Experimental research of accurate reduction of zygomatic-orbitomaxillary complex fractures with individual templates

To develop a feasible intraoperative guiding device using computer-aided design and computer-aided manufacturing of individual templates to permit anatomic fracture reduction of zygomatic-orbitomaxillary complex (ZOMC) comminuted fractures. The simplicity and accessibility of this method should allow its widespread clinical application.

Under an institutional review board-approved protocol, diverse ZOMC fracture types were created in 6 cadaver heads with a hammer and a saw, and preoperative multislice spiral computerized tomography scan and 3-dimensional reconstruction were performed. Three individual templates were made by computer-aided design and computer-aided manufacturing, and the fractures were repaired under the guidance of individual templates. A clinical case was carried out with this method. After surgery, the outcome evaluation was completed by superimposing the postoperative computed tomographic model onto the planned model.

Successful planning and repositioning of the 6 cadavers and a clinical patient were achieved using this method. Computer-aided design and computer-aided manufacturing of individual templates were successfully used in all cases at the time of surgery. Postoperative computed tomographic scans confirmed anatomic repair in all cases.

A feasible intraoperative ZOMC fracture monitoring and reduction guidance device has been developed. This technique is a simple, economical, and readily accessible method of comminuted ZOMC fracture reduction that can be learned and used rapidly.