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Three-dimensional analysis of zygomatic-maxillary complex fracture patterns.

Candace Y Pau¹, Jose E Barrera, Jaehwan Kwon

¹Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California.

Craniomaxillofacial Trauma & Reconstruction

|November 24, 2011

Summary

This study introduces a new 3D CT analysis for zygomaticomaxillary complex (ZMC) fractures. Greater malar eminence displacement indicates a higher likelihood of requiring surgical repair, aiding treatment decisions.

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Area of Science:

Oral and Maxillofacial Surgery
Radiology
Trauma Surgery

Background:

Zygomaticomaxillary complex (ZMC) fractures are common injuries resulting from facial trauma.
Accurate assessment of fracture patterns is crucial for effective treatment planning.

Purpose of the Study:

To introduce and validate a novel method for analyzing ZMC fracture patterns using 3D CT visualization.
To correlate ZMC fracture characteristics with treatment outcomes, specifically the need for open reduction and internal fixation (ORIF).

Main Methods:

A retrospective analysis of facial CT scans from 29 patients with unilateral ZMC fractures and 30 controls.
Three-dimensional measurement of malar eminence (ME) displacement in x, y, z dimensions and Euclidean distance compared to the unfractured side.

Keywords:

Malar fracture orbitozygomatic

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Accounting for baseline asymmetry by analyzing non-fractured subjects.

Main Results:

Significantly greater cumulative ME displacements were observed in patients requiring ORIF for ZMC fractures (p=0.02).
Higher fracture scores (indicating more severe displacement) correlated with increased rates of ORIF (p=0.05).
Severe displacement, particularly in the x-dimension, showed the strongest correlation with surgical intervention (p=0.02).

Conclusions:

Fracture severity, quantified by the novel 3D analysis, is associated with higher rates of ORIF in unilateral ZMC fractures.
This method provides valuable information for determining appropriate treatment strategies for ZMC fractures.