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At least 19 recordsLinked to original sources
PubMed1997

[Zygomatic fractures].

The zygomatic bone is important for the midfacial contour and for protection of the orbital contents. Zygomatic fractures frequently occur. Because they are hidden behind a simple black eye in many instances, there is a potential risk of missing the diagnosis. Fresh zygomatic fractures are relatively easy to treat, but late secondary corrections are difficult and often have dissatisfying results. The most important clinical signs of a zygomatic fracture are: flattening of the zygomatic contour, edema, haematoma, unilateral nose-bleeding, disturbed sensibility, diplopia, restricted mandibular movements, contour defects. In this paper the clinical signs of a zygomatic fracture are emphasized to enable the general practitioner to examine the patient with a simple black eye appropriately and be able to recognize a zygomatic fracture.

Diagnosis, Differential↗
PubMed1987

Single-point stabilization of zygomatic fractures with the minicompression plate.

Unstable zygomatic fractures frequently require stabilization at two points. A new "mini" dynamic compression plating system designed specifically for zygomatic fractures permits single-point stabilization. We used a minicompression plating system with a series of patients at the University of Washington Affiliated Hospitals, Seattle. Satisfactory single-point stabilization of displaced zygomatic fractures was consistently achieved with this method. The plate and screws are substantially smaller than commonly used in mandibular fractures facilitating cosmetic concealment. There are theoretical advantages of this plating system as they apply to the unique geometry of the zygomatic fracture.

Bone Plates↗
PubMed2002

Plane measurement of three-dimensional CT images on the diagnosis of zygomatic fractures.

OBJECTIVE: To investigate an available method for quantitative diagnosis of zygomatic fractures to quantitatively classify and diagnose the deformities of zygomatic fractures. METHODS: Traditional X-ray, two and three dimensional CT images of 96 patients with zygomatic fractures were measured and analysed by computer-assisted measuring system before and after operation to diagnose the displacement and deformity of the fractures. RESULTS: 1. Using anthropology points and computer assisted measuring system, a new method was established to assess the displacement of the zygomatic fractures. 2. Displacement of the zygomatic fractures was approximately diagnosed by measuring different angle of 3D CT photographs. 3. A classification was proposed based on the deformities of the zygomatic fractures. CONCLUSIONS: Computer-assisted 3D CT measuring system is accurate, reliable and feasible in clinic for diagnosing zygomatic fractures.

Adolescent↗
PubMed2000

Computer-assisted quantitative measurements by three-dimensional images on zygomatic fracture deformities.

OBJECTIVE: To investigate an available method for quantitative diagnosis of zygomatic fractures that allow quantitative classification and diagnosis. METHODS: The radiographs and 2- and 3-dimensional CT images of 57 patients with zygomatic fractures were measured and analyzed by a computer-assisted measuring system before and after treatment. This was used to diagnose the displacement and deformity of the fractures. RESULTS: (1) Using anthropology points and a computer-assisted measuring system, a new method was established to assess the displacement of the zygomatic fractures. (2) Displacement of the zygomatic fractures was approximately diagnosed by measuring different angles of the CT images. (3) A new classification was proposed based on the deformities of the zygomatic fractures: Type A, zygomatic body was intact and not displaced; Type B, zygomatic body was intact but displaced (including comminuted zygomatic arch fractures); Type C, zygomatic body was comminuted and displaced. (4) There were 4 subtypes with characteristics in the most common Type B fractures. (5) Different images had different advantages for diagnosing zygomatic fractures. CONCLUSIONS: (1) Displacement of the zygomatic fractures can be quantitatively diagnosed by measuring 3-D CT images. (2) The computer-assisted 3-D CT measuring system is accurate, reliable, and clinically feasible for diagnosing zygomatic fractures. (3) The best image to diagnose the displacement of the fractures should be used.

Adolescent↗
PubMed1986

Zygomatic fractures: classification and complications.

A retrospective study of zygomatic fractures is presented in order to analyse late complications and to evaluate the different radiographic classifications. The study comprises 109 patients with 111 zygomatic fractures. The aetiology was violence in 39% and traffic accidents in 28%. Associated fractures of the craniofacial skeleton occurred in 42% of the patients. Seventy-two patients were available for the follow-up study. Malar flattening was found in 16% of the patients operated on. Thirty-four per cent of the patients had sensory disturbances, 6% had enophthalmos, and 1% had diplopia. Classifications of zygomatic fractures are reviewed. The fractures in the current study were grouped in accordance with the classifications of Knight & North and Larsen & Thomsen. Neither of these classifications was found to be useful in the preoperative evaluation of the postreductive fracture stability. The most reliable method of evaluating this stability is the preoperative evaluation, but CT classification systems may in the future demonstrate their value.

Adolescent↗
PubMed1986

Skin incision parallel with skin cleavage lines for access to the fractured zygomatic arch.

In surgery of the fractured zygomatic arch the skin incision was placed parallel with the skin cleavage lines, directly over the zygomatic arch. The fracture site was exposed by blunt dissection of the subcutaneous tissue. Facial palsy may be predicted as a possible sequel to this incision. In fact, facial paresis occurred in 1/3 of the patients but it disappeared within 6 months. It appeared that the facial nerve was only damaged by stretching during the surgical procedure but was not severed by the incision. The postoperative scars presented no unsightly appearance, if the incision was placed completely parallel with the cleavage lines.

Adolescent↗
PubMed2005

Simplified repair of zygomatic fractures through a transconjunctival approach.

OBJECTIVE: To describe a simplified technique of zygomatic fracture repair. DESIGN: Retrospective, noncomparative case series with description of a surgical technique. PARTICIPANTS: Twenty consecutive patients with zygomatic fractures undergoing repair with the described technique. INTERVENTION: Fracture repair was accomplished with a technique that used a T-bar screw for reduction through a transconjunctival approach. MAIN OUTCOME MEASURE: Successful fracture reduction. RESULTS: Twenty patients with zygomatic fractures underwent successful reduction with the simplified technique. No complications were observed. CONCLUSIONS: The use of the T-bar through a transconjunctival approach is a simplified and effective technique for zygomatic fracture repair.

Adolescent↗
PubMed1992

Classification and treatment of zygomatic fractures: a review of 1,025 cases.

The treatment of zygomatic fractures varies among surgeons, and the cosmetic and functional results are frequently less than optimal. A treatment guideline based on a simple classification of zygomatic fractures is presented. The emphasis is placed on the indications for closed and open reduction, consistent methods of three-dimensional alignment and fixation, and the management of concomitant infraorbital rim and orbital floor fractures. Postoperative results with regard to infraorbital nerve and maxillary sinus dysfunction, malar asymmetry, and orbital complications in the treatment of 1,025 consecutive zygomatic fractures are presented.

Adolescent↗
PubMed2004

[A clinical investigation on the surgical approach and fixation in operative treatment zygomatic fractures].

OBJECTIVE: To investigate the effect of soft tissue incision and rigid internal fixation in the treatment of zygomatic fracture. METHODS: 70 cases with zygomatic fracture were entered into the study. The clinical data of 65 patients who were performed operations in the treatment were analyzed. The study focused on the incision, number and locations of Titanium plate. The facial contour, reduction,fixation, healing of incision, facial bisymmetry and complications of the operation were followed up 3 - 24 months after surgery. RESULTS: All the incisions were primary healing. Clinical and radiologic assessment of reduction was symmetric and stable in 91.5% of all cases, asymmetric in 8.5% of all cases. Subcutaneous hematoma happened in 5 cases, Ti plate exposure 1 in case, scalp scar width was more than 0.5 cm in 6 cases, frontal part or scalp paresthesia 8 cases. CONCLUSIONS: Coronal scalp incision has advantages such as good exposure, precise removal of the bone block and good symmetry of both sides. RIF can improve the stability of fracture, promotes fracture healing and guarantees the rehabilitation of zygomatic complex. direct reduction and rigid internal fixation with Titanium microplate or miniplate are satisfactory in zygomatic fracture.

Adolescent↗
PubMed1990

[Osteosynthesis with miniplates in unstable maxillo-zygomatic fractures].

This article discusses the etiology and classification of zygomatic fractures, as well as indications and methods of surgery. Osteosynthesis with a miniplate is a new treatment modality for unstable zygomatic fractures. The operative procedure is relatively simple and gives good cosmetic and functional results. We describe the technique illustrated with pre- and postoperative x-rays of a patient.

Bone Plates↗
PubMed1992

Zygomatic fractures: reduction with the T-bar screw.

The prominent zygomatic bone is one of the most commonly fractured. Fracture with displacement of the bone results in a cosmetic and functional deformity. The fractured zygomatic bone is usually dislocated in an inferomedial and posterior direction, which results in a cosmetic deformity with loss of ipsilateral malar prominence, possible depression of the zygomatic arch, asymmetry of the bony orbital circumference, and possible enophthalmos. Fracture of the zygomatic bone may result in ocular, maxillary antral, and mandibular dysfunction; diplopia, restricted extraocular muscle movement, or intraocular injuries; infection or obstruction of the maxillary antrum; and restricted mandibular function and malocclusion. Various surgical methods have been used to reduce the displaced fractured zygomatic bone. Our preferred method for reduction is the T-bar (Carroll-Girard) screw. This clinical study reviews 30 cases of zygomatic complex fractures, outlines the surgical technique used, illustrates the proper use of the T-bar screw with anatomic schematics and clinical cases, and presents illustrative case summaries.

Adolescent↗
PubMed2000

Application of endoscope in zygomatic fracture repair.

The endoscope has been used to visualise the upper face and brow in aesthetic facial surgery which is performed without a coronal incision. We applied these principles to repair zygomatic fractures with the aid of a 4 mm, 30 degree telescope inserted through a small temporal incision. Fracture sites at the zygomatic arch and the zygomaticofrontal suture were exposed and fixed with miniplates under endoscopic control. This technique was used in 15 consecutive patients including 2 with isolated zygomatic arch comminuted fractures and 13 having displaced zygomatic fractures with segmental, displaced zygomatic arch fractures. Nine patients were men and six patients were women with a mean age of 35 years. Three patients had associated mandibular fractures. The periods of follow-up ranged from 3 to 22 months. Two patients developed transient frontal nerve palsy which recovered within 2 months. One patient had mild temporal hollowing on the side of the facial fracture. All patients achieved the adequate anatomic reduction and satisfactory malar symmetry. There has been no case of chewing problems, cheek numbness or progressive enophthalmos developing postoperatively. Application of the endoscope in zygomatic fracture repair minimises the scalp scar, avoids forehead numbness, provides a comfortable postoperative recovery and shortens hospital stay. Careful preoperative evaluation and proper surgical technique are mandatory for achieving optimal results in selected patients.

Accidents, Traffic↗
PubMed1992

Zygomatic fractures and infraorbital nerve disturbances. Miniplate osteosynthesis vs. other treatment modalities.

The present paper reviews the results obtained with different modalities of treatment employed in isolated fractures of the zygomatic complex. Seventy-three patients were re-examined with respect to infraorbital nerve function. The results obtained suggest that the incidence of hypoaesthesia of the infraorbital nerve following fracture of the zygomatic complex can be reduced if rigid fixation is applied on the infraorbital rim. The zygomatic bone is a protruding part of the human skeleton and is therefore easily affected by trauma to the facial region. The etiology and clinical appearance of fractures of the zygomatic complex are well known and previously described in detail (Afzelius and Rosen 1980, Ellis et al. 1985, Jungell and Lindqvist 1987). Fractures of the zygomatic complex are rarely fractures of the zygoma itself but of its connection to the skull and facial skeleton, e.g. the frontozygomatic suture, the zygomatico-maxillary suture, the zygomatic arch and the infraorbital rim. A fracture of the infraorbital rim usually involves the infraorbital foramen or bone close to it. Such a fracture also extends into the orbital floor through or adjacent to the infraorbital canal. Dislocation of the fractured zygomatic complex may thus result in injury to or compression of the infraorbital nerve. Such an injury may cause numbness/hypoaesthesia/dysaesthesia in the distribution of the nerve. Accordingly, reduced infraorbital nerve function is a frequently reported sequela of fractures of the zygomatic complex. Thus impaired infraorbital nerve function prior to treatment has been reported to occur in approximately 80% of such cases (Table 1). With respect to persistent impaired function of the infraorbital nerve, the literature demonstrates varying results following different types of treatment, ranging from 22% to 50% persistent hypoaesthesia (Table 1). Interestingly, the return of infraorbital nerve function continues with an extended observation period between treatment and follow-up and it has been claimed that infraorbital nerve function may continue to improve even after one year following injury/surgery (Afzelius and Rosen 1980). Cases with persistent and disturbing impaired function of the infraorbital nerve may be considered for decompressive nerve surgery or microsurgical reconstruction of the infraorbital nerve (Mozsary and Middleton 1983). The present report is a retrospective study and aimed to evaluate the recovery of infraorbital nerve function obtained with different modalities of treatment of isolated fractures of the zygomatic complex.

Bone Plates↗