INCIDENCE OF OPEN REDUCTION VERSUS CLOSED REDUCTION IN TREATING ZYGOMATICOMAXILLARY COMPLEX FRACTURES - AN INSTITUTIONAL BASED RETROSPECTIVE STUDY
DOI:
https://doi.org/10.61841/6hgws255Keywords:
Closed reduction, open reduction, zygomaticomaxillary complex fracturesAbstract
Introduction: Zygomaticomaxillary complex fractures (ZMC) are relatively common. They are also known as the tetrapod fractures. They are most commonly followed by the nasal bone fractures because of their prominent location. It complexly involves four bones, namely maxillary, temporal, orbital, and the greater wing of the sphenoid bone. At the same time, it is difficult to obtain perfect reduction and contour the facial structure postoperatively because of its complex involvement.
Aim of the study: The aim of the present study was to analyse the incidence rate of open reduction versus the closed reduction in zygomaticomaxillary complex fractures. Thereby providing better treatment for better outcomes, including esthetics, restorations of anatomical form, occlusion, functions, and neurological defects.
Materials and methods: Retrospective analysis of all the operational cases (open reduction and closed reduction) of zygomaticomaxillary complex fractures between June 2019 and March 2020 was retrieved among the overall data of 860000 patients visiting Saveetha Dental College. The data was entered in the Excel spreadsheets. And the collected data was analysed using SPSS software version 19. A chi-square test was done to evaluate the results.
Results: Among the overall 25 cases reviewed, the male population (91.30%) had a higher prevalence of ZMC fractures. And the mean age group was between 20 and 40 years of age (56.52%). Between open and closed reductions in zygomaticomaxillary fracture treatments, open reduction (56.52%) had a higher prevalence compared to closed reduction (43.48%). In correlation between age, gender, and the treatment (open/closed reduction) in ZMC fractures. (p value > 0.05), which is statistically not significant.
Conclusion: From the present small sampled retrospective study, open reduction with internal fixation in managing zygomaticomaxillary complex fractures has been dominating over closed reduction.
Downloads
References
1. Rao TD, Santhosh Kumar MP. Analgesic Efficacy of Paracetamol vs. Ketorolac after Dental Extractions [Internet]. Vol. 11, Research Journal of Pharmacy and Technology. 2018. p. 3375. Available from: http://dx.doi.org/10.5958/0974-360x.2018.00621.2
2. Schroeder H-G, Albanese S. Fractures of the Zygoma [Internet]. Vol. 7, Facial Plastic Surgery. 1990. p. 167–75. Available from: http://dx.doi.org/10.1055/s-2008-1064679
3. Avery LL, Susarla SM, Novelline RA. Multidetector and Three-Dimensional CT Evaluation of the Patient With Maxillofacial Injury [Internet]. Vol. 49, Radiologic Clinics of North America. 2011. p. 183–203. Available from: http://dx.doi.org/10.1016/j.rcl.2010.07.014
4. Jesudasan JS, Abdul Wahab PU, Muthu Sekhar MR. Effectiveness of 0.2% chlorhexidine gel and a eugenol-based paste on postoperative alveolar osteitis in patients having third molars extracted: a randomised controlled clinical trial [Internet]. Vol. 53, British Journal of Oral and Maxillofacial Surgery. 2015. p. 826–30. Available from: http://dx.doi.org/10.1016/j.bjoms.2015.06.022
5. Kumar S, Rahman R. KNOWLEDGE, AWARENESS, AND PRACTICES REGARDING BIOMEDICAL WASTE MANAGEMENT AMONG UNDERGRADUATE DENTAL STUDENTS [Internet]. Vol. 10, Asian Journal of Pharmaceutical and Clinical Research. 2017. p. 341. Available from: http://dx.doi.org/10.22159/ajpcr.2017.v10i8.19101
6. Mendonca D, Kenkere D. Avoiding occlusal derangement in facial fractures: An evidence-based approach [Internet]. Vol. 46, Indian Journal of Plastic Surgery. 2013. p. 215–20. Available from: http://dx.doi.org/10.4103/0970-0358.118596
7. Kumar S, Sneha S. KNOWLEDGE AND AWARENESS REGARDING ANTIBIOTIC PROPHYLAXIS FOR INFECTIVE ENDOCARDITIS AMONG UNDERGRADUATE DENTAL STUDENTS [Internet]. Asian Journal of Pharmaceutical and Clinical Research. 2016. p. 154. Available from:
http://dx.doi.org/10.22159/ajpcr.2016.v9s2.13405
8. Evans BGA, Evans GRD. MOC-PSSM CME Article: Zygomatic Fractures [Internet]. Vol. 121, Plastic and Reconstructive Surgery. 2008. p. 1–11. Available from: http://dx.doi.org/10.1097/01.prs.0000294655.16607.ea
9. Knight JS, North JF. The classification of malar fractures: An analysis of displacement as a guide to treatment [Internet]. Vol. 13, British Journal of Plastic Surgery. 1960. p. 325–39. Available from: http://dx.doi.org/10.1016/s0007-1226(60)80063-x
10. Ribeiro AL, Ribeiro ALR, da Silva Gillet LC, de Vasconcelos HG, de Castro Rodrigues L, de Jesus Viana Pinheiro J, et al. Facial Fractures: A Large Epidemiologic Survey in Northern Brazil Reveals Some Unique Characteristics [Internet]. Vol. 74, Journal of Oral and Maxillofacial Surgery. 2016. p. 2480.e1–2480.e12. Available from: http://dx.doi.org/10.1016/j.joms.2016.08.015
11. Kumar S. THE EMERGING ROLE OF BOTULINUM TOXIN IN THE TREATMENT OF OROFACIAL DISORDERS: LITERATURE UPDATE [Internet]. Vol. 10, Asian Journal of Pharmaceutical and Clinical Research. 2017. p. 21. Available from: http://dx.doi.org/10.22159/ajpcr.2017.v10i9.16914
12. McBride S, Barry T. Fractures of the zygomatic complex—a comprehensive review over 10 years of surgical management [Internet]. Vol. 53, British Journal of Oral and Maxillofacial Surgery. 2015. p. e72. Available from: http://dx.doi.org/10.1016/j.bjoms.2015.08.105
13. Ellstrom CL, Evans GRD. Evidence-Based Medicine [Internet]. Vol. 132, Plastic and Reconstructive Surgery. 2013. p. 1649–57. Available from: http://dx.doi.org/10.1097/prs.0b013e3182a80819
14. Patturaja K, Pradeep D. Awareness of Basic Dental Procedure among General Population [Internet]. Vol. 9, Research Journal of Pharmacy and Technology. 2016. p. 1349. Available from: http://dx.doi.org/10.5958/0974-360x.2016.00258.4
15. Christabel A, Anantanarayanan P, Subash P, Soh CL, Ramanathan M, Muthu Sekar MR, et al. Comparison of pterygomaxillary dysjunction with tuberosity separation in isolated Le Fort I osteotomies: a prospective, multi-centre, triple-blind, randomized controlled trial [Internet]. Vol. 45, International Journal of Oral and Maxillofacial Surgery. 2016. p. 180–5. Available from: http://dx.doi.org/10.1016/j.ijom.2015.07.021
16. Marimuthu M, Andiappan M, Wahab A, Muthusekhar MR, Balakrishnan A, Shanmugam S. Canonical Wnt pathway gene expression and their clinical correlation in oral squamous cell carcinoma [Internet]. Vol. 29, Indian Journal of Dental Research. 2018. p. 291. Available from: http://dx.doi.org/10.4103/ijdr.ijdr_375_17
17. Matsunaga RS, Simpson W, Toffel PH. Simplified Protocol for Treatment of Malar Fractures [Internet]. Vol. 103, Archives of Otolaryngology. 1977. p. 535. Available from:http://dx.doi.org/10.1001/archotol.1977.00780260065007
18. Stoll P, Schilli W. Primary reconstruction with AO-miniplates after severe cranio-maxillofacial trauma [Internet]. Vol. 16, Journal of Cranio-Maxillofacial Surgery. 1988. p. 18–21. Available from: http://dx.doi.org/10.1016/s1010-5182(88)80008-8
19. Patil SB, Durairaj D, Suresh Kumar G, Karthikeyan D, Pradeep D. Comparison of Extended Nasolabial Flap Versus Buccal Fat Pad Graft in the Surgical Management of Oral Submucous Fibrosis: A Prospective Pilot Study [Internet]. Vol. 16, Journal of Maxillofacial and Oral Surgery. 2017. p. 312–21. Available from: http://dx.doi.org/10.1007/s12663-016-0975-6
20. Stassen LFA, Moos KF, El-Attar A. A comparison of the use of external pin and transnasal Kirschner wire fixation for the unstable tripod malar fracture: A prospective trial [Internet]. Vol. 27, British Journal of Oral and Maxillofacial Surgery. 1989. p. 99–106. Available from: http://dx.doi.org/10.1016/0266-4356(89)90056-9
21. Verma R, Parmar J, Carter L. Surgical Management of Zygomaticomaxillary Complex Fractures as DayCase Procedures [Internet]. Vol. 56, British Journal of Oral and Maxillofacial Surgery. 2018. p. e69. Available from: http://dx.doi.org/10.1016/j.bjoms.2018.10.197
22. Kaastad E, Freng A. Zygomatico-maxillary fractures [Internet]. Vol. 17, Journal of Cranio-Maxillofacial Surgery. 1989. p. 210–4. Available from: http://dx.doi.org/10.1016/s1010-5182(89)80070-8
23. Abhinav R, Selvarasu K, Maheswari G, Taltia A. The patterns and etiology of maxillofacial trauma in South India [Internet]. Vol. 9, Annals of Maxillofacial Surgery. 2019. p. 114. Available from: http://dx.doi.org/10.4103/ams.ams_233_18
24. Manson PN, Crawley WA, Yaremchuk MJ, Rochman GM, Hoopes JE, French JH, et al. Midface Fractures [Internet]. Vol. 76, Plastic and Reconstructive Surgery. 1985. p. 11–2. Available from: http://dx.doi.org/10.1097/00006534-198507000-00002
25. Hwang K. One-point fixation of tripod fractures of zygoma through a lateral brow incision. J Craniofac Surg. 2010 Jul;21(4):1042–4.
26. Forouzanfar T, Salentijn E, Peng G, van den Bergh B. A 10-year analysis of the “Amsterdam” protocol in the treatment of zygomatic complex fractures [Internet]. Vol. 41, Journal of Cranio-Maxillofacial Surgery. 2013. p. 616–22. Available from: http://dx.doi.org/10.1016/j.jcms.2012.12.004
27. Kumar S. KNOWLEDGE, ATTITUDE AND AWARENESS OF DENTAL UNDERGRADUATE STUDENTS REGARDING HIV/AIDS PATIENTS [Internet]. Vol. 10, Asian Journal of Pharmaceutical and Clinical Research. 2017. p. 175. Available from: http://dx.doi.org/10.22159/ajpcr.2017.v10i5.17277
28. Packiri S, Gurunathan D, Selvarasu K. Management of Paediatric Oral Ranula: A Systematic Review. J Clin Diagn Res. 2017 Sep;11(9):ZE06–9.
29. Ellis E, Perez D. An Algorithm for the Treatment of Isolated Zygomatico-Orbital Fractures [Internet]. Vol. 72, Journal of Oral and Maxillofacial Surgery. 2014. p. 1975–83. Available from: http://dx.doi.org/10.1016/j.joms.2014.04.01
30. Kumar S. RELATIONSHIP BETWEEN DENTAL ANXIETY AND PAIN EXPERIENCE DURING DENTAL EXTRACTIONS [Internet]. Vol. 10, Asian Journal of Pharmaceutical and Clinical Research. 2017. p. 458. Available from: http://dx.doi.org/10.22159/ajpcr.2017.v10i3.16518
31. Jain SV, Vijayakumar Jain S, Muthu Sekar MR, Baig MF, Senthilnathan P, Loganathan S, et al. Evaluation of Three-Dimensional Changes in Pharyngeal Airway Following Isolated Lefort One Osteotomy for the Correction of Vertical Maxillary Excess: A Prospective Study [Internet]. Vol. 18, Journal of Maxillofacial and Oral Surgery. 2019. p. 139–46. Available from: http://dx.doi.org/10.1007/s12663-018-1113-4
32. Abhinav RP, Sweta VR, Ramesh A. Role of virtual reality in pain perception of patients following the administration of local anesthesia [Internet]. Vol. 9, Annals of Maxillofacial Surgery. 2019. p. 110. Available from: http://dx.doi.org/10.4103/ams.ams_263_18
33. Jayashree KA, Senthilnathan KP, Santhosh Kumar MP. Association between impacted mandibular third molars and distal caries in second molars—A radiographic study [Internet]. Vol. 11, Research Journal of Pharmacy and Technology. 2018. p. 2309. Available from: http://dx.doi.org/10.5958/0974-360x.2018.00428.6
34. Perry M, Brown A, Banks P. Fractures of the Facial Skeleton. John Wiley & Sons; 2015. 176 p.
35. Manganello-Souza LC, de Freitas RR. Transconjunctival approach to zygomatic and orbital floor fractures [Internet]. Vol. 26, International Journal of Oral and Maxillofacial Surgery. 1997. p. 31–4. Available from: http://dx.doi.org/10.1016/s0901-5027(97)80843-0
36. Farhat Yaasmeen Sadique Basha, Rajeshkumar S., Lakshmi T., Anti-inflammatory activity of Myristica fragrans extract. Int. J. Res. Pharm. Sci., 2019 ;10(4), 3118-3120 DOI: https://doi.org/10.26452/ijrps.v10i4.1607
Downloads
Published
Issue
Section
License
Copyright (c) 2020 AUTHOR

This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation .
No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.