Treatment of zygomatic fractures: a follow-up study of 105 patients

Abstract

One hundred and five patients with zygomatic fractures are presented. The main cause of the fracture was violence, followed by traffic accidents, fall and sport. In more than 25% of the cases, the fractures were accompanied by another fracture of the facial skeleton, viz maxillary, mandibular and nasal fractures. In severe cases of traffic accidents there were associated fractures in more than half of the cases. The follow-up study showed visible asymmetry of the face in 17 patients and sensory disturbances in 37 patients. We did not find the X-ray subdivision by Knight & North useful in the evaluation of the stability of the fractures. As a method of choice in cases of dislocated zygomatic fractures, we used reposition by the method of Gillies and in cases of instability this reposition was combined with internal wiring, reconstruction of the orbital floor and antral packing. An active attitude towards reconstruction of the orbital floor is recommended.

Correlation between clinical findings and CT-measured displacement in patients with fractures of the zygomaticomaxillary complex

“…In the literature the incidence of posttraumatic sensory disturbances following fractures of the zygomaticomaxillary complex is reported to be between 31% and 94% (De Man and Bax, 1988;Lund, 1971;Champy et al, 1986;Nordgaard, 1976;Zachariades et al, 1990;Vriens and Moos, 1995;Zingg et al, 1992;Schotland and Spiessl, 1980;Kristensen and Tveterås, 1986;Finlay et al, 1984;Ellis et al, 1985;Wiesenbaugh, 1970;Winstanley, 1981;Balle et al, 1982). Postoperatively, no significant differences in regaining sensibility were found.…”

The Gillies procedure in the treatment of zygomatic fractures and dislocations

“…Like most authors [4,14,16,23,26,27,33,44], for the treatment of a zygoma fracture and/or dislocation initially the simple closed reduction was performed.…”

“…This is more than in the comparable literature. Zingg [46] reported 10% minor and 1.3% major asymmetry, Balle [4] 10.7%, and Kristensen [26] described 11.5% of the cases of malar flattening after a simple reduction. Because most of the authors did not specify the way asymmetry was scored a real comparison cannot be made.…”

“…Various classifications as Knight and North [25], Rowe and Dilley [38] and the classification modified by Yanagisawa [45] have led to a better understanding of the nature of the zygomatic fractures. However, from a practical point of view most of them proved to be of little value to predict instability [4,26,28].…”

“…During the last few years a closed reduction is more favored by most authors [4,14,16,23,[26][27][28]33].…”