Artigo publicado no Journal of Oral and Maxillofacial Surgery, Volume 70, 6ª edição , Páginas e378-e388, Junho de 2012
Link do artigo: http://www.joms.org/article/S0278-2391%2812%2900194-2/abstract
Purpose
The present prospective study sought to evaluate a
new rigid internal fixation device called a “neck screw,” which was
applied to patients presenting with a tripod fracture of the
zygomaticomaxillary complex.
Patients and Methods
Seventeen
patients with tripod fractures received surgical treatment from 2007 to
2010, and had their zygomaticomaxillary complex monofragments fixed
using the neck screw protocol. The adequacy of fracture reduction,
stability of the zygomatic monofragment after fixation, cosmetic
outcomes, and postoperative complications were used to determine the
efficacy of this protocol. The stability provided by the neck screw was
evaluated by computed tomography (CT) scans by comparing the immediate
postoperative distances between the fractured bone segments (control
group) with those distances measured on CT scans obtained 5 weeks later
(late group).
Results
The average distance observed
between the fractured ends on the immediate postoperative CT scan was
less than 0.58 mm, demonstrating adequate fracture reduction. No
significant changes were seen in these postoperative values after 5
weeks (Wilcoxon test, P = 1.0000), demonstrating no displacement of the zygomaticomaxillary complex monofragment after fixation using the neck screw.
Conclusions
The
proposed surgical treatment proved efficient in 17 patients. The
fixation stability provided by the neck screw was confirmed by
subsequent CT scan measurements, statistical analysis, and clinical
follow-up during the postoperative period, in which patients showed no
significant associated complications, facial asymmetry, enophthalmos, or
diplopia.
