Choi Bong Gyu, Kang Chan-Su, Kim Yong-Ha, Chung Kyu-Jin
From the Department of Plastic & Reconstructive Surgery, College of Medicine, Yeungnam University, Daegu, South Korea.
Ann Plast Surg. 2020 Jul;85(1):33-37. doi: 10.1097/SAP.0000000000002239.
Several approaches are available for managing zygomatic fractures; however, each approach has its complications. Use of the Carroll-Girard T-bar screw (CGTS) can reduce complications because it reduces the number of approaches needed for reduction. This study aimed to analyze the efficiency of the CGTS compared with the 3-point approach.
A retrospective study was conducted by reviewing the computed tomography scans of 204 patients who underwent reduction surgery of Knight and North type 3, 4, or 5 zygomatic fractures from March 2009 to August 2017. Facial asymmetry, operative time, and complications were evaluated to compare 2 groups of patients: those who underwent CGTS and those who did not. Bilateral differences in the distance from the reference plane to the malar eminence in 3 dimensions based on computed tomography scans were used to calculate facial asymmetry.
Among 204 patients, 91 were treated with CGTS whereas 113 patients underwent a 3-point approach. Bilateral differences in the position of the malar eminence and facial asymmetry were not statistically different in both groups. Operative time was not different in both groups. However, when patients with type 4 fracture were independently compared, the mean operative time was significantly shorter for the CGTS group. Wound dehiscence occurred in 11 patients (9.7%) in the 3-point approach group, compared with none in the CGTS group. None of the patients in the CGTS group complained of postoperative cheek scars over their incision sites.
This study revealed that CGTS is a useful and feasible instrument that can reduce the number of approaches for zygomatic bone reduction and help clinicians achieve satisfactory outcomes.
治疗颧骨骨折有多种方法;然而,每种方法都有其并发症。使用卡罗尔 - 吉拉德T型杆螺钉(CGTS)可减少并发症,因为它减少了复位所需的手术入路数量。本研究旨在分析CGTS与三点入路相比的有效性。
通过回顾2009年3月至2017年8月接受奈特和诺斯3型、4型或5型颧骨骨折复位手术的204例患者的计算机断层扫描图像进行回顾性研究。评估面部不对称、手术时间和并发症,以比较两组患者:接受CGTS治疗的患者和未接受CGTS治疗的患者。基于计算机断层扫描图像,使用参考平面到颧突在三维空间中的距离的双侧差异来计算面部不对称。
在204例患者中,91例接受了CGTS治疗,而113例患者采用了三点入路。两组患者颧突位置的双侧差异和面部不对称在统计学上无差异。两组手术时间无差异。然而,当独立比较4型骨折患者时,CGTS组的平均手术时间明显更短。三点入路组有11例患者(9.7%)发生伤口裂开,而CGTS组无此情况。CGTS组患者均未抱怨切口部位术后脸颊有瘢痕。
本研究表明,CGTS是一种有用且可行的器械,可减少颧骨复位的手术入路数量,并帮助临床医生获得满意的治疗效果。