Retrospective Comparison of One Point Fixation versus Two Point Fixation in the Treatment of Tripod Fractures.
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 3
Abstract
Introduction: Tripod fractures constitute ofzygomatic bone and its four articulations viz; frontal bone, maxillary bone, sphenoid bone and temporal bone. When ever a Tripod fracture happens ,one or more of these articulations are interrupted. Up to 40% of all facial fracturesfall into this category. The prominence of this bone results in high incidence of its fracture. Motor vehicle accident is the most common cause.4 There are various approaches for open reduction of this fracture which include lateral eyebrow incision, sub ciliary, sub tarsal, trans conjunctival and maxillary vestibular incision. Aim: The purpose of this retrospective study was to compare one point fixation with two point fixation for isolated zmc fractures. Materials And Methods: Sixetypatients with isolated tripod fractures which reported to the deptt of dental surgery, KAP Vishwanatham medical college, Trichy from 2016-2018 were included in this retrospective study with 30 patients in each of the two groups . The surgical treatment planned in group 1 patients was one point fixation at zygomaticomaxillary buttress and in group 2 patients wastwo point fixation at frontozygomatic and zygomaticomaxillary buttress region. The inclusion criteria wereisolatedfractures of zygomaticomaxillary complex. The exclusion criteria were severely comminuted fractures, infected fractures and orbital fractures for both group 1 and 2 patients. The surgical procedure in GROUP 1 patients included a maxillary vestibular incision. In GROUP 2patients, lateral eyebrow incision was given along with maxillary vestibular incision Results: All the patients underwent open reduction and internal fixation. Comparing the surgery time, the treatment time in Group I patients was 30 minutes and in Group II patients, 55 minutes showing that one point fixation had shorter operating time and lesser costs involved Conclusion: Two-point fixation is superior in stability over one point fixation. However it had various disadvantages which included, longer operating time, increased cost of the surgery, implant palpability and unaesthetic scars. But the fixation at the ZM buttress was quicker and withoutearlier disadvantages but fixation was inadequate in case of extensively comminuted or displaced fractures. So we conclude that one point fixation at zygomatic buttress is a cost effective, swift and reasonably stable option for isolated ZMC fractures.
Authors and Affiliations
P. Senthil Kumar, M. Gurkirpal singh
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