A long term follow up of reduced isolated zygomatic arch fracture by Gillies' approach

Ha, Seung Il; Kim, Joon Buhm; Choi, Jai Koo; Ahn, Duk Kyun

Abstract

Many methods have been developed for the reduction of the isolated zygomatic arch fracture. Even though the reduction of isolated zygomatic arch fracture can be made well according to the various methods, the Gillies' method has been selected as the 1st choice. But long term follow-up study of this method was not reported. So long term follow up of zygomatic arch fracture was performed in 35 patients who were treated by Gillies' method. Authors divided isolated zygomatic arch fractures into three classes (Type A : a simple fracture with one fracture line and one greenstick fracture, TyPe B : medially depressed fracture with three fracture lines, Type C : a medially depressed fracture segment with two fracture lines) and followed up the reduced isolated zygomatic arch fracture cases using Gillies' method by radiographes and interview. The depression of lesion site was estimated by comparing with tracing the zygomatic arch shadow of normal side. The results were as follows: 1. The mean follow up time was 33.4 month. 2. The isolated zygomatic fractures were classified by three group. A: a simple fracture (16 cases) B: the central fracture point was a medially depressed fracture (14 cases) C: fracture with a medially depressed segment (5 cases) 3. The mean depression of lesion site was 2.3 mm. (Type A: 2.0 mm, Type B: 3.2 mm, Type C: 2.4 mm and difference between A and B was significant statistically (p < 0.037)). 4. The mean depression of zygomatic arch fracture was 2.1 mm in excellent group, 2.4 mm in good group and 5.2 mm in poor group and difference between excellent and poor, and between good and poor group were statistically significant (p < 0.0001). 5. On result of subjective satisfaction, number of excellent case was 17(48.6%), it of good case was 15(42.9%) and it of poor case was 3(8.6%) (Type A: 9, 7, 0, Type B: 5, 7, 2 and Type C: 3, 1, 1 excellent, good and poor in sequence). 6. The mean depression of overcorrection group(17, 8, 1 excellent good and poor in sequence) and nonovercorrection group(2, 5 and 2 in excellent, good and poor in sequence) was 2.26 and 3.6 mm in each other(p < 0.004). After reviewing all of results, it is concluded that Gillies' method is acceptable as the 1st choice for the reduction method of an isolated zygomatic arch.