Orbitozygomatic fractures and the value of Knight and North´s classification.

Abstract

A descriptive observational study of 250 patients, who were operated on from orbitozygomatic fractures at the Maxillofacial Surgery Service of “Manuel Ascunce Domenech” provincial teaching hospital in Camaguey from January 1999 to December 2003, was conducted . The objective was to describe the importance of Knight and North´s classification for the selection of therapeutic surgical variants to be applied in orbitozygomatic fractures on the basis of the experience of this service. Knight and North´s classification was used to select treatment variants; besides, age, sex, therapeutic surgical classification, complications and postoperative results were determined as variables. It was observed that males predominated with 75,7% of total number and such surgery was mostly performed on 25-34 years-old group (34,3%); Knight & North´s class III was the most frequent (45,6%) followed by class II and class IV, with 31,3 and 10,1% respectively. On the basis sof this classification and taking into account the expected degree of postreduction instability, there was a right selection of the correspondieng therapeutic variant to be used in 98,8% of cases, that is, indirect reduction without fixation in 100% of cases in class II and V, and in 47,5% of class III fractures. Indirection reduction with temporary support was applied to 52,5% of the rest of class III cases; 58,3% of class VI fractures and 25% of class IV whereas direct reduction and osteosynthesis was performed in 75% of the rest of class IV cases. It was concluded that incidence of orbitozygomatic fracxtures was high, being Knight & North´s class III the most common. This classification is recommended to treat them since it allows choosing the most suitable therapeutic variant according to the expected degree of postreduction instability, thus achieving positive aesthetic and functional results, with few postoperative complications.