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Single transconjunctival incision and two-point fixation for the treatment of noncomminuted zygomatic complex fracture.

Lee PK, Lee JH, Choi YS, Oh DY, Rhie JW, Han KT, Ahn ST - J. Korean Med. Sci. (2006)

Bottom Line: All patients had transconjunctival approaches with lateral canthal extensions, and six out of 53 patients also had an additional small (about less than 2 cm) gingivobuccal incision to achieve an accurate reduction.There were 3 minor complications, and the overall esthetics and functional results were satisfactory with a long term follow-up.In addition, it provides excellent simultaneous visualization of the inferior orbital rim and frontozygomatic suture area.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic Surgery, The Catholic University of Korea College of Medicine, Seocho-Gu, Seoul, Korea. pklee@catholic.ac.kr

ABSTRACT
The ultimate goal in treating zygomatic complex fracture is to obtain an accurate, stable reduction while minimizing external scars and functional deformity. The present authors present our experiences with a single transconjunctival incision and two-point (inferior orbital rim and frontozygomatic suture) fixation in 53 patients with zygomatic complex fracture which were not comminuted. All patients had transconjunctival approaches with lateral canthal extensions, and six out of 53 patients also had an additional small (about less than 2 cm) gingivobuccal incision to achieve an accurate reduction. There were 3 minor complications, and the overall esthetics and functional results were satisfactory with a long term follow-up. Our method has the following advantages in the reduction of zygomatic complex fracture; It leaves only an inconspicuous lateral canthal scar. In addition, it provides excellent simultaneous visualization of the inferior orbital rim and frontozygomatic suture area. Hence, two point fixation through a single incision can be performed with a satisfactory stability.

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Related in: MedlinePlus

After lateral canthal incision is made down to the periosteum of lateral orbital rim, the conjunctiva is incised 2, 3 mm below the tarsus from a point just lateral to the punctum to the lateral canthal incision site.
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Figure 1: After lateral canthal incision is made down to the periosteum of lateral orbital rim, the conjunctiva is incised 2, 3 mm below the tarsus from a point just lateral to the punctum to the lateral canthal incision site.

Mentions: Under general endotracheal anesthesia, a lateral canthal incision, about 1.0-2.0 cm, is made down to the periosteum of lateral orbital rim. Then, the conjunctiva is incised 2-3 mm below the tarsus extending from the commissure to a point just lateral to the punctum, and the transconjunctival incision is connected to the lateral canthal incision (Fig. 1). In the lateral canthal area, the lower eyelid flap is pulled down by cutting the superficial lateral canthal tendon and inferior limb of deep lateral canthal tendon with fine scissors. Dissection proceeds anteriorly and inferiorly between the orbicularis oculi muscle and orbital septum until the periosteum of the inferior orbital rim is exposed.


Single transconjunctival incision and two-point fixation for the treatment of noncomminuted zygomatic complex fracture.

Lee PK, Lee JH, Choi YS, Oh DY, Rhie JW, Han KT, Ahn ST - J. Korean Med. Sci. (2006)

After lateral canthal incision is made down to the periosteum of lateral orbital rim, the conjunctiva is incised 2, 3 mm below the tarsus from a point just lateral to the punctum to the lateral canthal incision site.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2721933&req=5

Figure 1: After lateral canthal incision is made down to the periosteum of lateral orbital rim, the conjunctiva is incised 2, 3 mm below the tarsus from a point just lateral to the punctum to the lateral canthal incision site.
Mentions: Under general endotracheal anesthesia, a lateral canthal incision, about 1.0-2.0 cm, is made down to the periosteum of lateral orbital rim. Then, the conjunctiva is incised 2-3 mm below the tarsus extending from the commissure to a point just lateral to the punctum, and the transconjunctival incision is connected to the lateral canthal incision (Fig. 1). In the lateral canthal area, the lower eyelid flap is pulled down by cutting the superficial lateral canthal tendon and inferior limb of deep lateral canthal tendon with fine scissors. Dissection proceeds anteriorly and inferiorly between the orbicularis oculi muscle and orbital septum until the periosteum of the inferior orbital rim is exposed.

Bottom Line: All patients had transconjunctival approaches with lateral canthal extensions, and six out of 53 patients also had an additional small (about less than 2 cm) gingivobuccal incision to achieve an accurate reduction.There were 3 minor complications, and the overall esthetics and functional results were satisfactory with a long term follow-up.In addition, it provides excellent simultaneous visualization of the inferior orbital rim and frontozygomatic suture area.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic Surgery, The Catholic University of Korea College of Medicine, Seocho-Gu, Seoul, Korea. pklee@catholic.ac.kr

ABSTRACT
The ultimate goal in treating zygomatic complex fracture is to obtain an accurate, stable reduction while minimizing external scars and functional deformity. The present authors present our experiences with a single transconjunctival incision and two-point (inferior orbital rim and frontozygomatic suture) fixation in 53 patients with zygomatic complex fracture which were not comminuted. All patients had transconjunctival approaches with lateral canthal extensions, and six out of 53 patients also had an additional small (about less than 2 cm) gingivobuccal incision to achieve an accurate reduction. There were 3 minor complications, and the overall esthetics and functional results were satisfactory with a long term follow-up. Our method has the following advantages in the reduction of zygomatic complex fracture; It leaves only an inconspicuous lateral canthal scar. In addition, it provides excellent simultaneous visualization of the inferior orbital rim and frontozygomatic suture area. Hence, two point fixation through a single incision can be performed with a satisfactory stability.

Show MeSH
Related in: MedlinePlus