Is transfacial Kirschner wire fixation still indicated in isolated zygomaticomaxillary complex fractures? Retrospective study of 216 cases in CHRU of Lille: epidemiology, therapeutic management, and results.

INTRODUCTION

No consensus on both contention and reduction a type in zygomaticomaxillary complex (ZMC) fractures' treatment exists. We tried to evaluate the percutaneous hook reduction method and the transfacial Kirschner wire (K-wire) fixation method in these fractures' treatment. This study also analyses epidemiological data of 4 million inhabitants (Nord-Pas-de-Calais region) in this trauma type.

MATERIALS AND METHODS

All the ZMC fractures treated in our department from September 2000 to November 2006 were reviewed retrospectively. The patients were evaluated by clinical and radiologic assessment. Therapeutic data and results were analyzed.

RESULTS

We reviewed 216 consecutively isolated ZMC fractures managed in our unit: 39 women and 177 men were included (sex ratio, 1:4.5). Mean age is 33.1 years. Assault is the main etiology before motor vehicle crashes. The average treatment delay is 3.5 days, and the mean delay before surgery is 10.3 days. All of the patients who had surgery underwent percutaneous hook reduction, and 77.3% of reduced fractures needed a contention realized at least by interosseous K-wire fixation in 94.6% of the cases. Reduction results were not satisfying in 5.6% of the patients who had surgery.

DISCUSSION

This study aimed to evaluate a method of ZMC fractures treatment and to eventually modify some aspects. We proposed a guideline allowing a main importance to clinical examination and to interosseous transfacial K-wire fixation associated with an open reduction with frontozygomatic and/or infraorbital rim osteosynthesis if mandatory.