Archives of Craniofacial Surgery (대한두개안면성형외과학회지)

Korean Cleft Palate-Craniofacial Association (대한두개안면성형외과학회)
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Zygomaticomaxillary complex fracture after two-jaw surgery

  • Park, Joseph Kyu-hyung (Department of Plastic and Reconstructive Surgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Kim, Sang Wha (Department of Plastic and Reconstructive Surgery, Seoul National University Hospital, Seoul National University College of Medicine)
  • Received : 2020.06.26
  • Accepted : 2020.08.18
  • Published : 2020.10.20
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Abstract

Orthognathic surgeries often utilize rigid fixation for stabilization of the osteotomy site. The longterm fate of rigid fixations is still under investigation, and whether they should be routinely removed is under debate despite their low complication rates. Here, we report a case where a 26-year-old man suffered high-velocity trauma to his face 7 years after a two-jaw surgery. Computed tomography examination revealed a zygomaticomaxillary complex fracture, and open reduction and internal fixation was performed along with anterior maxillary wall reconstruction using absorbable mesh. Intraoperative examination revealed a broken L-shaped titanium plate near the fracture site with multiple bony fragments near each titanium screw. The rigid titanium system may have caused comminution of the fracture pattern, worsening the severity of the fracture.

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References

  1. el Deeb M, Wolford L, Bevis R. Complications of orthognathic surgery. Clin Plast Surg 1989;16:825-40. https://doi.org/10.1016/S0094-1298(20)31303-1
  2. D'Agostino A, Trevisiol L, Gugole F, Bondi V, Nocini PF. Complications of orthognathic surgery: the inferior alveolar nerve. J Craniofac Surg 2010;21:1189-95. https://doi.org/10.1097/SCS.0b013e3181e1b5ff
  3. Jung GS, Kim TK, Lee JW, Yang JD, Chung HY, Cho BC, et al. The effect of a condylar repositioning plate on condylar position and relapse in two-jaw surgery. Arch Plast Surg 2017;44:19-25. https://doi.org/10.5999/aps.2017.44.1.19
  4. Patel PK, Morris DE, Gassman A. Complications of orthognathic surgery. J Craniofac Surg 2007;18:975-85. https://doi.org/10.1097/scs.0b013e318068442c
  5. Orringer JS, Barcelona V, Buchman SR. Reasons for removal of rigid internal fixation devices in craniofacial surgery. J Craniofac Surg 1998;9:40-4. https://doi.org/10.1097/00001665-199801000-00009
  6. Murthy AS, Lehman JA Jr. Symptomatic plate removal in maxillofacial trauma: a review of 76 cases. Ann Plast Surg 2005;55:603-7. https://doi.org/10.1097/01.sap.0000183802.38116.37
  7. Nagase DY, Courtemanche DJ, Peters DA. Plate removal in traumatic facial fractures: 13-year practice review. Ann Plast Surg 2005;55:608-11. https://doi.org/10.1097/01.sap.0000189666.13860.c0
  8. Wilson GW, Iovino WM. Severe facial trauma after orthognathic surgery with rigid fixation. J Oral Maxillofac Surg 1989;47:640-2. https://doi.org/10.1016/S0278-2391(89)80084-9
  9. Ueki K, Miyazaki M, Okabe K, Mukozawa A, Marukawa K, Moroi A, et al. Assessment of bone healing after Le Fort I osteotomy with 3-dimensional computed tomography. J Craniomaxillofac Surg 2011;39:237-43. https://doi.org/10.1016/j.jcms.2010.06.008
  10. Brandtner C, Hachleitner J, Rippel C, Krenkel C, Gaggl A. Long-term skeletal and dental stability after orthognathic surgery of the maxillo-mandibular complex in Class II patients with transverse discrepancies. J Craniomaxillofac Surg 2015;43:1516-21. https://doi.org/10.1016/j.jcms.2015.07.007
  11. Chu SG, Lee JS, Lee JW, Yang JD, Chung HY, Cho BC, et al. Comparisons among four types of absorbable plates used for internal fixation of zygomaticomaxillary complex fractures. J Craniomaxillofac Surg 2019;47:383-8. https://doi.org/10.1016/j.jcms.2019.01.014
  12. Dobbins JJ, Seligson D, Raff MJ. Bacterial colonization of orthopedic fixation devices in the absence of clinical infection. J Infect Dis 1988;158:203-5. https://doi.org/10.1093/infdis/158.1.203
  13. Ballon A, Landes CA, Zeilhofer HF, Herzog M, Klein C, Sader R. The importance of the primary reconstruction of the traumatized anterior maxillary sinus wall. J Craniofac Surg 2008; 19:505-9. https://doi.org/10.1097/SCS.0b013e318163f2ea
  14. Lee HR, Shin HK, Lee DL, Jung GY. Delayed-onset methicillin-resistant Staphylococcus aureus infection at 18 months after absorbable plate fixation for zygomaticomaxillary complex fracture. Arch Craniofac Surg 2016;17:229-32. https://doi.org/10.7181/acfs.2016.17.4.229
  15. Kim YM, Lee JH. Clinical courses and degradation patterns of absorbable plates in facial bone fracture patients. Arch Craniofac Surg 2019;20:297-303. https://doi.org/10.7181/acfs.2019.00409
  16. Gosain AK, Song L, Corrao MA, Pintar FA. Biomechanical evaluation of titanium, biodegradable plate and screw, and cyanoacrylate glue fixation systems in craniofacial surgery. Plast Reconstr Surg 1998;101:582-91. https://doi.org/10.1097/00006534-199803000-00004