Klinische Untersuchung zum intraoperativen Einsatz eines 3D C-Bogens bei der Versorgung isolierter Jochbeinfrakturen mit Beteiligung des Orbitabodens

Abstract

During the repair of zygomatico-orbital complex (ZMC) fractures, the lateral orbital wall and/or the orbital floor is often reduced by merely reducing the zygoma. Intraoperative 3D imaging can help surgeons decide whether the orbit must be reconstructed as well. The pur-pose of this study was therefore to assess the usefulness of intraoperative 3D C-arm imaging in evaluating the adequacy of fracture reduction. A total of 66 patients with unilateral ZMC fractures were enrolled in this retrospective study. Nineteen fractures were treated with a closed reduction technique. Forty-seven fractures were repaired with open reduction and internal fixation of the zygomaticomaxillary buttress area. Intraoperative 3D C-arm imaging was performed in all cases. All patients underwent post-operative computed tomography and a clinical examination no earlier than five months after the procedure. After reduction of the ZMC fractures, intraoperative 3D scans showed inadequate repair of the orbital floor in two patients and inadequate repair of the lateral orbit in two patients too. Zygoma and zygomatic arch fracture reduction had to be corrected in two further cases. The other 40 patients did not need an additional procedure. Postoperative imaging showed that no patient required a further operation. No postoperative diplopia or enophthalmos developed in any patient. Intraoperative 3D C-arm imaging appears to be an effective tool for evaluating ZMC fracture reduction. It helps avoid additional procedures and thus helps reduce morbidity. In addition, there appears to be no need for postoperative imaging.