Reduction of zygomaticomaxillary complex fractures with elevator and modified wire and screw: A case report

Zygomaticomaxillary complex (ZMC) fractures can lead to significant facial asymmetry due to displacement of the zygomatic bone. Its management is challenging because of the complex 3D structure and difficult surgical access to the ZMC. This case report evaluates the combination of elevator and modified wire and screw technique to treat ZMC fractures displacement with facial asymmetry.

A 31-year-old male patient was referred to the emergency room with complaints of pain, swelling on the right face, and facial asymmetry after a motorcycle accident. Anamnesis revealed that the patient is not under medication nor has systemic diseases. Physical examination demonstrated facial asymmetry, oedema, raccoon eyes, paraesthesia, and signs consistent with ZMC fracture. The patient underwent a CT scan, and a displaced ZMC fracture was found. The patient underwent ORIF 3-point fixation to stabilize the zygomaticomaxillary complex fractures mechanically. Elevator and modified wire and screw were used to reduce the fractured fragment and restore the anatomical position of the zygoma. Postoperative follow-up demonstrated a restored midfacial symmetry, improved ocular motility, and high patient satisfaction, with minimal complications.

The modified elevator, wire and screw combination technique offers a solution for the management of complex ZMC fractures, especially those involving rotational deformity in medial rotational fractures. The use of screws and wires is effective in cases of ZMC group IV with controlled strength.

Combination of elevator and modified wire and screw technique is effective in restoring anatomical facial symmetry and functional recovery in the management of ZMC fracture.