EXPERIENCE OF USING THE OPERATIVE-ORTHOPEDIC METHOD OF TREATMENT FOR FRACTURES OF THE VYLYCEORBITAL COMPLEX

Abstract

The aim of the study was to increase the effectiveness of treatment of patients with fractures of the zygomaticoorbital complex by developing a surgical-orthopedic method of bone fragment reduction. Materials and methods. 41 patients with a fracture of the zygomaticoorbital complex were under observation, in the treatment of which the surgical-orthopedic method was used using the proposed device. The first stage was surgical intervention. At the second stage, the bone fragment was reduced using the device. At the third stage, the final fixation of the reduced bone fragment was performed. The method of which depended on the characteristics of the fracture line. Results of the study. The bone fragment was repositioned using the developed device for old and straightened fractures of the zygomatico-orbital complex. The device was used for suture fractures, large-fractured, small-fractured. Based on these characteristics, groups of patients were formed. The first stage of treatment was surgical intervention to revise the maxillary sinus, destroy the accessible connective tissue adhesions between the bone fragments, and attempt a single-stage reduction. If the single-stage reduction attempt failed, a wire ligature was passed through the fragment of the zygomatic bone body and brought out. This ligature was fixed in the developed extraoral repositioning and fixation device, which was fixed on the patient’s head. The device is securely fixed on the patient’s head. The design of the developed device allows for a step-by-step reduction in all three planes. After the reduction stage, we performed the final fixation surgically. During the treatment, indications for the use of the surgical orthopedic method in fractures of the zygomatico-orbital complex were formulated. Conclusions. The surgical-orthopedic method of treatment is indispensable for old and improperly fused fractures of the maxillo-orbital complex in the event of an unsuccessful attempt at one-step reduction. In such cases, we suggest using the developed extraoral device. It is securely fixed on the patient’s head, allows you to change the force applied. The device also allows you to change the movement of the fragment in the required plane. After the reduction stage, we recommend fixing the reduced fragment surgically. The choice of the final fixation method depends on the type of fracture and its characteristics.