Virtual surgical planning and three-dimensional printing for the treatment of comminuted zygomaticomaxillary complex fracture


the objective of the study is to evaluate the interest of advanced computer technology, including virtual surgical planning, three-dimensional modeling and pre-bended titanium plate and mesh in the treatment of comminuted zygomaticomaxillary complex fractures.
Material and methods: A total of 19 patients were included. In the study group (n = 6) surgery was combined with preoperative planning including mirroring and bending of the titanium plates and mesh on a 3D model. In the control group (n = 13) plates and mesh were bended on the patient during the surgery. Patient characteristics, clinical outcomes, orbital volumes, zygoma projection and complica- tions were recorded.

Results: After surgery, the orbital volume and the zygoma projection variations between injured side and unaffected side were compared. Orbital volume variation was 2.1 mL [1.5; 4.0] in the control group and 0.4 mL [0.1; 1.0] in the study group. Zygoma projection variation was 0.2 cm in the control group and 0.1 cm in the study group. Orbital volume restoration (P = 0.004) and zygoma symmetrisation (P = 0.04) were significantly better when titanium plates and meshes were pre-bent on a stereolithographic model. Conclusion: This study confirms the interest of surgical planification using 3D models to improve treatment of midface trauma.

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