The stability of different fixation methods in L-shaped reduction malarplasty: a comparative retrospective study
10.3760/cma.j.cn114453-20240401-00084
- VernacularTitle:L形颧骨颧弓缩窄术不同固定方式稳定性的对比研究
- Author:
Yifan WU
1
;
Yingyou HE
;
Heyou GAO
;
Han GE
;
Zihang ZHOU
;
Jihua LI
Author Information
1. 口腔疾病国家重点实验室 口腔疾病国家临床研究中心 四川大学华西口腔医院正颌及关节外科，成都 610041
- Keywords:
Orthognathic surgery;
Reduction malarplasty;
Prominent malar;
Stability;
Fixation method;
Displacement
- From:
Chinese Journal of Plastic Surgery
2024;40(10):1065-1072
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the stability of the zygomatic complex in reduction malarplasty (RM) with different fixation method.Methods:The clinical data of patients with zygomatic arch protrusion at the Department of Orthognathic and Temporomandibular Joint Surgery, West China Hospital of Stomatology, Sichuan University from January 2018 to January 2021 were analyzed retrospectively. All patients underwent L-shaped osteotomy reduction malarplasty which were divided into zygomatic body fixation (ZBF) and zygomatic arch fixation (ZAF) according to fixation technique. As for ZBF, there were 4 different groups including two bicortical screws (2LS), an L-shaped plate with one bicortical screw (LPLS), an L-shaped plate with short-wing on the zygoma (LPwZ) and an L-shaped plate with short-wing on the maxilla (LPwM). As for ZAF, there were 3 different groups including mortice-tenon (MT), 3-hole plate (3HP) and short screw (SS). CT imaging data of two postoperative periods (1 week later; 6 months later) were collected. ITK-SNAP and 3D Slicer software were applied to evaluate the difference in the displacement distance of relevant landmarks of the zygomatic complex, so as to compare the postoperative stability of RM under different fixation methods. Statistical analyses were performed using IBM SPSS Statistics, version 25.0, and Kruskal-Wallis method was used to compare the difference of relevant landmarks displacement distance between ZBF group and ZAF group. P<0.05 was considered statistically significant. Results:60 patients (120 zygomatic arches) who were composed of 21 men and 39 women, aged (27.1±4.9) years were included. There were 30 samples in each group of ZBF and 40 samples in each group of ZAF. Compared with the single L-shaped plate (LPwZ, LPwM) group, the displacement distance of zygomatic complex in 2LS and LPLS groups was shorter ( P<0.05). The three fixation method of zygomatic arch (MT, 3HP, SS) had similar effects on the displacement of zygomatic complex ( P>0.05). Conclusion:After RM, the "two-bridge" fixation method (2LS and LPLS) provides better stability than the single L-shaped plate. The stability of all ZAF is similar when combined with 2LS or LPLS.
