Management of ZMO Fracture Using Transcutaneous Approaches Versus ‎Retroseptal Transconjunctival Approach

Abstract

. Objective: ZMO fracture indicated for ORIF can be accessed using many approaches, comparison andevaluation of methods was mandatory to reveal the most convenient approach with special attentionto surgical scar appearance and patient’s esthetics. Design: Prospective study of the ZMO trauma patients. Participants: Twenty-one patients were operated. Distributed in three groups seven patients in each.Groups represented the three approaches, transconjunctival, subtarsal and subciliary. Additionalhealthy un-operated patients were examined as control. Methods: Patients suffering from ZMO fracture were randomly distributed and operated using thethree mentioned approaches. Patients were evaluated post operatively regarding to esthetic outcome,patient satisfaction, pain, incidence of poor wound healing and the quality of fixation. Results: Modified Vancouver Scar Scale (MVSS) results showed lower values for Transconjunctivalapproach ( 4 ±1.225) followed by Subtarsal approach ( 6 ±2.83) and highest value for Subciliaryapproach ( 7.2 ±1.095). With statistically significant difference between Subciliary andTransconjunctival but there is no statistically significant difference between Subtarsal and the othertwo groups. Conclusions: The transconjunctival approach was associated with lower rates of complications,patient complaints and pain.