Cisternas CS, Mendoza TJP, Hernández FP

Language: Spanish
References: 11
Page: 92-97
PDF size: 1868.01 Kb.

ABSTRACT

Introduction: orbitozygomatic-maxillary (OZM) fractures represent a common pattern of facial trauma. When left untreated, they may consolidate in an inadequate position, compromising both function and facial aesthetics. Objective: to present a case of consolidated OZM fracture managed with corrective osteotomy and osteosynthesis, highlighting the surgical strategy and outcomes. Case presentation: a 57-year-old male patient was referred to the maxillofacial service for the management of an OZM fracture sustained 43 days prior, presenting with facial aesthetic sequelae and limitation of ocular dynamics. After preoperative clinical evaluation, the case was diagnosed as a consolidated fracture. Surgical treatment consisted of a controlled refracture of the displaced bone segments, followed by reduction and stabilization at two key anatomical points. Results: six-month postoperative evaluation demonstrated restoration of facial symmetry, improvement in malar projection, and expansion of the patient's visual field, consistent with outcomes reported in the literature. Conclusions: corrective osteotomy with OTS plates (pOTS) may be considered an effective alternative in the secondary reconstruction of consolidated orbitozygomatic-maxillary fractures. Multicenter studies and long-term follow-up are required to validate this approach.

REFERENCES

1. Castillo CMG, Flores VJL, González OA, Cervantes GG, Cervantes CGA, Ramírez SMV et al. Fracturas faciales, manejo quirúrgico y resultados en un hospital de tercer nivel. Rev Esp Cir Oral Maxilofac. 2021; 43 (3): 96-100.

2. Lu W, Zhou H, Xiao C, Shen Q, Lin M, Fan X. Late correction of orbital-zygomatic-maxillary fractures combined with orbital wall fractures. J Craniofac Surg. 2012; 23 (6): 1672-1676.

3. Morales ND, Grau LIB. Fracturas del complejo cigomático. Rev Cubana Estomatol. 2019; 56 (1).

4. Cruz AAV, Eichenberger GCD. Epidemiology and management of orbital fractures: Curr Opin Ophthalmol. 2004; 15 (5): 416-421.

5. Peretti N, MacLeod S. Zygomaticomaxillary complex fractures: diagnosis and treatment. Curr Opin Otolaryngol Head Neck Surg. 2017; 25 (4): 314-319.

6. Ellis E 3rd, Reddy L. Status of the internal orbit after reduction of zygomaticomaxillary complex fractures. J Oral Maxillofac Surg. 2004; 62 (3): 275-283.

7. Vahidi N, Kwak P, Sismanis D, Schuman T, Hawkins D, Lee TS. Management of complications and secondary deformity after fractures of the midface, orbit, and upper third of the maxillofacial skeleton. Otolaryngol Clin North Am. 2023; 56 (6): 1151-1167.

8. Marcelo MM, Fernández TMA, Bravo AR, Pedemonte TC, Ulloa MC. Traumatología máxilo facial: diagnóstico y tratamiento. Rev Med Clin Condes. 2011; 22 (5): 607-616.

9. Raghoebar II, Rozema FR, de Lange J, Dubois L. Surgical treatment of fractures of the zygomaticomaxillary complex: effect of fixation on repositioning and stability. A systematic review. Br J Oral Maxillofac Surg. 2022; 60 (4): 397-411.

10. Trindade PAK, Vieira EH, Gabrielli MAC, Gabrielli MFR, Pereira-Filho VAT. Int J Odontostomatol. 2012; 6 (3): 255-262.

11. Schneider M, Besmens IS, Luo Y, Giovanoli P, Lindenblatt N. Surgical management of isolated orbital floor and zygomaticomaxillary complex fractures with focus on surgical approaches and complications. J Plast Surg Hand Surg. 2020; 54 (4): 200-206.