{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T23:04:34Z","timestamp":1780095874986,"version":"3.54.0"},"reference-count":14,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"vor","delay-in-days":28,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Soonchunhyang University Research Fund"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Plast Surg"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Surgical approaches for zygomaticomaxillary complex (ZMC) fractures have evolved toward minimizing cutaneous incisions while maintaining adequate exposure. Conventional approaches for frontozygomatic fixation, such as lateral brow or transconjunctival incisions with lateral extension, may result in visible scarring or periocular complications. Building on previous transconjunctival techniques, we applied an independent upper eyelid transconjunctival incision as a non-cutaneous approach for frontozygomatic fixation in selected ZMC tripod fractures.<\/jats:p>\n                  <jats:p>This retrospective comparative study included 27 patients with unilateral ZMC tripod fractures, of whom 12 underwent non-scar fixation using an upper eyelid transconjunctival approach, and 15 underwent fixation through preexisting periorbital traumatic lacerations. The surgical strategy consisted of initial reduction and fixation via an intraoral approach, followed by selective additional fixation of the frontozygomatic region when residual step deformity or instability was present. Preoperative and 6-month postoperative computed tomography and three-dimensional photogrammetry were used to evaluate bony and soft tissue intermalar height differences.<\/jats:p>\n                  <jats:p>Preoperative intermalar height differences were comparable between groups. At 6 months postoperatively, both groups showed marked improvement, with bony differences of \u22120.2\u2009\u00b1\u20091.2\u2009mm and \u22120.4\u2009\u00b1\u20090.4\u2009mm, and soft tissue differences of 0.0\u2009\u00b1\u20090.6\u2009mm and \u22120.2\u2009\u00b1\u20090.7\u2009mm in the non-scar and control groups, respectively, with no clinically meaningful between-group differences. No clinically significant approach-related ophthalmic complications were observed.<\/jats:p>\n                  <jats:p>The upper eyelid transconjunctival approach is a reliable non-cutaneous option for frontozygomatic fixation in selected ZMC tripod fractures, providing adequate exposure and stable fixation without visible scarring.<\/jats:p>","DOI":"10.1055\/a-2875-5296","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T22:48:11Z","timestamp":1780094891000},"page":"234-240","source":"Crossref","is-referenced-by-count":0,"title":["Non-Scar Fixation Technique for Zygomaticomaxillary Complex Tripod Fracture Using Upper Lid Transconjunctival Incision"],"prefix":"10.1055","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3059-1334","authenticated-orcid":false,"given":"Han Gyu","family":"Cha","sequence":"additional","affiliation":[{"name":"Soonchunhyang University Bucheon Hospital, Soonchunhyang University, Korea","department":["College of Medicine, Department of Plastic and Reconstructive Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7690-778X","authenticated-orcid":false,"given":"Seo Koo","family":"Lee","sequence":"additional","affiliation":[{"name":"Soonchunhyang University Bucheon Hospital, Soonchunhyang University, Korea","department":["College of Medicine, Department of Plastic and Reconstructive Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6398-8242","authenticated-orcid":false,"given":"Joon Suk","family":"Bae","sequence":"additional","affiliation":[{"name":"Soonchunhyang University Bucheon Hospital, Soonchunhyang University, Korea","department":["College of Medicine, Department of Plastic and Reconstructive Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7865-5013","authenticated-orcid":false,"given":"Seung Min","family":"Nam","sequence":"additional","affiliation":[{"name":"Soonchunhyang University Bucheon Hospital, Soonchunhyang University, Korea","department":["College of Medicine, Department of Plastic and Reconstructive Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2966-9122","authenticated-orcid":false,"given":"Eun Soo","family":"Park","sequence":"additional","affiliation":[{"name":"Soonchunhyang University Bucheon Hospital, Soonchunhyang University, Korea","department":["College of Medicine, Department of Plastic and Reconstructive Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"issue":"06","key":"ref1","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1097\/01.scs.0000235111.92988.b2","article-title":"A retrospective analysis of 101 zygomatico-orbital fractures","volume":"17","author":"M Eski","year":"2006","journal-title":"J Craniofac Surg"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"171","DOI":"10.7181\/acfs.2022.00164","article-title":"One-point versus two-point fixation in the management of zygoma complex fractures","volume":"23","author":"K S Lee","year":"2022","journal-title":"Arch Craniofac Surg"},{"issue":"07","key":"ref3","doi-asserted-by":"crossref","first-page":"e605","DOI":"10.1097\/SCS.0000000000002050","article-title":"Optimal osteosynthesis in zygomatic complex fractures","volume":"26","author":"M K Rath","year":"2015","journal-title":"J Craniofac Surg"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1055\/s-2005-922855","article-title":"Transconjunctival approach to the zygomatico-frontal limb of orbitozygomatic complex fractures","volume":"21","author":"P R Langsdon","year":"2005","journal-title":"Facial Plast Surg"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1186\/s40463-019-0359-2","article-title":"Evaluation of one-point fixation for zygomaticomaxillary complex fractures using a three-dimensional photogrammetric analysis","volume":"48","author":"S Y Kim","year":"2019","journal-title":"J Otolaryngol Head Neck Surg"},{"issue":"07","key":"ref6","doi-asserted-by":"crossref","first-page":"2030","DOI":"10.1097\/SCS.0000000000005724","article-title":"Defining the zygomaticosphenoidal angle as a guide to anatomic zygomaticomaxillary complex fracture reduction","volume":"30","author":"B J De Ruiter","year":"2019","journal-title":"J Craniofac Surg"},{"issue":"01","key":"ref7","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1097\/SCS.0000000000010694","article-title":"Aesthetic approaches to zygomatic fracture management: Achieving optimal outcomes with minimal scarring","volume":"36","author":"G Saponaro","year":"2025","journal-title":"J Craniofac Surg"},{"key":"ref8","first-page":"265","volume-title":"Open Reduction and Internal Fixation of Zygomaticomaxillary Complex Fracture","author":"R Siy","year":"2017"},{"issue":"04","key":"ref9","doi-asserted-by":"crossref","first-page":"325","DOI":"10.5999\/aps.2018.00311","article-title":"Open reduction of zygoma fractures with the extended transconjunctival approach and T-bar screw reduction","volume":"45","author":"S H Song","year":"2018","journal-title":"Arch Plast Surg"},{"issue":"02","key":"ref10","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1097\/00006534-199002000-00006","article-title":"Toward CT-based facial fracture treatment","volume":"85","author":"P N Manson","year":"1990","journal-title":"Plast Reconstr Surg"},{"issue":"02","key":"ref11","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1097\/00006534-200202000-00069","article-title":"Stability of one-plate fixation for zygomatic bone fracture","volume":"109","author":"M Fujioka","year":"2002","journal-title":"Plast Reconstr Surg"},{"issue":"01","key":"ref12","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1097\/00006534-199007000-00004","article-title":"Zygomatic fractures: comparison of methods of internal fixation","volume":"86","author":"J Davidson","year":"1990","journal-title":"Plast Reconstr Surg"},{"issue":"04","key":"ref13","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1097\/SCS.0b013e3181e48607","article-title":"One-point fixation of tripod fractures of zygoma through a lateral brow incision","volume":"21","author":"K Hwang","year":"2010","journal-title":"J Craniofac Surg"},{"issue":"03","key":"ref14","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1097\/01.SCS.0000157308.39420.74","article-title":"Treatment of zygomatic fractures without inferior orbital rim fixation","volume":"16","author":"Y Yonehara","year":"2005","journal-title":"J Craniofac Surg"}],"container-title":["Archives of Plastic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2875-5296.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T22:48:24Z","timestamp":1780094904000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2875-5296"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":14,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2026,5,29]]},"published-print":{"date-parts":[[2026,5]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2875-5296","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2234-6163","2234-6171"],"issn-type":[{"value":"2234-6163","type":"print"},{"value":"2234-6171","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]}}}