Virtual surgical planning and three-dimensional printing for the treatment of comminuted zygomaticomaxillary complex fracture.

Objective: the objective of the study is to evaluate the interest of advanced computer technology, including virtual surgical planning, three-dimensional modeling and pre-bended titanium plate and mesh in the treatment of comminuted zygomaticomaxillary complex fractures.

Material And Methods: A total of 19 patients were included. In the study group (n=6) surgery was combined with preoperative planning including mirroring and bending of the titanium plates and mesh on a 3D model. In the control group (n=13) plates and mesh were bended on the patient during the surgery. Patient characteristics, clinical outcomes, orbital volumes, zygoma projection and complications were recorded.

Results: After surgery, the orbital volume and the zygoma projection variations between injured side and unaffected side were compared. Orbital volume variation was 2.1mL [1.5; 4.0] in the control group and 0.4mL [0.1; 1.0] in the study group. Zygoma projection variation was 0.2cm in the control group and 0.1cm in the study group. Orbital volume restoration (P=0.004) and zygoma symmetrisation (P=0.04) were significantly better when titanium plates and meshes were pre-bent on a stereolithographic model.

Conclusion: This study confirms the interest of surgical planification using 3D models to improve treatment of midface trauma.