Surgical treatment of zygomatic bone fracture using two points fixation versus three point fixation-a randomised prospective clinical trial

<p>Abstract</p> <p>Background</p> <p>The zygoma plays an important role in the facial contour for both cosmetic and functional reasons; therefore zygomatic bone injuries should be properly diagnosed and adequately treated. Comparison of various surgical approaches and their complications can only be done objectively using outcome measurements which in turn require protocol management and long-term follow up. The preference for open reduction and internal fixation of zygomatic fractures at three points has continued to grow in response to observations of inadequate results from two point and one point fixation techniques.</p> <p>The objectives of this study were to compare the efficacy of zygomatic bone after treatment with ORIF using 2 point fixation and ORIF using 3 point fixation and compare the outcome of two procedures.</p> <p>Methods</p> <p>100 patients were randomly divided equally into two groups. In group A, 50 patients were treated by ORIF using two point fixation by miniplates and in group B, 50 patients were treated by ORIF using three point fixation by miniplates. They were evaluated for their complications during and after surgery with their advantages and disadvantages and the difference between the two groups was observed.</p> <p>Results</p> <p>A total of 100 fractures were sustained. We found that postoperative complication like decreased malar height and vertical dystopia was more common in those patients who were treated by two point fixation than those who were treated with three point fixation.</p> <p>Conclusions</p> <p>Based on this study open reduction and internal fixation using three point fixation by miniplates is the best available method for the treatment zygomatic bone fractures.</p

Petrology and geochemistry of amphibolites and greenschists from the metamorphic sole of the Muslim Bagh ophiolite (Pakistan): implications for protolith and ophiolite emplacement

© 2014, Saudi Society for Geosciences. Metamorphic sole rocks are exposed beneath both the Jang Tor Ghar Massif (JTGM) and Saplai Tor Ghar Massif (STGM) of the Muslim Bagh ophiolite. The sole rocks comprise the basal mylonitic part of the ophiolite peridotites and the sub-ophiolitic metamorphic rock series showing inverted metamorphic gradients. The latter mainly consist of garnetiferous amphibolites, amphibolites and greenschists. The mineralogy of the amphibolites (hornblende + plagioclase ± quartz ± biotite ± epidote ± apatite ± opaque) and garnet amphibolites in the metamorphic sole rocks of the Muslim Bagh ophiolite is similar except for the presence of garnet in the latter. Greenschists contain minerals such as chlorite + plagioclase + epidote ± actinolite ± quartz ± opaques. The mineral assemblages of these rocks suggest that they are meta-basites. Geochemical analyses indicate that the garnetiferous amphibolites are metamorphosed tholeiitic to alkaline basalts, akin to ocean island basalts (OIB). By contrast, the amphibolites and greenschists have geochemical signatures akin to mid-oceanic ridge basalts (MORB). Basalts of OIB type are also found in the hyaloclastite-mudstone unit (Bhm), while the MORB-type basalts are found in the basalt-chert unit (Bbc) of Bagh complex underlying the ophiolite nappe. Here, we interpret an early stage OIB-type basalt accretion to the base of the obducted plate associated with extrusion of volcanic rocks in the Bhm unit of Bagh complex followed by amphibolite facies metamorphism. During the later stage of the advancing ophiolitic thrust sheet, MORB-like basalts, such as those found in the Bbc unit of the Bagh complex, are underplated and metarmophosed to greenschist facies with subsequent accretion of the entire sequence of the Muslim Bagh ophiolite and the Bagh complex onto the Indian Platform sediments