الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 148 |  |  |
| | | from | 148 | | |
Abstract
The zygomaticomaxillary complex (ZMC) is a major buttress of the midfacial skeleton. It is essential to structural, functional, and aesthetic aspects of the facial skeleton. The etiology of ZMC fractures primarily includes road traffic accidents, violent assaults, falls and sports injuries. The main clinical features of ZMC fractures are diplopia, enophthalmos, subconjunctival ecchymosis, extraocular muscle entrapment, cosmetic deformity with depression of the malar eminence, facial widening, malocclusion and neurosensory disturbances of the infraorbital nerve. Diagnosis of ZMC fractures is usually clinical, with confirmation by computed tomography (CT) scan. A ZMC fracture is also known as a tripod, tetrapod, quadripod, trimalar or malar fracture and is classified according to Knight and North based on the direction of anatomic displacement and the pattern created by the fracture. The standard treatment for zygomaticomaxillary complex (ZMC) fracture is open reduction and internal fixation (ORIF), and sites of one-, two-, or three-point fixation are selected based on stability of the fracture. In ZMC fractures many incisions (transconjunctival, subciliary, superior gingivobuccal) can be used. The aim of this work is to compare single versus multiple point fixation of zygomaticomaxillary complex fracture. This prospective study that included 28 patients who were classified into two groups: • group 1 (n=14): included the patients who underwent single point fixation (one point is fixated with plate and screws at infraorbital rim or zygomatico-maxillary buttress). • group 2(n=14): included the patients who underwent two or three-point fixation (fixation at two points with plates and screws at zygomatico-maxillary buttress and infraorbital rim or at three-points at zygomatico-maxillary buttress, infraorbital rim and Zygomatico-frontal buttress). The fracture sites were approached via subcilliary, transconjunctival, and superior gingivobuccal incisions. Summary of our results: • There was no statistically significant difference between the studied groups as regard baseline data. • There was no statistically significant difference between the studied groups as regard examinations. • There was no statistically significant difference between the studied groups as regard operation data. • There was statistically significant difference between the studied groups as regard patients VAS score. VAS score was significantly higher in group 2 compared to group 1. Our results revealed that, satisfaction assessed by VAS was significantly higher in group 1 compared to group 2 with a mean (±SD) (2.1 ± 1.09 versus 5 ± 1.47). • There was statistically significant difference between the studied groups as regard VAS score assessed by independent surgeon. VAS score was significantly higher in group 2 compared to group 1. Our results revealed that, visibility was significantly higher in group 2 compared to group 1with a mean (±SD) (4 ± 1.07 versus 1.5 ± 1.07). • There was no statistically significant difference between the studied groups as regard radiological alignment . • There was no statistically significant difference between the studied groups as regard clinical assessment of enophthalmous correction. • There was no statistically significant difference between both groups as regard degree of changes in orbital volume postoperatively.