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KMID : 0358819870140040521
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Journal of Korean Society of Plastic and Reconstructive Surgeons
1987 Volume.14 No. 4 p.521 ~ p.534
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A GEOMETRIC, RADIOLOGIC, AND SURGCAL ANALYSIS OF THE ZYGOMATIC FRACTURES
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Lee Jong-Won
Ahn Hee-Chang
Hong Sang-Pyo
Choi Eung-Ok
Lee Jong-Hyun
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Abstract
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The zygoma is prominent bilaterally on the face so that a slight asymmetry can be easily noticealbe. It has been reported that 21 to 31% of "well- reduced fractures" leave a residual flattening of the upper cheek.
If the fractured zygoma is reduced by the Dingman’s approach that is the fixation of two points of the zygomaticofrontal suture and the inferior orbital rim, the downward, backward, and media rotation of the malar eminence may occur due to strong contraction of masseteric contraction despite two-point fixation.
Therefore we present the analysis of this mechanism by the geometric, radiologic, and surgical study. This study suggests that four-point accurate alignments and at least three-plint stable fixations are essential for preventing the fragment from rotating after the reduction. We identify the zygomaticofrontal suture and the zygomatic, arch through the hemicoronal incision, the orbital rim through the subcilliary incision and the zygomaticomaxillary buttress through gingivobuccal incision and align accurately and fix stably them.
Even though the reduction like this methods spends much more operating time than the clssic approach, the patients don’t need the extraskeletal suspension for the purpose of keeping the symmetry of malar. body, and may eat the solid food immediately and feel the better comforts. Besides these, the whole hospitalization is decreased and the postoperative results are more satisfactory than before.
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KEYWORD
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