Management of Zygomaticomaxillary Complex Fractures in Children

Zygomaticomaxillary complex (ZMC) fractures in children can lead to severe aesthetic and functional complications, including pronounced facial asymmetry, visual impairment, associated ophthalmic injuries. The management of ZMC fractures in pediatric patients presents unique challenges. This article verified the feasibility of using absorbable plate through intraoral approach in the reduction and fixation of ZMC fractures in children.

The operation was performed through the intraoral maxillary sulcus incisions. The 3D printed prototype and repaired models were used intraoperatively. The tooth germs in the maxilla were revealed by fenestration on the models. Collapsed fracture segments were reduced and fixed with absorbable plates at the infraorbital margin and upper end of the zygomatic alveolar ridge.

The patient's facial appearance was restored after the surgery. The postoperative CT showed good alignment of the fracture segments. The drilling holes at the zygomatic alveolar ridge were located outside the tooth germs region.

The intraoral maxillary sulcus incision is suitable for treating ZMC fractures in children with Knight and North Group Ⅲ zygomatic fractures. Stable reduction can be achieved by using absorbable plates at the inferior orbital margin and the upper end of the zygomatic alveolar ridge. The 3D printed model with tooth germs revealed can provide practical reference value.