Single-Point Fixation for Noncomminuted Zygomaticomaxillary Complex Fractures-A 20-Year Experience

Area of Science:

• Oral and Maxillofacial Surgery
• Trauma Surgery
• Facial Reconstruction

Background:

• Zygomaticomaxillary complex (ZMC) fractures are common facial injuries.
• Optimal surgical management, specifically the number of fixation points for open reduction and internal fixation (ORIF), lacks clinical consensus.
• Noncomminuted ZMC fractures present a specific challenge in determining the most effective fixation strategy.

Purpose of the Study:

• To evaluate the efficacy and outcomes of single-point fixation in managing noncomminuted ZMC fractures.
• To assess the complication rates associated with this minimally invasive fixation technique.
• To contribute to the understanding of surgical options for ZMC fracture repair.

Main Methods:

• Retrospective case series analysis of 211 patients treated over a 20-year period.
• Focus on 162 patients with noncomminuted ZMC fractures treated with single-point fixation at the zygomaticomaxillary buttress.
• Data collection included follow-up assessments of surgical outcomes and complications.

Main Results:

• A mean follow-up of 3.4 months was recorded.
• Low incidence of complications: 1 tooth loss, 7 intraoral plate exposures (2 requiring revision), and 8 wound infections.
• No cases required orthognathic surgery, cheek implants for asymmetry, hypoglobus, or enophthalmos, and no revision ORIF was necessary.

Conclusions:

• Single-point fixation of the zygomaticomaxillary buttress is a safe and effective surgical option for noncomminuted ZMC fractures.
• This study represents the largest series to date reporting outcomes for this specific fixation method.
• With careful surgical consideration, single-point fixation can be a viable approach in experienced surgical hands.