Some aspects of zygomaticomaxillary fractures

Early diagnosis and treatment of zygomaticomaxillary fractures are essential. From results obtained in the treatment of 500 patients with fractures of the zygomaticomaxillary complex it was concluded that insertion of an implant on the orbital floor through an infra-orbital incision can be avoided. This procedure is seldom indicated, and has to be reserved for some old untreated fractures. However, it may also be indicated for young children with a blow-out fracture of the orbital floor (solitary or as part of a zygomaticomaxillary fracture). In these cases an approach through the maxillary sinus, as commonly used in adults, will result in injury or removal of the dental germs, which are still localized high in the maxilla. The possible cause of a blow-out fracture of the orbital floor (traumatic lesion of the infra-orbital margin) is discussed with reference to recent literature and to a number of patients, including a boy aged 7 1/2 years.