Zygomaticomaxillary fracture fixation: a prospective comparative evaluation of two-point versus three-point fixation

Zygomatic bone has a higher risk of sustaining injuries in the maxillofacial skeleton. On fracturing, zygomatic bone separates from the four neighbouring bones at its articulations. Treatment for zygomaticomaxillary fractures has evolved a long way since 3000 BC. With the advent of miniplates for midface fracture, controversies still exist regarding the stability of zygoma following 1, 2, and 3 points for fixation. The study aims to compare and determine the most effective technique for the reduction of zygomaticomaxillary fractures and the ability to retain the fractured zygoma in a stable position. Hence, a study was conducted in our institute to compare 2 and 3-point fixation of zygomaticomaxillary fractures taking into account the clinical and radiographic parameters.

Twenty-four patients were divided into 2 equal groups A and B, receiving 2- and 3-point fixation respectively. Fracture displacement and stability were assessed using coronal and axial CT scan tracings at preoperatively, immediate, and 5-week postoperatively.

Group B showed a significant reduction in postoperative mean displacement at sphenozygomatic and infraorbital region when compared with group A. Patients in group A had an increase incidence in vertical dystopia and enophthalmos. There was no postoperative displacement at any site in both the groups.

The fractured segment was held in place by both the fixation methods but 3-point fixation gave better stability in maintaining the fractured segment in desired reduced position.