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Rotational Mapping-Designed Approach for Minimally Invasive Fixation of Zygomaticomaxillary Fractures: A Retrospective Study
Abstract
Objective: This study aimed to evaluate the early clinical efficacy of a standardized incision approach based on the rotational mapping method. The approach was applied in significantly displaced Zingg Type B and mildly comminuted Zingg Type C zygomaticomaxillary complex (ZMC) fractures requiring direct exposure of the zygomatic arch. Methods: A total of 43 patients with selected Zingg Type B/C ZMC fractures requiring open reduction of the zygomatic arch were retrospectively assessed. The “rotational mapping method” was used intraoperatively to plan a preauricular incision for direct zygomatic arch exposure and fixation, combined with other standard incisions for ZMC reduction. Surgical parameters, postoperative complications, and facial symmetry restoration were evaluated using three-dimensional digital analysis of the mean absolute differences (MAD). Results: At 3 months postoperatively, maximum interincisal opening improved to 3.51±0.44 cm. Only 1 patient (2.3%) developed transient postoperative facial nerve dysfunction, which resolved completely within 3 months. The MAD between the bilateral zygomaticomaxillary complexes decreased from 1.18±0.11 mm preoperatively to 0.59±0.47 mm postoperatively. The mean incision length was 2.12±0.42 cm, and Vancouver Scar Scale scores improved during follow-up. Conclusion: The “rotational mapping method” provides a structured quantitative framework for designing preauricular incisions. The Rotational Mapping-Designed (RMD) approach serves as an effective adjunctive option for selected Zingg Type B/C ZMC fractures requiring direct visualization of the zygomatic arch, with favorable early safety and clinical outcomes.
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Metadata
- Authors
- Wu, S., Wang, Z., Zhang, C., Zhang, Y., Zhang, J., & Jing, W.
- Affiliations
- Sichuan University (CN)
- Corresponding author
- Zhang, Chi
- Zhang, Yi
- Zhang, Jiankang
- Jing, Wei
- Venue
- Journal of Craniofacial Surgery
- Published
- 2026-04-30
- ISSN
- 1049-2275 (ISSN-L)
- 1536-3732
- OpenAlex
- W7158502197
- Cited by
- 0
- References
- 1
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Craniofacial Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Facial Trauma and Fracture Management
- Health Sciences › Medicine › Surgery › Reconstructive Facial Surgery Techniques
- Health Sciences › Medicine › Surgery › Spinal Fractures and Fixation Techniques
- Keywords
- zygomatic fractures, preauricular incision, minimally invasive fracture fixation, open reduction, facial symmetry, incision length, scar assessment
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- Wu, S., Wang, Z., Zhang, C., Zhang, Y., Zhang, J., & Jing, W. (2026). Rotational Mapping-Designed Approach for Minimally Invasive Fixation of Zygomaticomaxillary Fractures: A Retrospective Study. Journal of Craniofacial Surgery. https://doi.org/10.1097/scs.0000000000012828
