Efficacy of Two-Point Versus Three-Point Fixation for Zygomaticomaxillary Fractures: A Systematic Review and...

Area of Science:

• Oral and Maxillofacial Surgery
• Plastic Surgery
• Trauma Surgery

Background:

• Zygomaticomaxillary complex (ZMC) fractures are common midface injuries.
• Management of ZMC fractures is debated, with various fixation techniques available.
• Optimal fixation strategy, including the number of fixation points, remains unclear.

Purpose of the Study:

• To systematically review and meta-analyze existing literature on ZMC fractures.
• To compare the efficacy of two-point versus three-point fixation for ZMC fractures.
• To determine if two-point or three-point fixation is a superior treatment option.

Main Methods:

• Systematic review and meta-analysis following PRISMA guidelines.
• Literature search of PubMed, Google Scholar, and Ebsco Host (2000-2023).
• Included studies reporting outcomes of two-point and three-point fixation for ZMC fractures, analyzed using standardized mean difference (SMD) with a random-effect model.

Main Results:

• Eleven studies were included for qualitative synthesis; eight were suitable for meta-analysis.
• The pooled estimate (SMD: -0.21) favored two-point fixation, but with high heterogeneity (I²=89%, p=0.51).
• Publication bias was noted, with asymmetric funnel plot distribution.

Conclusions:

• Both two-point and three-point fixation are equally effective in treating ZMC fractures.
• Two-point fixation is as efficient as three-point fixation for managing ZMC fractures.
• Further research may be needed to resolve heterogeneity and confirm findings.