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ORIGINAL ARTICLE - COMPARATIVE STUDY
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Two-point versus three-point fixation in the management of zygomaticomaxillary complex fractures: A comparative study


1 Department of Oral and Maxillofacial Surgery, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Nagpur, Maharashtra, India
2 Department of Oral and Maxillofacial Surgery, Rajesh Ramdasji Kambe Dental College, Akola, Maharashtra, India
3 Department of Oral & Maxillofacial Surgery, DY Patil Dental college, Mumbai, India

Correspondence Address:
Mayur Janardan Gawande,
Department of Oral and Maxillofacial Surgery, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Wanadongari Road, Hingna, Nagpur - 440 016, Maharashtra
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ams.ams_75_20

Introduction: The zygoma plays an important role in the facial contour for both cosmetic and functional reasons; therefore, zygomatic bone injuries should be properly diagnosed and adequately treated. Comparison of various surgical approaches and their complications can only be done objectively using outcome measurements that require a protocol for management and long-term follow-up. The objectives of this study were to compare the efficacy of zygomatic bone after treatment with open reduction internal fixation (ORIF) using two-point fixation and ORIF using three-point fixation and compare the outcome of two procedures. Materials and Methods: Twenty patients were randomly divided equally into two groups. In Group A, ten patients were treated by ORIF using two-point fixation by miniplates and in Group B, ten patients were treated by ORIF using three-point fixation by miniplates. They were evaluated with their advantages and disadvantages and the difference between the two groups was observed. Results: We found that postoperative facial and neurological complications are minimum in two-point fixation group. Based on this study, open reduction and internal fixation using two-point fixation by miniplates is sufficient and the best available treatment of choice for the management of zygomaticomaxillary complex fractures. Discussion: Alignment of the fracture at three points and fixation at two stable points provide the most accurate and satisfactory postoperative results. Two-point interosseous fixation at the “buttress” fracture and the frontozygomatic (FZ) fracture is suitable for routine surgery. The results of these studies confirm with the present study that two-point fixation provided better stability in patients with clinical and radiological evidence of fracture in FZ and zygomaticomaxillary buttress area.


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    -  Gawande MJ
    -  Lambade PN
    -  Bande C
    -  Gupta M K
    -  Mahajan M
    -  Dehankar T
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