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Characterization, Outcomes, and Management of Pediatric Zygomaticomaxillary Complex Fractures: Does Plating Technique or Sequence Affect Outcomes?

JD Luck BA, Joseph Lopez MD MBA, Muhammad Faateh MBBS, Alexandra MacMillan MBBS, Robin Yang DDS MD, John Chao BS, Edward Davidson MBBS, Richard Redett MD, Anthony P. Tufaro DDS MD, Paul Manson MD, Amir Dorafshar MBChB
Northeast Ohio Medical University
2017-02-12

Presenter: John Chao, BS

Affidavit:
I certify the representation of the work below by John Chao on this project. This project has not been published in any scientific journal or previously presented at a major meeting

Director Name: Amir Hossein Dorafshar, M.B.Ch.B., James Lehman MD

Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial

ZMC fractures in children are rare, and occur only after severe trauma. While numerous studies have been published regarding the management of these fractures in adults, there remains very little analogous published data that focuses on the pediatric population. Operative techniques differ greatly from surgeon to surgeon, and are guided primarily by experience and assumptions. This 20-year retrospective study (n=43) is the largest of its kind to date, and has led us to propose several management recommendations. The authors believe that ORIF of pediatric ZMC fractures should only be pursued when absolutely necessary. At our institution, Johns Hopkins University, surgery is indicated only for type-II ZMC fractures. These ZMC fractures are defined as moderately/severely displaced and comminuted/unstable. In these cases, 2-point fixation seems to be superior to 1- and 3-point fixation in the youngest patients with deciduous dentition, while 1-point fixation is not only sufficient, but also associated with the fewest complications in operatively managed older children with mixed or permanent dentition.

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