Peleg Oren, Ianculovici Clariel, Shuster Amir, Mijiritsky Eitan, Oz Itay, Kleinman Shlomi
Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of Oral and Maxillofacial Surgery, Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
J Korean Assoc Oral Maxillofac Surg. 2021 Oct 31;47(5):382-387. doi: 10.5125/jkaoms.2021.47.5.382.
Zygomatic complex (ZMC) fractures comprise up to 40% of all facial fractures. Misaligned bone fragments and misplaced fixation hardware traditionally detected postoperatively on plain radiographs of the skull might require re-operation. The intraoperative O-Arm (Medtronic, USA) is a three-dimensional (3D) computed tomographic imaging system.
This retrospective single-center study evaluated the utility of O-Arm scanning during corrective surgeries for ZMC and zygomatic arch (ZA) fractures from 2018 to 2020. Three females and 16 males (mean age, 31.52 years; range, 22-48 years) were included. Fracture instability (n=6) and facial deformity (n=15) were the most frequent indications for intraoperative 3D O-Arm scan.
The images demonstrated that all fracture lines were properly reduced and fixed. Another scan performed at the end of the fixation or reduction stage, however, revealed suboptimal results in five of the 19 cases, and further reduction and fixation of the fracture lines were required.
Implementation of an intraoperative O-Arm system in ZMC and ZA fracture surgeries assists in obtaining predictable and accurate results and obviates the need for revision surgeries. The device should be considered for precise operations such as ZMC fracture repairs.
颧骨复合体（ZMC）骨折占所有面部骨折的40%。传统上，术后通过颅骨平片检测到的骨碎片错位和固定硬件位置不当可能需要再次手术。术中O型臂（美国美敦力公司）是一种三维（3D）计算机断层成像系统。
这项回顾性单中心研究评估了2018年至2020年期间O型臂扫描在ZMC和颧弓（ZA）骨折矫正手术中的效用。纳入3名女性和16名男性（平均年龄31.52岁；范围22 - 48岁）。骨折不稳定（n = 6）和面部畸形（n = 15）是术中进行3D O型臂扫描最常见的指征。
图像显示所有骨折线均得到妥善复位和固定。然而，在固定或复位阶段结束时进行的另一项扫描显示，19例中有5例结果不理想，需要对骨折线进行进一步复位和固定。
在ZMC和ZA骨折手术中实施术中O型臂系统有助于获得可预测和准确的结果，并避免了翻修手术的需要。对于诸如ZMC骨折修复等精确手术，应考虑使用该设备。
