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. 2023 Sep;22(3):661-665.
doi: 10.1007/s12663-022-01805-3. Epub 2022 Oct 5.

Feasibility of Laterocaudal Approach in Comparison with Subtarsal Approach in the Management of Orbital Rim Fractures in Indian Population: A Prospective Study

Centina Rose John  1 , Praveen Ganesh Natarajan  1 , Surya Rao Rao Venkata Mahipathy  1 , James Solomon Jesudasan  1 , Alagar Raja Durairaj  1 , Narayanamurthy Sundaramurthy  1 , Anand Prasath Jayachandiran  1
Affiliations

Feasibility of Laterocaudal Approach in Comparison with Subtarsal Approach in the Management of Orbital Rim Fractures in Indian Population: A Prospective Study

Centina Rose John et al. J Maxillofac Oral Surg. 2023 Sep.

Abstract

A balance between surgical access and aesthetics, with lesser post-op sequelae, is inevitable in the management of facial fractures. Even though various approaches are widely practised, further modifications and revisions are encouraged for better outcomes. We performed a prospective cross-sectional study on 30 patients with Zygomatico-Maxillary Complex (ZMC) fracture with inferior orbital rim involvement. Surgical management was performed using subtarsal (Group A) or laterocaudal (Group B) approach, during which the time taken to expose fracture and the ease of access was documented. Scar evaluation was performed using SCAR Scale on the 15th day and after one-month and three-month follow-up, and the post-op complications including ectropion, infections, edema, etc., were documented. There was a significant reduction in the time taken (p < 0.001) in group B than in group A. The ease of access did not demonstrate any significant difference. The SCAR scale score was significantly reduced at 3rd-month follow-up in group B compared to the other group (p = 0.009). Laterocaudal approach demonstrated lesser time-taken and better access to the inferolateral rim, with superior aesthetics and fewer complications. This approach can be employed in clinical practice, especially with inferolateral rim involvement in ZMC fractures.

Keywords: Laterocaudal approach; Orbital rim fractures; SCAR scale; Subtarsal approach; Transcutaneous incision.

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Conflict of interest statement

Conflicts of interestAll authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

Figures

Fig. 1
Fig. 1
Trend of SCAR Scale score at various time frames between Group A and B
Fig. 2
Fig. 2
15th day follow-up, left side ZMC fracture management using laterocaudal approach
Fig. 3
Fig. 3
One-month follow-up, left side ZMC fracture management using laterocaudal approach
Fig. 4
Fig. 4
Three-month follow-up, left side ZMC fracture management using laterocaudal approach
See this image and copyright information in PMC

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