Moreno Eduardo Fernando Chaves, Vasconcelos Belmiro Cavalcanti do Egito, Carneiro Suzana Célia de Aguiar Soares, Catunda Ivson Souza, Melo Auremir Rocha
Division of Oral and Maxillofacial Surgery, Restauração Hospital, Recife, PE, Brazil.
J Oral Maxillofac Surg. 2012 Oct;70(10):2386-93. doi: 10.1016/j.joms.2012.06.169. Epub 2012 Aug 11.
The aim of the present study was to assess the quality of treatment using two reduction and fixation techniques for zygoma fractures.
A randomized clinical trial was carried out involving a sample of 10 patients with Knight and North type III, IV and V zygoma fractures divided into two groups. One group underwent the closed reduction technique and fixation with Kirschner wire and the other group underwent the open reduction technique and fixation with titanium plates. The groups were submitted to subjective evaluation based on the patient's perception of areas of deformity and paresthesia as well as the measurement of range of mouth opening and pain upon mouth opening in the preoperative (T0) and postoperative (T1) periods. The assessment of bone reduction quality was performed using quantifiable points (lateral wall of the orbit, anteroposterior projection of the zygoma and ocular globe projection), measured based on tomographic images.
Seventy percent of the patients remained with paresthesia and 20% remained with the complaint of deformity at T1. Mouth opening range increased in both groups at T1. In the overall sample, mean total disjunction of the lateral wall of the orbit and the difference in the anteroposterior projection of the zygoma were reduced between T0 and T1 (4.36 mm to 1.25 mm and 6.94 mm to 2.86 mm, respectively). There was also a reduction in ocular globe projection in both groups between T0 and T1.
Both techniques achieved adequate reduction of zygoma fractures in the postoperative period.
本研究的目的是评估两种颧骨骨折复位固定技术的治疗质量。
进行了一项随机临床试验,纳入10例Knight和North III型、IV型和V型颧骨骨折患者样本,分为两组。一组采用闭合复位技术并用克氏针固定,另一组采用切开复位技术并用钛板固定。根据患者对畸形和感觉异常区域的感知以及术前(T0)和术后(T1)时期的开口度测量和开口时疼痛情况对两组进行主观评估。使用可量化的点(眼眶外侧壁、颧骨前后投影和眼球投影)评估骨折复位质量,基于断层图像进行测量。
在T1时,70%的患者仍有感觉异常,20%的患者仍有畸形主诉。两组在T1时开口度均增加。在整个样本中,眼眶外侧壁的平均总分离度以及颧骨前后投影的差异在T0和T1之间减小(分别从4.36 mm减小到1.25 mm和从6.94 mm减小到2.86 mm)。两组在T0和T1之间眼球投影也有所减小。
两种技术在术后均实现了颧骨骨折的充分复位。