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Orbitozygomatic Fracture Repairs-FER

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Orbitozygomatic Fracture Repairs : Are Antibiotics Necessary? 1.Department of Oral and Maxillofacial Surgery, Westmead Hospital, Sydney, New South Wales, Australia, 2.Maxillofacial Unit, Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia, 3.Trauma Service, Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia - September 13, 2014
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Orbitozygomatic Fracture Repairs : AreAntibiotics Necessary?Orbitozygomatic Fracture Repairs : AreAntibiotics Necessary?1.DepartmentofOralandMaillofacial!urgery" #estmead$ospital"!ydney"Ne%!outales" Australia"'.Maillofacial(nit"Royal)risbaneand #omen*s$ospital")risbane"+ueensland"Australia" ,.-rauma!er.ice"Royal)risbaneand#omen*s $ospital")risbane"+ueensland"Australia/ !eptember 1," '0111.DepartmentofOralandMaillofacial!urgery" #estmead$ospital"!ydney"Ne%!outales" Australia"'.Maillofacial(nit"Royal)risbaneand #omen*s$ospital")risbane"+ueensland"Australia" ,.-rauma!er.ice"Royal)risbaneand#omen*s $ospital")risbane"+ueensland"Australia/ !eptember 1," '0112ntroduction-&e orbitozygomatic fracture is one of t&e most commonly encountered maillofacial in3uries.-&is study aims to re.ie% orbitozygomatic fractures and present : Outcomes" complications" infection rate" and to suggest %&et&er antibiotic use is appropriateMaterial and Met&odsA retrospecti.e case selection study using t&e R)#$ Database of +ueensland $ealt& %&ic& prospecti.ely registers all maillofacial cases at t&e R)#$ from 4anuary 1" '011" to December ,1" '011.Material and Met&ods5atients %ere ecluded :6ounger t&an 11 years and 7 mont&s 2solated orbital fracturesFractures in.ol.ing more t&an t&e orbitozygomatic comple. Data%ere re.ie%ed and follo%/up eaminations at 1/" '/" and 7/%ee8 postoperati.e period.9linical assessments and plain :lm radiograp&s %ere performed to document t&e progress and complications of t&ese fractures suc& as implant failure" reoperations" and potential infections.Material and Met&ods-&e current standard protocol at t&e R)#$ for surgical management of orbitozygomatic fractures in.ol.es t&e use of prop&ylactic intra.enous ampicillin %it& metronidazole in all cases-&ese are started preoperati.ely and continued for '1 &ours postoperati.ely. Results-&e most common age group to &a.e &ad an orbitozygomatic fracture %as in t&e t&ird decade of lifeResultsMec&anism of in3ury of patients %it& orbitozygomatic fractures at t&e R)#$.ResultsNumber of :ation points in t&e treatment of orbitozygomatic fractures at t&e R)#$.Results-&e a.erage %aiting time to surgery %as ,.; days. 2n total" ;< cases =17.>?@ %ere managed conser.ati.ely.Results-&ree of t&e surgical cases =1.>?@ &ad complications t&at reAuired furt&er surgery.-%o cases %ere due to inadeAuate cosmesis One %as due to eposure of t&e mini/plate reAuiring its remo.al along %it& t&e scre%s9omplications/1A ,'/year/old man" due to an alleged assault.!e.ere left orbitozygomatic fracture. -&e patient &ad paraest&esia to t&e distribution of t&e left infraorbital ner.e9omplications/1$e complained of an inadeAuate aest&etic result-&e patient under%ent reoperation %it& remo.al of t&e :ation" correct anatomical reduction" and re:ation %it& mini/plates9omplications/'A 'B/year/old man in3ured" due to an assault. -&ere %as an anatomical defect in t&e left zygomatic arc&9omplications/'-&e arc& %as reduced .ia t&e Cillies* approac&. -&is resulted in inadeAuate reduction" poor cosmesis" and subseAuently t&e patient returned for appropriate correction. -&e second procedure %as repeat reduction %it&out :ation .ia t&e same approac& 9omplications/,A '1/year/old man %&o sustained a rig&t orbitozygomatic in3ury due to an assault.-&e si/&ole mini/plate became eposed intraorally after , mont&s. 2t %as remo.ed une.entfully under general anest&esiaDiscussion-&is study eamined t&e incidence and complications of orbitozygomatic fractures at a tertiary referral center of t&e R)#$ %it& good outcomes and a .ery lo% complication rate.Discussion-&ere %ere 170 orbitozygomatic fractures treated at t&e R)#$ in '011.-&ere %ere no cases of early postoperati.e infection.DiscussionKnepil and Loukota report a%ide .ariation in use of antibiotic regimes %it& surgical repair of orbitozygomatic fractures and t&at t&e infection rate is lo% at 1.


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