# New Innovation: Custom Titanium Zygomaticomaxillary Complex (ZMC) Plate for Facial Reconstruction

## TL;DR

A custom titanium plate was successfully used to reconstruct a patient's facial bones after a severe gunshot injury when standard methods were not possible.

## Contribution

The paper introduces a novel application of a custom-made alloplastic implant for complex ZMC fractures with bone loss.

## Key findings

- A custom spanning plating system was successfully implanted in a patient with complex ZMC fractures.
- The patient recovered well without complications after the custom plate implantation.
- Standard plating methods were not feasible due to the extent of bone destruction.

## Abstract

Zygomaticomaxillary complex (ZMC) fractures typically result from traumatic injuries, such as motor vehicle-related incidents, assaults, falls, and sports-related injuries. These fractures characteristically occur along suture lines where the zygomatic bone borders the frontal bone, maxilla, temporal bone, and sphenoid bone, resulting in a “tetrapod” fracture pattern that can be surgically fixated utilizing one, two, and three-point plate and screw fixation. However, fractures with complete loss of bone stock are less common, and standardized methods of fixation are not suitable for such complex fractures. Here, we present an interesting case of implantation of a custom-made alloplastic implant in a patient with complex ZMC fractures with loss of bone stock. A 52-year-old male sustained a traumatic gunshot wound to the face, resulting in significant destruction of bones involving the left orbital floor, left lateral orbital wall, and left zygomatic arch. Routine plating was not feasible, so a custom spanning plating system by DePuy Synthes (Synthes USA Products, LLC, West Chester, PA) was designed using the patient’s CT scans. The patient recovered well with no complications. This case illustrates the successful application of patient-specific custom plates for complex ZMC fractures when standard plating methods are not suitable.