Quantitative Comparison of Open Reduction and Internal Fixation versus the Gillies Method in the Treatment of Orbitozygomatic Complex Fractures
Bibliographic record
Abstract
BACKGROUND: Precise repair of orbitozygomatic complex fractures is essential for proper re-establishment of facial symmetry, ocular globe position, and infraorbital nerve function. Controversy regarding the optimal treatment method remains. METHODS: To compare uniform study groups, only patients without previous craniofacial injuries or operations who had sustained moderate-energy orbitozygomatic complex fractures, based on preoperative computed tomography scans, and who were treated using the Gillies repair or open reduction and internal fixation were selected. Quantifiable end-points, including orbitozygomatic complex position, ocular globe projection, and infraorbital nerve function, were measured to objectively compare the accuracy of repair produced by the Gillies procedure and open reduction and internal fixation. Negative sequelae resulting from cutaneous access were tabulated. RESULTS: Overall, 12 patients treated using the Gillies repair and 12 treated with open reduction and internal fixation were examined. The results demonstrated that the open reduction and internal fixation technique produces superior realignment of the orbitozygomatic complex, that is, a smaller difference in the position of the orbitozygomatic complex between the injured and noninjured sides of the face. The differences in orbitozygomatic complex projection, height, and lateral position were 1.4 mm, 1.4 mm, and 1.6 mm, respectively, in the open reduction and internal fixation group and 7.5 mm, 5.6 mm, and 4.1 mm in the Gillies group. The p values were 0.0003, 0.01, and 0.06, respectively. Visible cutaneous scarring was present in four patients and lower lid shortening was seen in three patients treated using open reduction and internal fixation. CONCLUSIONS: To the authors' knowledge, this is the first study to objectively show that the open reduction and internal fixation technique results in superior positioning of the orbitozygomatic complex in moderate-energy orbitozygomatic complex fractures compared with the Gillies repair. Although negative sequelae from surgical access were substantial, recently introduced transconjunctival and upper lid blepharoplasty incisions will minimize these drawbacks.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".