Surgical management of zygomatic complex fractures in a major trauma centre

Abstract

Aim: To analyse the epidemiology, aetiology, and surgical management of zygomatic complex (ZMC) fractures in our major trauma centre, and to compare the number and location of fixation points and surgical access in our patient cohort with the literature. Methods: Retrospective analysis of all operative cases (Open Reduction and Internal Fixation) of zygomatic complex fractures over a one year period (2016). Results: A greater proportion of patients in our cohort (54%) were treated with one-point fixation compared to the literature, with the zygomaticomaxillary (ZM) buttress being the most popular fixation point (90%). ZM buttress and frontozygomatic (FZ) suture were the commonest choices for two-point fixations (70%). Buccal sulcus incision was used for ZM access in all cases. For FZ access, upper blepharoplasty incision was the most common (56%). For infra-orbital margin access, transconjunctival incision was the most common (75%). There was no significant association between number of fixation points and presence of associated injuries, impact of injury, or time to operation. There were no post-operative complications. Conclusion: A greater proportion of patients in our cohort were successfully treated with one point fixation compared to the literature, and fewer patients underwent orbital floor exploration and repair in our cohort compared to the literature. This study highlights the ongoing variation in the surgical management of ZMC fractures.

Management of Multiple Maxillofacial Fracture With Mild Head Injury

“…Although maxillofacial fractures rarely require immediate surgical intervention, accompanying structural brain injuries are often a surgical emergency. 1,2,3,4,5 Facial trauma often causes injury to soft tissues, teeth, bone components including mandible, maxilla, zygoma, ethmoid naso-orbital complex and supraorbital. Facial fractures vary in their severity, some involves one bone or several complex bones, depending on the force degree on the facial.…”

“…Radiographic examination is very essential in studying and evaluating a fracture. 2,5,6 Anatomically, the head is divided into the skull (cranium) and the facial bones. The skull bones consist of the calvary bones and the skull base bones, while the facial bones consist of the maxilla, zygoma, lacrimal, nasal, and vomer bone.…”

“…These bones are interconnected and support each other to form the skeleton of the head, so that when a fracture occurs in the midfacial area, several bones that form the cranial base, such as the sphenoid, frontal and ethmoid, are often involved. 1,2,4 Maxillofacial fractures cannot be separated from head injuries because of their adjacent location and structures. Patients of maxillofacial fractures are often accompanied by head injuries, such as intracranial hemorrhage, skull base fractures and decreased consciousness which can result in damage to the central nervous system.…”

Fracturas maxilofaciales tratadas quirúrgicamente: experiencia de 3 años de un hospital cubano

“…The patterns of MFT have been studied in different countries, such as Colombia 2 , Brazil 3,6 , Chile 7 , China 8,9 , United States 10 , Ethiopia 11 , India [12][13][14][15] , Iran 16 , Mexico 17 , Malaysia 18 , Nigeria 19 , United Kingdom 20 , Sudan 21 , and Romania 22 . However, few published Cuban articles are available analyzing the epidemiology and management of MF fractures in general [23][24][25][26] .…”

Zygomatico-Maxillary Complex Fracture Fixation: How Much Is Enough?

“…Due to the architectural form of the zygomatic bone, it generally can withstand great forces of trauma without fracturing, though inadvertently it tends to fractures at its articulations [3]. Contrary to the previously believed idea of the zygomatic complex fracture as a tripod fracture, the currently perceived notion is that it is a tetrapod fracture [4].…”