Department of Plastic and Reconstructive Surgery, Dankook University Hospital, Dankook University College of Medicine, 201 Manghyang-ro, Dongnam-gu, Cheonan-si, Chungcheongnam-do 31116, Republic of Korea.
Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Korea University College of Medicine 73, Inchon-ro, Seongbuk-gu, Seoul 02841, Republic of Korea.
J Plast Reconstr Aesthet Surg. 2019 May;72(5):831-841. doi: 10.1016/j.bjps.2018.11.014. Epub 2018 Nov 22.
This study was designed to introduce a novel method of applying osteosynthetic materials to the upper zygomatic arch border for fracture fixation through a temporal incision, and analyze the radiologic morphometric dimensions of the arch to verify its validity.
Radiological morphometry was analyzed in 51 adult patients with unilateral isolated zygomatic arch fractures. Frequent fracture sites, sites of minimal thickness and height, and their correlation were evaluated, as were the locations and dimensions of fixation vantage points. The novel surgical method based on the results was implemented in 17 clinical cases.
Frequent fracture sites, occurring 4.40, 16.47 and 30.48 mm posterior to the arch origin, did not correlate to sites of minimal height and thickness. Arch minimal thickness and height locations were 12.23 and 27.09 mm behind its origin, respectively. Fixation vantage point dimensions varied from point to point, with upper thickness ranging from 1.67 to 4.86 mm and mid-portion thickness ranging from 2.06 to 7.36 mm, and height ranging from 8.99 to 22.53 mm. Arch vertical axis inclination ranged from 6.51° to 16.47°, which increased as the arch stretches posteriorly. These results suggested the use of 1.5 mm-wide plates and 1 mm-diameter screws with 6-8 mm length. Patients received surgery based on these morphometry results for satisfactory stabilization.
This study introduces a new method for open reduction and internal fixation of arch fractures, with morphometric analysis of the arch verifying the validity of tangential plate application to the upper border.
本研究旨在介绍一种通过颞部切口在上颧骨弓边缘应用骨合成材料进行骨折固定的新方法，并通过放射形态计量学分析弓的形态尺寸来验证其有效性。
对 51 例单侧孤立性颧骨弓骨折患者进行放射形态计量学分析。评估常见骨折部位、最小厚度和高度部位及其相关性，以及固定优势点的位置和尺寸。基于结果实施了一种新的手术方法，并在 17 例临床病例中进行了应用。
常见骨折部位分别位于弓起点后 4.40、16.47 和 30.48mm 处，与最小高度和厚度部位无相关性。弓最小厚度和高度部位分别位于其起点后 12.23 和 27.09mm 处。固定优势点的尺寸因部位而异，上部厚度范围为 1.67 至 4.86mm，中部厚度范围为 2.06 至 7.36mm，高度范围为 8.99 至 22.53mm。弓垂直轴倾斜范围为 6.51°至 16.47°，随着弓向后伸展而增加。这些结果表明，使用 1.5mm 宽的钢板和 1mm 直径的螺钉，长度为 6-8mm。根据这些形态计量学结果，患者接受了手术，获得了满意的固定效果。
本研究介绍了一种新的颧骨弓骨折切开复位内固定方法，通过对弓的形态计量学分析验证了切线钢板在上缘应用的有效性。
