Refining Operative Indications for Zygomaticomaxillary Complex Fracture Repair

Area of Science:

• Oral and Maxillofacial Surgery
• Trauma Surgery
• Radiology

Background:

• Zygomaticomaxillary complex (ZMC) fractures are common facial injuries.
• Optimal management strategies for ZMC fractures remain debated.
• Pre-operative imaging is crucial for assessing fracture severity and guiding treatment.

Purpose of the Study:

• To analyze the correlation between CT-derived displacement measures and clinical symptoms in ZMC fractures.
• To enhance surgeon understanding of operative intervention necessity based on imaging.
• To provide objective data for surgical decision-making in ZMC fracture management.

Main Methods:

• Retrospective analysis of 95 patients with ZMC fractures (2015-2020).
• Inclusion of patient demographics, CT characteristics, and surgical indications.
• Statistical analysis to correlate radiographic findings with symptomatology and surgical need.

Main Results:

• Lateral maxillary wall impaction and anterior-posterior displacement correlated with malar flattening/facial asymmetry.
• Infraorbital rim step-off linked to lateral maxillary wall impaction.
• Specific displacement thresholds (posterior > 2.5 mm, lateral > 4.5 mm) significantly increased operative likelihood, while total displacement < 15 mm decreased it.

Conclusions:

• CT imaging characteristics reliably predict symptom development and surgical intervention needs for ZMC fractures.
• These findings can aid surgeons in making informed decisions for ZMC fracture management.
• Objective radiographic criteria can standardize surgical indications for ZMC fractures.