture. We then made measurements at three points—the zygomaticofrontal suture, inferior orbital wall, and malar height—using 3-month postoperative computed tomography images and performed statistical analyses to compare the results of the two methods.Results: All three measurements (zygomaticofrontal suture, inferior orbital wall, and malar height) showed significant differences (<i>p</i> < 0.05) between one-point and two-point fixation. Highly significant differences were found for the zygomaticofrontal suture and malar height parameters. The difference in the inferior wall measurements was less meaningful, even though it also reached statistical significance.Conclusion: Using three parameters in a statistical analysis of imaging findings, this study demonstrated significant differences in treatment outcomes according to the number of fixations. The results indicate that bone alignment and continuity can be achieved to a greater extent by two-point fixation instead of one-point fixation.

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“…1 Following the nasal bone, zygoma is the second most prominent bone of the midface; therefore, it is frequently injured bone seen in daily clinical practice. 2 Zygoma is fractured due to various trauma, including accidental injuries, personal assaults, sports injuries, fall from height, and road traffic accidents (RTAs). 3 As in any fracture of the body, the assessment consists of a detailed history of trauma (such as the cause, mechanism, and duration), clinical evaluation, and radiologic investigations such as computed tomography (CT).…”

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confidence: 99%

“…The zygomaticomaxillary complex (ZMC) fractures refer to the osseous disruption of all buttresses of zygomatic (malar) bone: zygomaticomaxillary, frontozygomatic, zygomatico-sphenoid, and zygomaticotemporal 1 . Following the nasal bone, zygoma is the second most prominent bone of the midface; therefore, it is frequently injured bone seen in daily clinical practice 2 . Zygoma is fractured due to various trauma, including accidental injuries, personal assaults, sports injuries, fall from height, and road traffic accidents (RTAs) 3 .…”

mentioning

confidence: 99%

Direct or Indirect Surgical Approach of Zygomatic Complex Fracture: A Comparative Study

Alshalah,

Enezei,

Aldaghir

et al. 2023

Journal of Craniofacial Surgery

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Zygoma is considered the main support of the midface. Zygoma is frequently fractured owing to its prominent site on the face. Treatment of zygomaticomaxillary complex fractures can be performed through either conservative or surgical measures (closed or open reduction). The study was a cross-sectional retrospective observational investigation done at 4 hospitals in Ramadi and Baghdad cities, Iraq. This investigation covered a duration of 6 years (2016–2021). We reviewed the medical records of patients with ZCFs. The participants were divided into 2 groups according to the approach used for their management (direct versus indirect approach). Data regarding the demographic and clinical characteristics were recorded for each subject. Of 265 patients with ZCFs, 209 (78.9%) were males. The highest age group affected was 18 to 40 years (51.7%). The majority of the ZCFs were caused by road traffic accidents (31.7%). Most of the cases belong to single fractures (72.1%). Cheek flattening (73.6%) was the commonest sign of the ZCFs. The majority of the fractures were treated by direct approach, 65.4% of the isolated fractures and 62.2% for multiple fractures. Excellent patient satisfaction was seen in the majority of the cases. There were no statistically significant differences between the 2 approaches regarding the abovementioned variables (P-value > 0.05). The majority of the cases were with excellent patient satisfaction (n = 149) while only 7 patients with poor satisfaction. The age groups below 18 years and 18 to 40 years were associated with excellent patient satisfaction than good and poor satisfaction. All (n = 7) of the cases with poor satisfaction belong to the age group above 40 years. The majority of male (n = 113) and female (n = 36) patients were with excellent satisfaction, while all patients with poor results were males (n = 7). There were statistically significant differences between the results of the patient satisfaction and age group and complications (P-value < 0.05). The ophthalmic complications were the most complications seen after ZCF surgical treatment (2.56%). Direct and indirect approaches can be used safely in the treatment of ZCFs owing to excellent patient satisfaction in the majority of the cases and a low complication rate. This study aims to evaluate the demographic and clinical characteristics and to compare different surgical procedures to treat patients with zygomaticomaxillary complex fractures in a country overwhelmed by violence.

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Two-Point versus Three-Point Fixation in the Management of Zygomaticomaxillary Complex Fractures

Cited by 12 publications

References 33 publications

Management of zygomatico maxillary complex fractures among Indian patients

Management of zygomatico maxillary complex fractures among Indian patients

One-point versus two-point fixation in the management of zygoma complex fractures

Direct or Indirect Surgical Approach of Zygomatic Complex Fracture: A Comparative Study

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