Zygomatic Arch Reconstruction With Miniplate of 2.0 System in Complex Fracture

    loading  Checking for direct PDF access through Ovid


To the Editor: The orbital zygomatic complex fractures may result in the zygomatic arch fracture. These arch fractures when simple, are resolvable through less invasive access (Gilles access or maxillary vestibule fund) and reduction of fracture without internal fixation. In complex patients, access of Al-Kayat and Bramley, and Rowe are necessary for a better view and reduction of fracture with internal fixation. When there is a fracture in both proximal and distal stump, it is necessary to fix this segment. If there is no possibility of fixing this bone, an alternative must be sought.1,2 Thus, through this, the present patient shows a resolution to this problem.
A 38-year-old male patient, attended by the Maxillofacial Surgery and Traumatology service of Hospital de Base of Bauru, reporting being a victim of physical aggression studying clinically with loss of transversal projection at the zygomatic bone region and mouth opening limitation. Radiographic examination revealed fracture lines in frontozygomatic suture region, in the body of the zygomatic bone, and a complex fracture of zygomatic arch with bone displacement. Initial planning for the treatment of fractures was the reduction and fixation with miniplates and screws of 1.5 system. After Al-Kayat and Bramley access was possible to note that it would be not possible to use the fragment displaced because their comminution. Then the infraorbital and supraciliary accesses were made, and the fractures were reduced. At this time the initial planning has changed, opting for the use of miniplates and screws of 2.0 system to reduce the fractures of zygomatic bone and frontozygomatic suture, as well the reconstruction of the zygomatic arch thus replacing its function through the miniplates and screws of this system. The sutures by planes were made, as well the longitudinal monitoring of the patient, which in the immediate postoperative period had returned the transversal projection of the body and zygomatic arch, and follow-up 3 months after surgery, no mouth opening limitation was noticed (Fig. 1A-D). Therefore, it is possible to notice that in cases with loss of substance or infeasibility of using zygomatic arch fragments on fracture reduction, the use of the miniplates of 2.0 system connecting the anterior portion of the arch to the rear is feasible for the arc projection devolution on the face and mouth opening.
    loading  Loading Related Articles