RESEARCH ARTICLE
Treatment of Zygomatic Complex Fractures with Surgical or Nonsurgical Intervention: A Retrospective Study
Thomas Starch-Jensen1, *, Linda Busk Linnebjerg2, Janek Dalsgaard Jensen1
Article Information
Identifiers and Pagination:
Year: 2018Volume: 12
First Page: 377
Last Page: 387
Publisher ID: TODENTJ-12-377
DOI: 10.2174/1874210601812010377
Article History:
Received Date: 20/2/2018Revision Received Date: 12/4/2018
Acceptance Date: 12/4/2018
Electronic publication date: 21/5/2018
Collection year: 2018
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Objective:
Evaluate the 1-year treatment outcome of zygomatic complex fractures with surgical or nonsurgical intervention.
Materials and Methods:
One hundred and forty-two consecutive patients with a zygomatic complex fracture were enrolled. Sixty-eight patients underwent surgical intervention and 74 patients nonsurgical intervention. The 1-year examination evaluated cosmetic and functional outcome including malar symmetry, ocular motility, occlusion, mouth opening, neurosensory disturbances, and complications.
Results:
Forty-six patients allocated to surgical intervention responded to the 1-year follow-up examination. Satisfying facial contour and malar alignment was observed in 45 patients. All patients presented with identical position of the eye globe without enophthalmos and normal ocular movement. A habitual occlusion was seen in all patients with a mean interincisal mouth opening without pain of 49 mm. One patient presented with minor ectropion. Wound infection occurred in five patients. Persistent infraorbital neurosensory disturbance was described by 19 patients. The 1-year radiographic examination showed adequate fracture alignment in all patients with satisfying facial contour. However, dissimilar position of the orbital floor was seen in three patients having orbital reconstruction. None of the patients were re-operated or needed secondary correction of the zygomatic complex or orbital floor.
Conclusion:
Surgical intervention is an effective treatment modality of depressed zygomatic complex fractures, whereas a nonsurgical approach is often used for nondisplaced fractures. Most zygomatic complex fractures can be treated solely by an intraoral approach and rigid fixation at the zygomaticomaxillary buttress. Further exposure of the zygomaticofrontal junction or inferior orbital rim is necessary for severely displaced fractures, which require additional fixation.
