Evaluation of one-point fixation surgery with computer-aided root mean square deviation in zygomaticomaxillary complex fractures

Abstract

Aims: Our paper aimed to present the results of the one-point fixation method in zygomaticomaxillary fractures by computer-aided mirror image superimposition with root mean square (RMS) deviation. Methods: One-point fixation performed zygomaticomaxillary complex fracture patients (n=18) by one surgeon were included in our study. Virtual 3D data of preoperative and postoperative CT-scan images was obtained by Slicer software. Sagittal plan mirror image superpositioning were used to obtain RMS data by Slicer. Mirror image superimposition of the undamaged side to the broken side in preoperative CT-scan imaging was referred as group B or broken group. Superposition of the repaired side’s postoperative imaging to the preoperative broken side was measured as group R or repair group in order to examine zygomatic bone’s postoperative spatial location. Superpositioned mirror 3D images of the non-traumatic side onto post-fixation 3D in postoperative data was measured as group M or mirror group. RMS deviation values of the groups obtained by Slicer were statistically compared. Results: Shapiro-Wilk test of groups were demonstrated normal distribution of the data for each group with no difference (p>0.05). In order to compare between groups, paired t-test covariance analysis were shown statistically similar data distrubition between experimental groups (p>0.05). Conclusion: Considering the nature of maxillofacial surgery, which disapproves even millimetric errors, we believe that the mean square root deviation will become standard as it allows three-dimensional evaluation and precise mathematical measurements. Besides, in accordance with the recent literature, this study might pay the way for future studies that would increase the usage of the one-point fixation method conducted on larger case series, as this method prevents lower eyelid complications without a visible scar.