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Fractures of zygomaticomaxillary and zygomatic-orbito-maxillary complexes

Annotation

During the period 2017–2021, 112 patients with fractures of the zygomaticomaxillary and zygomatic-orbito-maxillary complexes were diagnosed and surgically treated. The patients were divided into 2 groups. In the first group, after a comprehensive study of the clinical and radiological picture of the injury area, 86 patients were treated in the traditional way. The essence of the method was to create access through a small puncture-incision along the lower edge of the zygomatic bone and perform the reposition of fragments using the hook of A.A. Limberg. The remaining 26 patients were treated with open reposition and rigid fixation of bone fragments with transconjunctival, intraoral, and sometimes blepharoplastic incisions using titanium microplates and micro-screws. The results of the “traction test” were checked to identify the infringement of the lower oblique muscle of the eyeball. A computed tomography scan revealed a symptom of a “hanging drop” in combination with damage to the bottom of the eye socket. Despite such disadvantages as the need for a longer intervention, high financial costs and additional skills of the operating surgeon, after the treatment of the second group of patients, there was a decrease in postoperative complications and thus an improvement in the results of surgical treatment.

Keywords

zygomaticomaxillary and zygomatic-orbito-maxillary complexes fractures; traction test; hanging drop symptom; A.A. Limberg hook reposition; open reposition and rigid fixation of fragments

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DOI

10.20310/2658-7688-2021-3-2(10)-7-16

UDC

616.833.17-001

Pages

7-16

References

1. Ellis III E., El-Attar A., Moos K.F. An analysis of 2,067 cases of zygomatico-orbital fracture. J. Oral Maxillofac. Surg. 1985;43:417-28. 2. Cheema S.A., Amin F. Incidence and causes of maxillofacial skeletal injuries at the Mayo Hospital in Lahore, Pakistan. Br. J. Oral Maxillofac. Surg. 2006;44:232-4. 3. Schutz P., Šafař S., Belal M.S., Al-Yassin S., Kořinek P. Maxillofacial fractures in Kuwait between 1992–1997. Asian J. Oral Maxillofac. Surg. 2001;13:195-201. 4. Leech T.R., Martin B.C., Trabue J.C. An analysis of the etiology, treatment and complications of fractures of the malar compound and zygoma. J. Surg. 1956;92:920-4.

Received

2021-04-06

Section of issue

Traumatology and orthopedics

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