Jung Seil, Yoon Sihyun, Nam Sang Hyun
Department of Plastic and Reconstructive Surgery, Inje University Sanggye Paik Hospital, Inje University School of Medicine, Seoul, Korea.
Arch Craniofac Surg. 2022 Jun;23(3):111-118. doi: 10.7181/acfs.2022.00045. Epub 2022 Jun 20.
Although the zygomatic arch is an important structure determining facial prominence and width, no consensus exists regarding the classification of isolated zygomatic arch fractures, and the literature on this topic is scarce. To date, five papers have subdivided zygomatic arch fractures; however, only one of those proposed classifications includes the injury vector, although the injury vector is one of the most important factors to consider in fracture cases. Furthermore, the only classification that does include the injury vector is too complicated to be suitable for daily practice. In addition, the existing classifications are clinically limited because they do not consider greenstick fractures, nondisplaced fractures, or coronoid impingement. In the present study, we present a rearrangement of the previously published classifications and propose a modified classification of isolated zygomatic arch fractures that maximizes the advantages and overcomes the disadvantages of previous classification systems.
The classification criteria for isolated zygomatic arch fractures described in five previous studies were analyzed, rearranged, and supplemented to generate a modified classification. The medical records, radiographs, and facial bone computed tomography findings of 134 patients with isolated zygomatic arch fractures who visited our hospital between January 2010 and December 2019 were also retrospectively analyzed.
We analyzed major classification criteria (displacement, the force vector of the injury, V-shaped fracture, and coronoid impingement) for isolated zygomatic arch fracture from the five previous studies and developed a modified classification by subdividing zygomatic arch fractures. We applied the modified classification to cases of isolated zygomatic arch fracture at our hospital. The surgery rate and injury severity differed significantly from fracture types I to VI.
Using our modified classification, we could determine that both the injury force and the injury vector meaningfully influenced the surgery rate and the severity of the injuries.
虽然颧弓是决定面部突出度和宽度的重要结构，但对于孤立性颧弓骨折的分类尚无共识，且关于该主题的文献较少。迄今为止，有五篇论文对颧弓骨折进行了细分；然而，其中只有一篇提出的分类包括损伤向量，尽管损伤向量是骨折病例中最重要的考虑因素之一。此外，唯一包括损伤向量的分类过于复杂，不适合日常临床实践。此外，现有的分类在临床上存在局限性，因为它们没有考虑青枝骨折、无移位骨折或冠状突撞击。在本研究中，我们对先前发表的分类进行了重新整理，并提出了一种改良的孤立性颧弓骨折分类方法，该方法最大限度地发挥了先前分类系统的优点，克服了其缺点。
分析、重新整理并补充了先前五项研究中描述的孤立性颧弓骨折的分类标准，以生成改良分类。我们还回顾性分析了2010年1月至2019年12月期间在我院就诊的134例孤立性颧弓骨折患者的病历、X线片和面部骨计算机断层扫描结果。
我们分析了先前五项研究中孤立性颧弓骨折的主要分类标准（移位、损伤力向量、V形骨折和冠状突撞击），并通过细分颧弓骨折制定了改良分类。我们将改良分类应用于我院的孤立性颧弓骨折病例。从骨折类型I到VI，手术率和损伤严重程度存在显著差异。
使用我们的改良分类，我们可以确定损伤力和损伤向量均对手术率和损伤严重程度有显著影响。
