Single Transconjunctival Incision and Two-point Fixation for the Treatment of Noncomminuted Zygomatic Complex Fracture
Identifieur interne : 004084 ( Pmc/Curation ); précédent : 004083; suivant : 004085Single Transconjunctival Incision and Two-point Fixation for the Treatment of Noncomminuted Zygomatic Complex Fracture
Auteurs : Paik-Kwon Lee [Corée du Sud] ; Jung-Ho Lee [Corée du Sud] ; Yoon-Seok Choi [Corée du Sud] ; Deuk-Young Oh [Corée du Sud] ; Jong-Won Rhie [Corée du Sud] ; Ki-Taik Han [Corée du Sud] ; Sang-Tae Ahn [Corée du Sud]Source :
- Journal of Korean Medical Science [ 1011-8934 ] ; 2006.
Abstract
The ultimate goal in treating zygomatic complex fracture is to obtain an accurate, stable reduction while minimizing external scars and functional deformity. The present authors present our experiences with a single transconjunctival incision and two-point (inferior orbital rim and frontozygomatic suture) fixation in 53 patients with zygomatic complex fracture which were not comminuted. All patients had transconjunctival approaches with lateral canthal extensions, and six out of 53 patients also had an additional small (about less than 2 cm) gingivobuccal incision to achieve an accurate reduction. There were 3 minor complications, and the overall esthetics and functional results were satisfactory with a long term follow-up. Our method has the following advantages in the reduction of zygomatic complex fracture; It leaves only an inconspicuous lateral canthal scar. In addition, it provides excellent simultaneous visualization of the inferior orbital rim and frontozygomatic suture area. Hence, two-point fixation through a single incision can be performed with a satisfactory stability.
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DOI: 10.3346/jkms.2006.21.6.1080
PubMed: 17179691
PubMed Central: 2721933
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Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Lee, Jung Ho" sort="Lee, Jung Ho" uniqKey="Lee J" first="Jung-Ho" last="Lee">Jung-Ho Lee</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Plastic Surgery, The Catholic University of Korea College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Plastic Surgery, The Catholic University of Korea College of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Choi, Yoon Seok" sort="Choi, Yoon Seok" uniqKey="Choi Y" first="Yoon-Seok" last="Choi">Yoon-Seok Choi</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Plastic Surgery, The Catholic University of Korea College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Plastic Surgery, The Catholic University of Korea College of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Oh, Deuk Young" sort="Oh, Deuk Young" uniqKey="Oh D" first="Deuk-Young" last="Oh">Deuk-Young Oh</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Plastic Surgery, The Catholic University of Korea College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Plastic Surgery, The Catholic University of Korea College of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Rhie, Jong Won" sort="Rhie, Jong Won" uniqKey="Rhie J" first="Jong-Won" last="Rhie">Jong-Won Rhie</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Plastic Surgery, The Catholic University of Korea College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Plastic Surgery, The Catholic University of Korea College of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Han, Ki Taik" sort="Han, Ki Taik" uniqKey="Han K" first="Ki-Taik" last="Han">Ki-Taik Han</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Plastic Surgery, The Catholic University of Korea College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Plastic Surgery, The Catholic University of Korea College of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Ahn, Sang Tae" sort="Ahn, Sang Tae" uniqKey="Ahn S" first="Sang-Tae" last="Ahn">Sang-Tae Ahn</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Plastic Surgery, The Catholic University of Korea College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Plastic Surgery, The Catholic University of Korea College of Medicine, Seoul</wicri:regionArea></affiliation></author></analytic><series><title level="j">Journal of Korean Medical Science</title><idno type="ISSN">1011-8934</idno><idno type="eISSN">1598-6357</idno><imprint><date when="2006">2006</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>The ultimate goal in treating zygomatic complex fracture is to obtain an accurate, stable reduction while minimizing external scars and functional deformity. The present authors present our experiences with a single transconjunctival incision and two-point (inferior orbital rim and frontozygomatic suture) fixation in 53 patients with zygomatic complex fracture which were not comminuted. All patients had transconjunctival approaches with lateral canthal extensions, and six out of 53 patients also had an additional small (about less than 2 cm) gingivobuccal incision to achieve an accurate reduction. There were 3 minor complications, and the overall esthetics and functional results were satisfactory with a long term follow-up. Our method has the following advantages in the reduction of zygomatic complex fracture; It leaves only an inconspicuous lateral canthal scar. In addition, it provides excellent simultaneous visualization of the inferior orbital rim and frontozygomatic suture area. Hence, two-point fixation through a single incision can be performed with a satisfactory stability.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Nunery, Wr" uniqKey="Nunery W">WR Nunery</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tenzel, Rr" uniqKey="Tenzel R">RR Tenzel</name></author><author><name sortKey="Miller, Gr" uniqKey="Miller G">GR Miller</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tessier, P" uniqKey="Tessier P">P Tessier</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Converse, Jm" uniqKey="Converse J">JM Converse</name></author><author><name sortKey="Firman, F" uniqKey="Firman F">F Firman</name></author><author><name sortKey="Wood Smith, D" uniqKey="Wood Smith D">D Wood-Smith</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lynch, Dj" uniqKey="Lynch D">DJ Lynch</name></author><author><name sortKey="Lamp, Jc" uniqKey="Lamp J">JC Lamp</name></author><author><name sortKey="Royster, Hp" uniqKey="Royster H">HP Royster</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mccord, Cd" uniqKey="Mccord C">CD McCord</name></author><author><name sortKey="Moses, Jl" uniqKey="Moses J">JL Moses</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Waite, Pd" uniqKey="Waite P">PD Waite</name></author><author><name sortKey="Carr, Dd" uniqKey="Carr D">DD Carr</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Shaw, Gy" uniqKey="Shaw G">GY Shaw</name></author><author><name sortKey="Khan, J" uniqKey="Khan J">J Khan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Manson, Pn" uniqKey="Manson P">PN Manson</name></author><author><name sortKey="Ruas, E" uniqKey="Ruas E">E Ruas</name></author><author><name sortKey="Iliff, N" uniqKey="Iliff N">N Iliff</name></author><author><name sortKey="Yaremchuk, M" uniqKey="Yaremchuk M">M Yaremchuk</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Strong, Eb" uniqKey="Strong E">EB Strong</name></author><author><name sortKey="Sykes, Jm" uniqKey="Sykes J">JM Sykes</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Appling, Wd" uniqKey="Appling W">WD Appling</name></author><author><name sortKey="Patrinely, Jr" uniqKey="Patrinely J">JR Patrinely</name></author><author><name sortKey="Salzer, Ta" uniqKey="Salzer T">TA Salzer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Suga, H" uniqKey="Suga H">H Suga</name></author><author><name sortKey="Sugawara, Y" uniqKey="Sugawara Y">Y Sugawara</name></author><author><name sortKey="Uda, H" uniqKey="Uda H">H Uda</name></author><author><name sortKey="Kobayashi, N" uniqKey="Kobayashi N">N Kobayashi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Manganello Souza, Lc" uniqKey="Manganello Souza L">LC Manganello-Souza</name></author><author><name sortKey="De Freitas, Rr" uniqKey="De Freitas R">RR de Freitas</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Knize, Dm" uniqKey="Knize D">DM Knize</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rinehart, Gc" uniqKey="Rinehart G">GC Rinehart</name></author><author><name sortKey="Marsh, Jl" uniqKey="Marsh J">JL Marsh</name></author><author><name sortKey="Hemmer, Km" uniqKey="Hemmer K">KM Hemmer</name></author><author><name sortKey="Bresina, S" uniqKey="Bresina S">S Bresina</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Davidson, J" uniqKey="Davidson J">J Davidson</name></author><author><name sortKey="Nickerson, D" uniqKey="Nickerson D">D Nickerson</name></author><author><name sortKey="Nickerson, B" uniqKey="Nickerson B">B Nickerson</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Korean Med Sci</journal-id><journal-id journal-id-type="publisher-id">JKMS</journal-id><journal-title-group><journal-title>Journal of Korean Medical Science</journal-title></journal-title-group><issn pub-type="ppub">1011-8934</issn><issn pub-type="epub">1598-6357</issn><publisher><publisher-name>The Korean Academy of Medical Sciences</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">17179691</article-id><article-id pub-id-type="pmc">2721933</article-id><article-id pub-id-type="doi">10.3346/jkms.2006.21.6.1080</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject></subj-group></article-categories><title-group><article-title>Single Transconjunctival Incision and Two-point Fixation for the Treatment of Noncomminuted Zygomatic Complex Fracture</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Lee</surname><given-names>Paik-Kwon</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib><contrib contrib-type="author"><name><surname>Lee</surname><given-names>Jung-Ho</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib><contrib contrib-type="author"><name><surname>Choi</surname><given-names>Yoon-Seok</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib><contrib contrib-type="author"><name><surname>Oh</surname><given-names>Deuk-Young</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib><contrib contrib-type="author"><name><surname>Rhie</surname><given-names>Jong-Won</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib><contrib contrib-type="author"><name><surname>Han</surname><given-names>Ki-Taik</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib><contrib contrib-type="author"><name><surname>Ahn</surname><given-names>Sang-Tae</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib></contrib-group><aff id="A1">Department of Plastic Surgery, The Catholic University of Korea College of Medicine, Seoul, Korea.</aff><author-notes><corresp>Address for correspondence: Paik-Kwon Lee, M.D. Department of Plastic Surgery, Kang-Nam St. Mary's Hospital, The Catholic University of Korea College of Medicine, 505 Banpo-dong, Seocho-gu, Seoul 137-040, Korea. Tel: +82.2-590-2769, Fax: +82.2-594-7230, <email>pklee@catholic.ac.kr</email></corresp></author-notes><pub-date pub-type="ppub"><month>12</month><year>2006</year></pub-date><pub-date pub-type="epub"><day>31</day><month>12</month><year>2006</year></pub-date><volume>21</volume><issue>6</issue><fpage>1080</fpage><lpage>1085</lpage><history><date date-type="received"><day>08</day><month>2</month><year>2006</year></date><date date-type="accepted"><day>07</day><month>4</month><year>2006</year></date></history><permissions><copyright-statement>Copyright © 2006 The Korean Academy of Medical Sciences</copyright-statement><copyright-year>2006</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/3.0"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0">http://creativecommons.org/licenses/by-nc/3.0</ext-link>) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><p>The ultimate goal in treating zygomatic complex fracture is to obtain an accurate, stable reduction while minimizing external scars and functional deformity. The present authors present our experiences with a single transconjunctival incision and two-point (inferior orbital rim and frontozygomatic suture) fixation in 53 patients with zygomatic complex fracture which were not comminuted. All patients had transconjunctival approaches with lateral canthal extensions, and six out of 53 patients also had an additional small (about less than 2 cm) gingivobuccal incision to achieve an accurate reduction. There were 3 minor complications, and the overall esthetics and functional results were satisfactory with a long term follow-up. Our method has the following advantages in the reduction of zygomatic complex fracture; It leaves only an inconspicuous lateral canthal scar. In addition, it provides excellent simultaneous visualization of the inferior orbital rim and frontozygomatic suture area. Hence, two-point fixation through a single incision can be performed with a satisfactory stability.</p></abstract><kwd-group><kwd>Surgical Procedures, Operative</kwd><kwd>Single Transconjunctival Incision</kwd><kwd>Zygomatic Fractures</kwd></kwd-group></article-meta></front><floats-group><fig id="F1" position="float"><label>Fig. 1</label><caption><p>After lateral canthal incision is made down to the periosteum of lateral orbital rim, the conjunctiva is incised 2, 3 mm below the tarsus from a point just lateral to the punctum to the lateral canthal incision site.</p></caption><graphic xlink:href="jkms-21-1080-g001"></graphic></fig><fig id="F2" position="float"><label>Fig. 2</label><caption><p>By pulling the lower eyelid flap down and pulling the upper eyelid flap up, the entire lateral and inferior orbital rim can be exposed.</p></caption><graphic xlink:href="jkms-21-1080-g002"></graphic></fig><fig id="F3" position="float"><label>Fig. 3</label><caption><p>Through a single transconjunctival incision, two-point fixation (inferior orbital rim and frontozygomatic suture) with four hole resorbable 2.0 mm miniplates systems (arrows) can be performed without difficulty.</p></caption><graphic xlink:href="jkms-21-1080-g003"></graphic></fig><fig id="F4" position="float"><label>Fig. 4</label><caption><p>(<bold>A</bold>) Preoperative zygomatic arch view (submentovertical view) shows fracture and displacement of the left zygoma bone. (<bold>B</bold>) Postoperative zygomatic arch view.</p></caption><graphic xlink:href="jkms-21-1080-g004"></graphic></fig><fig id="F5" position="float"><label>Fig. 5</label><caption><p>(<bold>A</bold>) Preoperative skull Waters view, (<bold>B</bold>) Postoperative skull Waters view, (<bold>C</bold>) Preoperative zygomatic arch view, (<bold>D</bold>) Postoperative zygomatic arch view.</p></caption><graphic xlink:href="jkms-21-1080-g005"></graphic></fig><fig id="F6" position="float"><label>Fig. 6</label><caption><p>Follow up at 2 yr after the operation. There is hardly visible scarring at the lateral canthal area (arrow).</p></caption><graphic xlink:href="jkms-21-1080-g006"></graphic></fig><table-wrap id="T1" position="float"><label>Table 1</label><caption><p>Patient data</p></caption><graphic xlink:href="jkms-21-1080-i001"></graphic><table-wrap-foot><fn><p>ZC, zygomatic complex; TCL, transconjunctival approach with lateral canthal extension; GBI, small gingivobuccal incision.</p></fn></table-wrap-foot></table-wrap></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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