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| [PMID]: | 28445374 |
| [Au] Autor: | Hindin DI; Muetterties CE; Mehta C; Boukovalas S; Lee JC; Bradley JP |
| [Ad] Endereço: | Philadelphia, Pa.; and Los Angeles, Calif. From the Division of Plastic and Reconstructive Surgery, Temple University; and the Division of Plastic and Reconstructive Surgery, University of California, Los Angeles. |
| [Ti] Título: | Treatment of Isolated Zygomatic Arch Fracture: Improved Outcomes with External Splinting. |
| [So] Source: | Plast Reconstr Surg;139(5):1162e-1171e, 2017 May. | | [Is] ISSN: | 1529-4242 |
| [Cp] País de publicação: | United States |
| [La] Idioma: | eng |
| [Ab] Resumo: | BACKGROUND: The various approaches to reduction and fixation of isolated displaced zygomatic arch fractures have not been well studied. The authors compared established treatment methods for zygomatic arch fractures for both aesthetic and functional outcomes. METHODS: Consecutive patients with isolated zygomatic arch fractures with a minimum of 6 months' follow-up were studied in five groups: group 1, intraoral approach (no fixation); group 2, temporal approach (no fixation); group 3, coronal flap plate fixation; group 4, external splint fixation; and group 5, no surgery. Perioperative complications, facial contour symmetry (aesthetic outcome), improvement in mouth opening (functional outcome), and reoperations were compared. RESULTS: Patients undergoing external splint fixation had no perioperative complications. Coronal flap plate fixation had the highest rate of perioperative complications (46 percent), with facial nerve injury (4 percent), hematoma (8 percent), and persistent hyperesthesia (8 percent). Reoperations (fat grafting or bony reconstruction) were highest with coronal flap plate fixation (23 percent) and the temporal approach (7.7 percent); external splint fixation and the intraoral approach required no reinterventions. Patients treated with external splint fixation had the largest improvement in mean interincisor mouth opening. Mean postoperative interincisor opening in decreasing order was as follows: external splint fixation (51.6 mm), coronal flap plate fixation (47.1 mm), no surgery (39.8 mm), intraoral approach (39.6 mm), and temporal approach (38.9 mm). The highest volumetric symmetry was seen in external splint fixation (97.9 percent), followed by coronal flap plate fixation (94 percent), temporal approach (76.2 percent), intraoral approach (73 percent), and no surgery (68.3 percent). CONCLUSION: For isolated zygomatic arch fracture, patients undergoing external splint fixation had the lowest risk of perioperative complications and the greatest improvement in functional and aesthetic outcomes compared with the intraoral approach (no fixation), the temporal approach (no fixation), coronal flap plate fixation, and no surgery. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II. |
| [Mh] Termos MeSH primário: |
Placas Ósseas
Fixadores Externos
Fixação de Fratura/instrumentação
Contenções
Zigoma/lesões
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| [Mh] Termos MeSH secundário: |
Adulto
Feminino
Pesquisas sobre Serviços de Saúde
Seres Humanos
Masculino
Estudos Prospectivos
Resultado do Tratamento
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| [Pt] Tipo de publicação: | COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL |
| [Em] Mês de entrada: | 1708 |
| [Cu] Atualização por classe: | 170817 |
[Lr] Data última revisão:
| 170817 |
| [Sb] Subgrupo de revista: | AIM; IM |
| [Da] Data de entrada para processamento: | 170427 |
| [St] Status: | MEDLINE |
| [do] DOI: | 10.1097/PRS.0000000000003281 |
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