3. Zygomatico-maxillary complex fractures: A retrospective study on etiology, pattern and management

Abstract

Abstract:The aim of the study was to record the etiology, pattern and management of zygomatico-maxillary complex (ZMC) fractures seen in two centres in Mysore and to compare the findings with other studies in literature. A fifteen year retrospective study involving 123 patients with ZMC fractures were selected from a pool of 219 patients who sustained maxillofacial fractures during the period under study. The age distribution, gender distribution, etiology, associated injuries, associated maxillofacial fractures, clinical features, distribution of radiographic investigation, radiographic findings associated with ZMC Fractures, pattern of fractures and various modalities of management and surgery were recorded. In this study, 86.17% were males and 13.83% females. Most (39.02%) patients were aged 21-30 years. There was highly significant association between road traffic accidents and ZMC fractures. (Chi square value 291.512, P < 0.001). The most frequently associated maxillofacial fracture was nasal bone fracture (28.45%). Circumorbital edema was the commonest clinical feature (88.61%); Keene's approach was the commonest method of zygoma elevation (78%). Two point internal fixation was commonly used (46.83%). Among two point fixation, frontozygomatic suture and zygomatico-maxillary suture were commonly plated (64.86%). Among one point internal fixation, zygomatico-maxillary suture was most commonly plated (40.74%). This study has shown that road traffic accidents have been responsible for most of the ZMC fractures in our geographical area and two point fixation at zygomatico-maxillary suture and fronto-zygomatic suture has been the commonest method of fixation and Keene's approach has been the choicest method for elevation of zygoma.