Department of Oral and Maxillofacial Surgery, Saraswati Dhanwantari Dental College and Hospital, Pathri road, NH222 Parbhani, Maharashtra, India.
Head Face Med. 2012 Mar 6;8:7. doi: 10.1186/1746-160X-8-7.
The zygomatic maxillary complex (ZMC) fractures are one of the most frequent injuries of the facial skeleton due to its position and facial contour. Assaults, road traffic accidents and falls are the principal etiologic factors that may cause fractures of zygomatic bone. The different fixation methods are applied to treat the zygomatic bone fractures, with many more classifications which have been described in the literature for the ease of management. The type of the fracture, its severity and associated facial fractures usually interferes the treatment modality.
The aim of this paper is to show the results of 18yrs prospective blind comparative study using wire and plate osteosynthesis which needed open reduction and internal fixation involving Type II to Type IV Spissel and Schroll ZMC fractures.
Total 80 cases included in the study out of 1780 ZMC cases which were treated using wire and plate osteosynthesis over a period of 18 yrs, involving only Type II to Type IV Spissel and Schroll ZMC fractures. Other types excluded from study to prevent observer bias. All the fixations carried out through Standard Dingman's incision using stainless steel 26 gauze wire and titanium 1.5 mm mini plate system under general anesthesia by single maxillofacial surgeon and evaluated by another maxillofacial surgeon who is blinded for surgical procedure after 2 and 4 wks of follow-up for facial symmetry, wound healing, functional assessment (mouth opening, diplopia), and sensory disturbance. All the data tabulated in Excel software (Microsoft) for statistical analysis. P-value calculated to know the Significance of treatment modality in all aspects.
Result shows no significant p-values indicating both the operating techniques are equally efficient in the surgical management of ZMC fracture.
Osteosynthesis by mini plates is simple, logical and effective treatment compared to wire osteosynthesis in regard to stability of fracture fragments. Wire osteosynthesis will be helpful in emergency surgeries or where the mini plates are not available. Even though the wire osteosynthesis is economical compared to mini plate fixation; but the time and skill is required for fixation of wires.
由于颧骨复合体（ZMC）的位置和面部轮廓，它是面部骨骼最常发生的骨折之一。攻击、道路交通意外和跌倒都是导致颧骨骨折的主要病因。为了治疗颧骨骨折，已经应用了不同的固定方法，并且文献中已经描述了许多更详细的分类，以便于管理。骨折的类型、严重程度和相关的面部骨折通常会影响治疗方式。
本文旨在展示 18 年前瞻性盲法比较研究的结果，该研究使用需要切开复位和内固定的钢丝和钢板骨合成术来治疗 II 型至 IV 型 Spissel 和 Schroll ZMC 骨折。
在 18 年的时间里，共有 80 例病例（1780 例 ZMC 病例中的 80 例）被纳入该研究，这些病例均使用钢丝和钢板骨合成术进行治疗，仅涉及 II 型至 IV 型 Spissel 和 Schroll ZMC 骨折。为了防止观察者的偏见，研究中排除了其他类型的骨折。所有固定均由同一位颌面外科医生通过标准 Dingman 切口进行，使用不锈钢 26 号纱布线和钛 1.5 毫米微型板系统进行，在全身麻醉下进行，并由另一位对手术过程不知情的颌面外科医生在术后 2 周和 4 周进行随访，评估面部对称性、伤口愈合、功能评估（张口度、复视）和感觉障碍。所有数据均在 Microsoft Excel 软件中进行制表，以便进行统计分析。计算 P 值以了解治疗方式在各个方面的显著性。
结果显示，没有显著的 P 值表明两种手术技术在 ZMC 骨折的手术治疗中同样有效。
与钢丝骨合成术相比，微型板骨合成术在骨折碎片的稳定性方面更为简单、合理和有效。在紧急手术或微型板不可用时，钢丝骨合成术将有所帮助。虽然与微型板固定相比，钢丝骨合成术更经济，但需要固定钢丝的时间和技能。
