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A retrospective study of zygomatic fractures
2:t6
P23-2 Trauma
P23-2 Trauma 3. A Simple Reduction Method Using a Screw Tap for Neglected Zygomatic Bone Fractures 1. Surgical Treatment of Posttraumatic Enophthalmos in Neglected, Untreated or Maltreated Pure and Impure Blowout Fractures of the Orbital Floor
De Man, K. Department of Oral and Maxillofacial Surgery, Erasmus University, Rotterdam, The Netherlands If one looks critically at the results of surgery to correct enophthalmos, it is evident that perfect correction of the deformity is difficult to achieve. In our hands, reduction of herniated orbital tissue and a titanium orbital floor plate to bridge the bony defect and support the globe, corrected most or all of late enophthalmos. If, in spite of this reconstructive procedure, enophthalmos still persists, orbital volumes were measured, using a low dose dynamic CT technique. The result of this measurement affords us the opportunity to place a non-resorbably implant with the exact quantity of implant material needed, on the orbital floor at a second operation. Although enophthalmos in most patients is due to volume discrepancy with an increase in orbital volume, there are some who have tethering of the globe posteriorly, possibly by entrapped muscles or even more likely, by cicatricial contracture of the retrobulbar tissues. Even in patients with a volume discrepancy, an element of fibrosis may also be present. Therefore, perfect corrction of enophthalmos is diffucult to achieve but significant improvement can be obtained and is appreciated by the patients.
2. A Retrospective Study of Zygomatic Fractures
Sakavicius, D., Sabalys, G., Lukosiunas, A.
Bukawa, H. 1, 8himizu~ 8. 2, Yamamoto, E 2, Mikami, T.2, Fujita, K, 1, Yoshida, T.2 1Department OMS, Yokohama City University School of Medicine, 2Department Plastic Reconstruc. Surg., Yokohama City University Hospital, Yokohama, Japan There are many methods for the reduction of zygomatic bone fractures. In the case of blind reduction, many kinds of approaches and instruments have been reported. For fractures of the zygomatic body, we have been using screw taps for penqtrating the zygomatic body. The use of a corkscrew was introduced in 1928 by Roberts, but the method did not come into widespread use. We were able to obtain better results by using screw taps to improve the shortcomings of the corkscrew method. In this new method a blind reduction is performed by screwing a tap directly into. the zygoma through a stab incision of the cheek skin. The dislocated bone is then reduced by manipulating the tap. The fixation of the tap to the zygomatic bone is firm enough, and the driving force can be transmitted directly to the dislocated bone. This new method is easy, safe and accurate for fresh zygomatic bone fractt~res. We have treated 20 cases successfully. We also treated a zygomatic bone fracture which had been overlooked for 3 weeks after injury. The method was effective in this case also.
Case report A 15-year-old Japanese woman was in a traffic accident and was referred to our hospital in December, 1996, for treatment of zygomatic bone fracture. Three weeks had already passed since her injury. Open surgery is usually performed in the case of fractures that are more than 14 days old. However, we tried the tap method for reduction, because it has an esthetic advantage over open surgery. A 4.5 mm diameter tap was used, and the fracture was reduced effectively.
Department of Maxillofacial Surgery, Kaunas Medical Academy, Kaunas, Lithuania 4. The Evaluation of Maxillo-zygomatic Fractures Using Three-dimensional Computed Tomography 624 patients with zygomatic fractures were treated in the period 1987-1996. There were 466 males and 158 females involved. 498 had fractures of the zygomatic bone, 59 just the arch whereas 67 had combined fractures. 584 cases were considered to be candidates for surgical reposition and fixation. 487 patients had dysaesthesia of the infraorbital nerve; in 197 cases this dissolved within 10-14 days postoperatively. In 251 patients (51%) long term follow-up was available. In 191 patients there was no functional nor aesthetic problem. In 61 patients some degree of infraorbital nerve dysaesthesia was present and in 13 patients a cosmetic problem still existed.
Kashima, K., Shiba, R., Sakoda, S., Nagatomo, O. Department of OMS, Miyazaki Medical College, Miyazaki, Japan Purpose The purpose of this study was to evaluate the diagnostic usefulness of three-dimensional computed tomographic (CT) imaging for maxillo-zygomatic fi'actures. Materials and methods Eight patients with maxillo-zygomatic fractures enrolled in this study. Each patient was sepeerately evaluated with 1) conventional roentgenographic images (Dental films, Orthopantomogram, Water's view and Posterio-anterior projec-
P23-2 Trauma
P23-2 Trauma 3. A Simple Reduction Method Using a Screw Tap for Neglected Zygomatic Bone Fractures 1. Surgical Treatment of Posttraumatic Enophthalmos in Neglected, Untreated or Maltreated Pure and Impure Blowout Fractures of the Orbital Floor
De Man, K. Department of Oral and Maxillofacial Surgery, Erasmus University, Rotterdam, The Netherlands If one looks critically at the results of surgery to correct enophthalmos, it is evident that perfect correction of the deformity is difficult to achieve. In our hands, reduction of herniated orbital tissue and a titanium orbital floor plate to bridge the bony defect and support the globe, corrected most or all of late enophthalmos. If, in spite of this reconstructive procedure, enophthalmos still persists, orbital volumes were measured, using a low dose dynamic CT technique. The result of this measurement affords us the opportunity to place a non-resorbably implant with the exact quantity of implant material needed, on the orbital floor at a second operation. Although enophthalmos in most patients is due to volume discrepancy with an increase in orbital volume, there are some who have tethering of the globe posteriorly, possibly by entrapped muscles or even more likely, by cicatricial contracture of the retrobulbar tissues. Even in patients with a volume discrepancy, an element of fibrosis may also be present. Therefore, perfect corrction of enophthalmos is diffucult to achieve but significant improvement can be obtained and is appreciated by the patients.
2. A Retrospective Study of Zygomatic Fractures
Sakavicius, D., Sabalys, G., Lukosiunas, A.
Bukawa, H. 1, 8himizu~ 8. 2, Yamamoto, E 2, Mikami, T.2, Fujita, K, 1, Yoshida, T.2 1Department OMS, Yokohama City University School of Medicine, 2Department Plastic Reconstruc. Surg., Yokohama City University Hospital, Yokohama, Japan There are many methods for the reduction of zygomatic bone fractures. In the case of blind reduction, many kinds of approaches and instruments have been reported. For fractures of the zygomatic body, we have been using screw taps for penqtrating the zygomatic body. The use of a corkscrew was introduced in 1928 by Roberts, but the method did not come into widespread use. We were able to obtain better results by using screw taps to improve the shortcomings of the corkscrew method. In this new method a blind reduction is performed by screwing a tap directly into. the zygoma through a stab incision of the cheek skin. The dislocated bone is then reduced by manipulating the tap. The fixation of the tap to the zygomatic bone is firm enough, and the driving force can be transmitted directly to the dislocated bone. This new method is easy, safe and accurate for fresh zygomatic bone fractt~res. We have treated 20 cases successfully. We also treated a zygomatic bone fracture which had been overlooked for 3 weeks after injury. The method was effective in this case also.
Case report A 15-year-old Japanese woman was in a traffic accident and was referred to our hospital in December, 1996, for treatment of zygomatic bone fracture. Three weeks had already passed since her injury. Open surgery is usually performed in the case of fractures that are more than 14 days old. However, we tried the tap method for reduction, because it has an esthetic advantage over open surgery. A 4.5 mm diameter tap was used, and the fracture was reduced effectively.
Department of Maxillofacial Surgery, Kaunas Medical Academy, Kaunas, Lithuania 4. The Evaluation of Maxillo-zygomatic Fractures Using Three-dimensional Computed Tomography 624 patients with zygomatic fractures were treated in the period 1987-1996. There were 466 males and 158 females involved. 498 had fractures of the zygomatic bone, 59 just the arch whereas 67 had combined fractures. 584 cases were considered to be candidates for surgical reposition and fixation. 487 patients had dysaesthesia of the infraorbital nerve; in 197 cases this dissolved within 10-14 days postoperatively. In 251 patients (51%) long term follow-up was available. In 191 patients there was no functional nor aesthetic problem. In 61 patients some degree of infraorbital nerve dysaesthesia was present and in 13 patients a cosmetic problem still existed.
Kashima, K., Shiba, R., Sakoda, S., Nagatomo, O. Department of OMS, Miyazaki Medical College, Miyazaki, Japan Purpose The purpose of this study was to evaluate the diagnostic usefulness of three-dimensional computed tomographic (CT) imaging for maxillo-zygomatic fi'actures. Materials and methods Eight patients with maxillo-zygomatic fractures enrolled in this study. Each patient was sepeerately evaluated with 1) conventional roentgenographic images (Dental films, Orthopantomogram, Water's view and Posterio-anterior projec-