The Relationship Between Morphometric Measurments, Severity and Success of Zygomatic Arch Fracture Reduction.

ABSTRACT

PURPOSE: Zygomatic arch fractures are commonly treated by closed reduction. This kind of treatment is highly influenced by the treating surgeon and type of fracture. Thus, it is important to choose the optimal treatment for different fractures. Current treatment schemes for zygomatic arch fractures reduction are based on subjective assessments. We believe this approach should be refined. Create a new treatment algorithm for the solitary and combined zygomatic arch fractures based on radiological morphometric measurements. This will assist the clinician in tailoring a suitable treatment for each case and avoiding pitfalls, thus achieving best possible results. METHODS: A total of 179 radiologic images of patients treated in our department for zygomatic arch fractures were morphometrically measured and analyzed. RESULTS: Three variables showed a capacity to predict a large remaining defect; The presence of a preoperative esthetic defect and a large initial latero-lateral (LL) defect reduced the probability of a large remaining defect (OR = 0.289, P= .019; (OR = 0.78, P= .008; respectively). Patients with initial LL defect < 3.5 mm presented postoperative residual defect 3-times greater than patients with initial LL defect > 3.5 mm A large antero-posterior telescoping increased the probability of a large remaining defect (OR = 1.27 P= .003). Cases that had antero-posterior telescoping > 1.45 mm had a 72.4% probability of remaining with a poor residual defect > 84.1% (P= .003). CONCLUSIONS: Based on our results we believe that the use of morphometric measurements is important when assessing zygomatic arch fractures. We found that there are measurements that can be used to predict esthetic and functional defects, as well as probability of resolving them. Morphometric measurements can be used to predict the reduction difficulty and can assist the clinician in choosing the optimal reduction method and thus increasing the success rate.