title: Closed reduction and percutaneous Kirschner wire fixation in the treatment of simple zygoma fractures: orbital volumetric outcomes.
abstract: BACKGROUND
  The primary goal of treatment of fractures of the zygoma is the perfect restoration of function and aesthetic appearance. An adequate surgical treatment must combine adequate fracture reduction with the lowest possible morbidity of the surrounding soft tissues. This is the principle that guides the use of closed method for the treatment of simple fractures of the zygomatic bone. For a long-term evaluation, it is necessary to develop a method of volumetric orbitometry using tomography and use it for the evaluation of recent and late outcomes of patients treated with the closed technique.
  
  
  METHODS
  We present a study consisting of 3 consecutive phases that aimed to evaluate the orbital volume in late postoperative patients with simple fractures of the zygomatic bone treated with closed reduction. In the first phase, examinations of 21 patients were selected and a method was developed for volumetric orbitometry. This method was tested by 3 averiguadores (certified radiologists). After defining the volumetric method, the second stage was started, when 10 examinations of the patients who had been diagnosed with simple fractures of the zygomatic bone were selected. These examinations were from the patients who underwent conservative treatment and who also had a computed tomographic scan in a maximum period of 7 days postoperatively. In the third phase of the study, we selected 10 other examinations of the patients who had been operated on with the closed method in over 12 months. Orbital volumetry analysis of late results was performed.
  
  
  RESULTS
  In the first phase, the method for orbital volumetry by helical computed tomographic scan showed adequate precision and accuracy. Furthermore, it was able to set the possibility of using an orbit control volume at each other. In the second phase, the statistical analysis of the mean orbital volumetry showed that zygomatic fractures alter the orbital volume and that the closed technique is able to restore these volumes. In the third phase, the volumetry of the orbits of the patients with late follow-up of unilateral closed reduction of fractures of the zygoma also showed the maintenance of the results.
  
  
  CONCLUSIONS
  The current study was able to develop a reliable method of volumetry and use it to the evaluation of patients in recent and late postoperative period who were treated with closed technique.
authors.affiliation: From the *Department of Plastic Surgery; and the †Department of General Surgery, University Federal of Paraná, Paraná, Brazil.
authors.forename: Maria Cecilia Closs
authors.initials: MC
authors.lastname: Ono
authors.forename: Sergio Eiji
authors.initials: SE
authors.lastname: Ono
authors.forename: Gilvani Azor
authors.initials: GA
authors.lastname: de Oliveira e Cruz
authors.forename: Renato
authors.initials: R
authors.lastname: da Silva Freitas
authors.forename: Jorge Eduardo Fouto
authors.initials: JE
authors.lastname: Matias
authors.forename: Antônio Carlos Ligocki
authors.initials: AC
authors.lastname: Campos
mesh_terms: D000328:Adult; D001864:Bone Wires; D054893:Cone-Beam Computed Tomography; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009915:Orbit / Q000000981:diagnostic imaging* / Q000601:surgery*; D009917:Orbital Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D009929:Organ Size / Q000502:physiology; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D015051:Zygomatic Fractures / Q000000981:diagnostic imaging / Q000601:surgery*