Lee Yong Jig, Han Dong Gil, Kim Se Hun, Shim Jeong Su, Kim Sung-Eun
Department of Plastic and Reconstructive Surgery, Daegu Catholic University School of Medicine, Daegu, Korea.
Arch Craniofac Surg. 2023 Feb;24(1):18-23. doi: 10.7181/acfs.2023.00031. Epub 2023 Feb 20.
When performing reduction of zygomatic arch fractures, locating the inward portion of the fracture can be difficult. Therefore, this study investigated the discrepancy between the locations of the depression on the soft tissue and bone and sought to identify how to determine the inward portion of the fracture on the patient's face.
We conducted a retrospective review of chart with isolated zygomatic arch fractures of type V in the Nam and Jung classification from March 2013 to February 2022. For consistent measurements, a reference point (RP), at the intersection between a vertical line passing through the end point of the root of the ear helix in the patient's side-view photograph and a transverse line passing through the longest horizontal axis of the external meatus opening, was established. We then measured the distance between the RP and the soft tissue depression in a portrait and the bone depression on a computed tomography (CT) scan. The discrepancy between these distances was quantified.
Among the patients with isolated zygomatic arch fractures, only those with a fully visible ear on a side-view photograph were included. Twenty-four patients met the inclusion criteria. There were four types of discrepancies in the location of the soft tissue depression compared to the bone depression: type I, forward and upward discrepancy (7.45 and 3.28 mm), type II, backward and upward (4.29 and 4.21 mm), type III, forward and downward (10.06 and 5.15 mm), and type IV, backward and downward (2.61 and 3.27 mm).
This study showed that discrepancy between the locations of the depressions on the soft tissue and bone exists in various directions. Therefore, applying the transverse and vertical distances measured from a bone image of the CT scan onto the patient's face at the indicated RP will be helpful for predicting the reduction location.
在进行颧弓骨折复位时，确定骨折的向内部分可能很困难。因此，本研究调查了软组织和骨骼上凹陷位置的差异，并试图确定如何在患者面部确定骨折的向内部分。
我们对2013年3月至2022年2月期间符合Nam和Jung分类中V型孤立性颧弓骨折的病历进行了回顾性研究。为了进行一致的测量，在患者侧视图照片中通过耳轮根部端点的垂直线与通过外耳道开口最长水平轴的横线的交点处确定一个参考点（RP）。然后我们测量了正面照片中RP与软组织凹陷之间的距离以及计算机断层扫描（CT）上骨骼凹陷之间的距离。对这些距离之间的差异进行了量化。
在孤立性颧弓骨折患者中，仅纳入了侧视图照片中耳朵完全可见的患者。24名患者符合纳入标准。与骨骼凹陷相比，软组织凹陷位置存在四种类型的差异：I型，向前和向上差异（7.45和3.28毫米），II型，向后和向上（4.29和4.21毫米），III型，向前和向下（10.06和5.15毫米），以及IV型，向后和向下（2.61和3.27毫米）。
本研究表明，软组织和骨骼上凹陷位置在各个方向上均存在差异。因此，将从CT扫描的骨骼图像测量的横向和纵向距离应用于患者面部指示的RP处，将有助于预测复位位置。
