Authors: Yaser Ishaq , Maria Noor , Fareed Ud Din Ahmad Chishti , Faisal Shafiq Malik , Fareed Ahmad , Hanan Shafiq

Abstract

Background and Objective: Zygomatico-maxillary complex (ZMC) fractures and associated infraorbital nerve paresthesia are the most prevalent features of facial trauma associated with road traffic accidents, accidental falls, and violent assaults. The objective of this study was to assess the recovery time of the infraorbital nerve functional status in individuals with paresthesia after open and closed reduction of ZMC fractures.

Method: A comparative cohort study was conducted in the Oral and Maxillofacial Surgery Department of Mayo Hospital in Lahore. The study comprised 100 patients with unilateral isolated en bloc ZMC fractures and post-traumatic paresthesia. Patients were equally divided into two groups: Group A comprised of patients who underwent closed reduction while patients of Group B had open reduction with micro plate osteosynthesis. Demographic information, infraorbital nerve healing, post-op complications, and patients’ satisfaction were documented. To compare the outcomes of the two groups, statistical analyses were done and p-value <0.05 was taken as statistically significant.

Results: The age distribution revealed a mean age of 37.43 ± 11.06 years, with 72% of the participants being males. In 63% of patients, there was overall functional nerve recovery. After 6 weeks, 74% of those in Group A (closed reduction) had functional nerve recovery, as compared to 52% of those in Group B (open reduction) (p = 0.023). Age subgroup analysis revealed no significant differences in the recovery rates. When compared to Group-A, patients in Group-B showed faster sensory improvement and better satisfaction levels. Complication rates were equal for both approaches.

Conclusion: In ZMC fractures with paresthesia, both open and closed reduction procedures yielded good results in recovering infraorbital nerve function; however, the open reduction technique demonstrated quicker sensory recovery and more patient satisfaction.

Keywords: Infra orbital nerve, open reduction, closed reduction, zygomaticomaxillary complex fractures, functional status.