Surgical approaches and fixation patterns in zygomatic complex fractures

Area of Science:

• Oral and Maxillofacial Surgery
• Trauma Surgery
• Orthognathic Surgery

Background:

• Zygomatic complex (ZC) fractures are common facial injuries.
• Effective surgical treatment requires careful consideration of approaches and fixation methods.
• Minimizing scarring while ensuring adequate reduction and fixation is crucial.

Purpose of the Study:

• To analyze surgical approaches and rigid fixation methods for zygomatic complex fractures over a decade.
• To evaluate the efficacy of different surgical techniques in treating ZC fractures.
• To identify optimal surgical strategies based on fracture characteristics.

Main Methods:

• Retrospective analysis of 153 patients with ZC fractures (1999-2008).
• Data collected included demographics, fracture signs/symptoms, classification, surgical approaches, and fixation methods.
• Statistical analysis included descriptive statistics and chi-test (P < 0.05).

Main Results:

• The mean patient age was 31 years, with a male predominance (82.3%).
• Single surgical approaches were used in 60.1% of cases; two approaches in 24.8%.
• Zygomaticomaxillary buttress fixation was most common (86.9%), followed by infraorbital rim and zygomaticofrontal fixation. Significant correlations were found between fracture displacement and infraorbital rim/zygomaticofrontal suture approaches (P < 0.0001).

Conclusions:

• The intraoral zygomaticomaxillary buttress approach is the preferred initial treatment for ZC fractures to minimize scarring and ensure adequate fixation.
• For fractures with displacement exceeding 5 mm, approaches to three or four points of the ZC are necessary for reduction.
• Infraorbital rim and zygomaticofrontal suture approaches are indicated for displaced ZC fractures.