ISOLATED ZYGOMATIC BONE FRACTURE

MANAGEMENT BY THREE POINT FIXATION

Abstract

Introduction: Facial bones injuries results in functional disturbances. Patients
may presents with flattening of normal malar prominence, lid drop, eye movement limited or
with double vision, numbness of cheek area and unilateral epitasis. Emphasizing upon incision
type, fixation method and occasionally reconstruction, surgeons suggest different methods for
repairing complex fractures of Zygoma. Study Design: Descriptive study. Setting: Department
of Oral & Maxillofacial Surgery, Liaquat University of Medical & Health Sciences, Jamshoro.
Period: Mar 2013 to Feb 2014. Materials and methods: Total 20 patients were included.
Patients with fracture more than 28 days old were excluded. Zygomatic bone can be approached
by lateral brow or subcilicary incisions and by subgingival buccal sulcus approach. When 3
fracture sites were reduced and aligned satisfactorily, application of miniplates was performed
at 3 points frontozygomatic suture, Zygomatico maxillary buttress and infraorbital rim, wound
were closed in 2 layers. At 2nd week follow-up patients were assessed for outcome. Results:
There were 14 male and 6 female patients. Most were of age <25 years. 45% fractures were
due to RTA. Duration of fracture of 2 patients was 2 days, 7 days of 11 patients, 4 patients had
14 days and 3 patients had 28 days. 5 fractures were reduced using Gilies temporal approach,
6 with Keen approach, 4 with Hook approach and 5 with Dingman approach. Preoperatively,
17 patients had facial asymmetry, 19 had limited mouth opening and postoperatively this was
reduced to 6 cases each for facial asymmetry and limited mouth opening. Conclusion: It
is concluded from this study that three point fixation is most effective and safe method for
reduction of fracture of Zygomatic bone.