Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Original article / research
Year : 2017 | Month : October | Volume : 11 | Issue : 10 | Page : PC15 - PC19

A Prospective Study to Compare the Functional and Aesthetic Outcomes with and without Primary Bone Grafting in Facial Fractures

Narayanamurthy Sundaramurthy, Tibar Banerjee, Surya Rao Rao Venkata Mahipathy, Alagar Raja Durairaj, Yogesh R Shenoy, Bhawna Prabhakar

1. Assistant Professor, Department of Plastic and Reconstructive Surgery, Saveetha Medical College, Chennai, Tamil Nadu, India. 2. Associate Professor, Department of Plastic and Reconstructive Surgery, IPGMER and SSKM Hospitals, Kolkata, West Bengal, India. 3. Associate Professor, Department of Plastic and Reconstructive Surgery, Saveetha Medical College, Chennai, Tamil Nadu, India. 4. Associate Professor, Department of Plastic and Reconstructive Surgery, Saveetha Medical College, Chennai, Tamil Nadu, India. 5. Consultant Paediatric Plastic Surgeon, Department of Paediatric Plastic Surgery, Dr. Indu Khoslas Newborn and Child Care Centre, Mumbai, Maharashtra, India. 6. Assistant Professor and Consultant, Plastic and Reconstructive Surgery, Shri Guru Ram Rai Institue of Medical and Health Sciences, Dehradun, Uttarakhand, India.

Correspondence Address :
Dr. Narayanamurthy Sundaramurthy,
3, 6th Floor, Block 3, Pace Prana Apartments, 109, Padikuppam Road Anna Nagar West Extension,
Chennai-600 040, Tamil Nadu, India.
E-mail: nanathesurgeon@gmail.com

Abstract

Introduction: Open Reduction and Internal Fixation (ORIF) has been the gold standard in treatment of facial fractures. Bone grafts have been used to correct bone defects in face. Many studies assessing outcomes of ORIF and primary bone grafting separately have been published in literature.

Aim: A prospective study to compare the functional and aesthetic outcomes with and without primary bone grafting in facial fractures.

Materials and Methods: Thirty patients, admitted between January 2012 and December 2013, were divided into two groups. Group 1 patients underwent ORIF with primary bone grafting and in group 2, only ORIF was done. Clinical and functional, photographic and radiological assessments were done after one month and three months.

Results: Mean value of vertical dystopia in groups 1 and 2 after three months postoperatively were 1.25mm and 0.67mm. Mean value of enophthalmos in groups 1 and 2 after three months postoperatively were 0.5mm and 1mm. Thus, vertical dystopia was corrected better without bone grafts and enophthalmos corrected better with bone grafts. Photographic assessment revealed no statistical difference between the two groups. Postoperatively, in upper face fractures, both groups had similar number of patients in grades 1 and 2. Only one patient from group 2 of midface fractures ended up with grade 3 asymmetry. Radiologically, in upper face fractures, group 2 had more mean projection, height and breadth deficits (1.28mm, 2.57mm and 2.42mm) when compared to group 1 (0.67mm, 1.50mm and 0.50mm). The mean projection and height deficits were statistically better in group 1. In midface fractures, mean zygomatic complex projection and height deficits were more in group 2 (1.88mm and 0.63mm) than group 1 (0.78mm and 0.44mm). The mean zygomatic complex projection was statistically better in group1. Postoperative complications were lesser with the bone graft group.

Conclusion: Judicious use of bone grafts in comminuted facial and orbital floor fractures primarily can give better functional and aesthetic outcomes.

Keywords

Comminuted fracture, Malar height, Malar projection, Plate-related complications

How to cite this article :

Narayanamurthy Sundaramurthy, Tibar Banerjee, Surya Rao Rao Venkata Mahipathy, Alagar Raja Durairaj, Yogesh R Shenoy, Bhawna Prabhakar. A PROSPECTIVE STUDY TO COMPARE THE FUNCTIONAL AND AESTHETIC OUTCOMES WITH AND WITHOUT PRIMARY BONE GRAFTING IN FACIAL FRACTURES. Journal of Clinical and Diagnostic Research [serial online] 2017 October [cited: 2018 Jan 17 ]; 11:PC15-PC19. Available from
http://www.jcdr.net/back_issues.asp?issn=0973-709x&year=2017&month=October&volume=11&issue=10&page=PC15-PC19&id=10774

DOI and Others

DOI: 10.7860/JCDR/2017/28471.10774

Date of Submission: Mar 18, 2017
Date of Peer Review: May 18, 2017
Date of Acceptance: Sep 06, 2017
Date of Publishing: Oct 01, 2017

FINANCIAL OR OTHER COMPETING INTERESTS: None.

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