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Radiographic evaluation of percutaneous transfacial wiring versus open internal fixation for surgical treatment of unstable zygomatic bone fractures.

Authors
  • Giran, Guillaume1
  • Paré, Arnaud2, 3
  • Croisé, Benjamin2
  • Koudougou, Carine1
  • Mercier, Jacques Marie1
  • Laure, Boris2
  • Corre, Pierre1, 3
  • Bertin, Hélios1, 4
  • 1 Service de Chirurgie Maxillo-faciale et Stomatologie, Centre Hospitalier Universitaire de Nantes, Nantes, France. , (France)
  • 2 Service de Chirurgie Maxillo-faciale et Plastique, Centre Hospitalier Universitaire de Tours, Chambray-lès-Tours, France. , (France)
  • 3 Laboratoire de Médecine Régénératrice et Squelette (RMeS), Faculté de Chirurgie Dentaire, Nantes, France. , (France)
  • 4 Laboratoire des Sarcomes Osseux et Remodelage des Tissus Calcifiés (Phy.Os), Faculté de Médecine, Nantes, France. , (France)
Type
Published Article
Journal
PLoS ONE
Publisher
Public Library of Science
Publication Date
Jan 01, 2019
Volume
14
Issue
8
Identifiers
DOI: 10.1371/journal.pone.0220913
PMID: 31415600
Source
Medline
Language
English
License
Unknown

Abstract

The fixation of unstable zygomaticomaxillary complex (ZMC) fractures can be achieved by open reduction with rigid internal fixation (ORIF) and/or by closed reduction with percutaneous transfacial Kirschner wire fixation (CRWF). The aim of this study was to tomographically assess the symmetry and the protrusion of the cheekbone with unstable ZMC fractures that had been treated by ORIF vs. CRWF. Sixty patients exhibiting a surgically unstable tetrapodal ZMC fracture were included in this multicenter retrospective study. The coordinates of 5 landmarks representing the zygomatic protrusion were comparatively studied on the healthy and on the broken side using preoperative and postoperative tridimensional computed tomography (CT) scans or cone beam CT. No significant difference was found in the zygomatic protrusion irrespective of the surgical technique that was used. The zygomatico-maxillary ansa was found to be the most complicated area to reduce, particularly in the frontal plane with both the CRWF and the ORIF technique (p1 = 0.001 and p2 = 0.0009, respectively). There was no difference in terms of the level of complications, while the mean duration of the surgery was significantly less for the CRWF group. With good postoperative radiographic outcomes, the CRWF can be proposed as an alternative or in association with the ORIF technique for fixation of tetrapodal fractures of the ZMC.

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