PARADIGM IN AETIOLOGY AND MANAGEMENT OF ZYGOMATIC COMPLEX FRACTURES IN PAKISTAN

Authors

  • Assad Abbas
  • Iffat Batool Syed
  • Hasnain Abbas
  • Iram Abbas

Abstract

Objective: The purpose of this study was to compare the outcome of wire osteosynthesis with boneplating in the management of zygomatic complex (ZMC) fractures. The rationale was to enable the oraland maxillofacial surgeon to select either of the treatment procedure with confidence. Methods: In thisquasi experimental study, Sixty five patients of ZMC fractures were randomly allocated in groups ofbone plating and wire osteosynthesis. This was done through envelope draw method. Three pointsfixation with either of the treatment modality was undertaken. Titanium bone plating or stain less steelwire osteosynthesis was carried out at frontozygomatic suture, infra orbital rim and atzygomaticomaxillary buttress. Results: In this quasi experimental study, three patients failed to followup. There were 31 patients in each group. Infra orbital step defect was observed in one patient of wireosteosynthesis and two patients of bone plating. Mild facial deformity was observed in two patients ofwire osteosynthesis while none in that of bone plating. Conclusion: There is insignificant difference ofproportion of infra orbital step defect and facial deformity between wire osteosynthesis and bone plating.Keywords: Zygomatic complex fracture; wire osteosynthesis; titanium bone plating, infra orbital stepdefect; facial deformity; malar flattening

References

Nayyar MS. Management of Zygomatic Complex Fractures. J

Coll Physicians Surg Pak 2002;12(11):700–5.

Olasoji MO, Tahir A, Ariobita GT. Changing pictures of facial

fractures in Northern Nigeria. Br J Oral Maxillofac Surg

;40:140–3.

Hussain S, Ahmad M, Khan I, Anwar M, Amin M, Amjad S, et

al. Maxillofacial trauma: current practice in management at

Pakistan Institute of Medical Sciences. J Ayub Med Coll

Abbottabad 2003;15(2):8–11.

Ellis E. Fractures of the zygomatic complex and arch. In:

Fonseca RJ, Walker RV. (Eds). Oral and Maxillofacial Surgery.

rd ed. Philadelphia: WB Saunders; 2002.p. 571–632.

Khan M, Ahmed W. A comparative study of management of

Zygomatic bone fracture with Traction hook versus Gillies

approach. Pak Armed Forces Med J 2003;53(1):47–50.

Carter TG, Bagheri S, Dierks EJ. Towel clip reduction of the

depressed zygomatic arch fracture. J Oral Maxillofac Surg

;63:1244–6.

Camilleri AC, Gilhooly M, Cooke ME. Stablisation of the

unstable fractured zygomatic arch with a Kirschner wire. Br J

Oral Maxillofac Surg 2005;43:183–4.

Adam WM. Internal wiring of facial fractures. Surgery

;14:651.

Spiessl B, Schargus G, Schroll K. Die stabile Osteosynthese bei

Frakturen des unbezahnten Kiefers. Schweiz Mschr Zahnheilk

;81:39.

Adekeye EO. The pattern of fractures of the facial skeleton in

kunduna, Nigeria a survey of 1447 cases. J Oral Surg

;49:491–4.

Haider Z. Fracture of the zygomatic complex in the south east

region of Scotland. Br J Oral Surg 1997;15:265–8.

Van Hoof RF, Merkx CA, Stekelenberg EC. The different

patterns of fractures of the facial skeleton in four European

countries. Int J Oral Surg 1977;6(1):3–11.

Bataineh AB. Etiology and incidence of maxillofacial fractures in

north of Jordan. Oral Surg Oral Med Oral Path Oral Radiol

Endod 1998; 86:31–5.

Zachariades BM, Papavassiliou D. The pattern and etiology of

maxillofacial injuries in Greece. J Cranio Maxillofac Surg

;18(6):251–4.

Afzelus LE, Rosen C. Facial fractures a review of 368 cases. Int J

Oral Surg 1980;9(1):25–32.

Starkhammer H, Olofsson J. Facial fracture: A review of 922

cases with special reference to incidence and etiology. Clin

Otolaryngology 1982;7:405–9.

Tanaka N, Tomitsuka K, Shionoya K, Andou H, Kimijima Y,

Tashiro T, et al. Etiology of maxillofacial fractures. Br J Oral

Maxillofac Surg 1994;32(1):19–23.

Telfer MR, Jane GM, Shepherd JP. Trends in the aetiology of

maxillofacial fractures in the United Kingdom (1977-1987). Br J

Oral Maxillofac Surg 1991; 29:250–5.

Van Beek GJ, Merkx CA. Changes in the pattern of fractures of

the maxillofacial skeleton. Int J Oral Maxillofac Surg

;28:424–8.

Torgerson S, Tornes K. Maxillofacial fractures in Norwagian

district. Int J Oral Maxillofac Surg 1992;21:335–8.

Tadj A, Kimble FW. Fracture zygomas. ANZ J Surg

;73:49–54.

Israr N, Shah AA. Retrospective study of zygomatic complex

fractures in Sheffield England. Pak Oral Dent J 2001;21(1):50–9.

Jungell P, Lindqvist G. Paresthesia of the infrorbital nerve

following fracture of the zygomatic complex. Int J Maxillofac

Surg 1987;16:363–7.

O’Sullivan ST, Panchal J, O’Donoghure JM, Beausang ES,

O’Shaughnessy M, O’Connor TPF. Is there still a role for

traditional methods in the management of fractures of zygomatic

complex? Injury 1998;29(6):413–5.

Covington DS, Wainwright DJ, Teichgraeber JE, Parks DH.

Changing patterns in the epidemiology and treatment of zygoma

fractures: 10 year review. J Trauma 1994;37:243–8.

Published

2012-12-01

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