Universität zu Köln

Buller, Johannes, Zirk, Matthias, Kreppel, Matthias, Maus, Volker and Zoeller, Joachim E. (2019). Intraoperative Ultrasound Control of Zygomatic Arch Fractures: Does Additional Imaging Improve Reduction Quality? J. Oral Maxillofac. Surg., 77 (4). S. 769 - 777. PHILADELPHIA: W B SAUNDERS CO-ELSEVIER INC. ISSN 1531-5053

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Abstract

Purpose: Intraoperative navigation to assess anatomic reduction is the general trend in maxillofacial trauma surgery. The aim of this study was to evaluate the closed reduction outcome of isolated zygomatic arch fractures using ultrasound compared with palpation control. Materials and Methods: In this case-and-control study, the authors identified consecutively treated patients who underwent closed reduction of isolated zygomatic arch fractures using the Volkmann reposition hook with intraoperative ultrasound. Controls were patients with the same diagnosis and surgical procedure without ultrasound imaging. Pre- and postoperative radiographic datasets were geometrically analyzed. The outcome variables postoperative cortical step, persistent postoperative displacement, and overall grade of reduction were compared in the 2 study groups. Subgroups of fracture patterns were classified as M-shaped or variable. Statistical analysis was performed using t test for continuous variables and 2-sided chi(2) test for categorical variables, with a P value less than .05 defined as significant. Results: Sixteen cases with intraoperative ultrasound and 60 controls were identified from the institution's database. The angle of postoperative displacement was significantly decreased in the ultrasound group for all fractures (2.4 degrees vs 5.3 degrees; P = .004) and the variable fracture type (1.6 degrees vs 8.1 degrees; P = .005). Overall grade of reduction was improved in the ultrasound group for all fractures (P = .03) but with no difference solely for M-shaped fractures (P = .37). Conclusions: Although reduction control using palpation and probing using the Volkmann hook showed satisfactory results for M-shaped fractures, additional intraoperative ultrasound imaging showed promise for increasing success rates for the variable type of zygomatic arch fracture. (C) 2018 American Association of Oral and Maxillofacial Surgeons

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Buller, Johannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Zirk, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Kreppel, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Maus, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED Zoeller, Joachim E. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-152673
DOI:	10.1016/j.joms.2018.11.012
Journal or Publication Title:	J. Oral Maxillofac. Surg.
Volume:	77
Number:	4
Page Range:	S. 769 - 777
Date:	2019
Publisher:	W B SAUNDERS CO-ELSEVIER INC
Place of Publication:	PHILADELPHIA
ISSN:	1531-5053
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CLOSED REDUCTION; X-RAY; C-ARM; ULTRASONOGRAPHY; DIAGNOSIS Multiple languages Dentistry, Oral Surgery & Medicine Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/15267