Alzahrani Abdullah Ali H, Alzahrani Mohammed S, Kukreja Pankaj, Bhat Nagesh
Department of Dental Health, School of Applied Medical Sciences, Al-Baha University, Al-Baha 65731, Saudi Arabia.
Department of Restorative Dental Sciences, School of Dentistry, Al-Baha University, Al-Baha 65731, Saudi Arabia.
J Pharm Bioallied Sci. 2024 Feb;16(Suppl 1):S726-S729. doi: 10.4103/jpbs.jpbs_975_23. Epub 2024 Feb 29.
The aim of this study was to evaluate the accuracy of the degree of fracture reduction after open reduction and internal fixation of Zygomaticomaxillary Complex (ZMC) fractures in the Saudi population of the Al-Baha region, using Gillies approach. Further comparison with preoperative and postoperative standardized computed tomography (CT) views with the calculation of residual deformity percentage, which remained after the ZMC rehabilitation.
A 5-year retrospective CT-based study on preoperative and postoperative axial CT scans of 46 male patients with ZMC fractures. The CT measurements were made (in millimeters) at the fracture site of maximum displacement through the anterior orbital rim and orbital floor, posterolateral wall of the maxillary sinus, zygomatic arch, and zygomaticofrontal suture. For the zygomatic arch, measurements were made (in mm) by drawing a tangent to the fractured arch segments and dropping a perpendicular to the inward displaced fractured arch. The total difference in all measured parts between preoperative and postoperative displacement was calculated in percentages.
Upon comparison of preoperative and postoperative zygomaticomaxillary complex CTs, three-point fixation at the regions of infraorbital rim, frontozygomatic suture, and posterolateral wall of the maxilla results in a reduction of the fracture sites in the range of 72.85% to 85%. Maximum reduction was noted at the zygomatic arch, that is, 85%, and minimum at the infraorbital rim, that is, 72.85%. The reduction obtained at all four sites was statistically significant, with values ranging from .011 to .039.
Gillies temporal approach and three-point fixation at the regions of the infraorbital rim, frontozygomatic suture, and posterolateral wall of the maxilla results in satisfactory treatment of ZMC fractures and improves patients oral health and quality of life.
本研究的目的是使用吉利斯（Gillies）入路，评估巴哈地区沙特人群中颧上颌复合体（ZMC）骨折切开复位内固定术后骨折复位程度的准确性。通过计算ZMC修复后残留畸形百分比，进一步比较术前和术后标准化计算机断层扫描（CT）图像。
一项基于CT的回顾性研究，对46例男性ZMC骨折患者术前和术后的轴向CT扫描进行分析。在骨折部位通过眶前缘和眶底、上颌窦后外侧壁、颧弓和颧额缝测量最大位移（以毫米为单位）。对于颧弓，通过绘制骨折弓段的切线并向下垂直于向内移位的骨折弓进行测量（以毫米为单位）。计算术前和术后所有测量部位位移的总差异百分比。
比较术前和术后的颧上颌复合体CT，眶下缘、颧额缝和上颌后外侧壁区域的三点固定导致骨折部位减少72.85%至85%。颧弓处的复位最大，为85%，眶下缘处最小，为72.85%。在所有四个部位获得的复位在统计学上具有显著意义，P值范围为0.011至0.039。
吉利斯颞部入路以及眶下缘、颧额缝和上颌后外侧壁区域的三点固定可使ZMC骨折得到满意治疗，并改善患者的口腔健康和生活质量。
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