Evaluation of Facial Asymmetry Following Zygomaticomaxillary Complex Fracture Reduction Using Two-Point Versus Three Point Fixation

Abstract

BackgroundWas to evaluate the degree of facial asymmetry after ZMC fracture reduction with two point fixation in comparison to three point fixation. Methods: Retrospective study was done on patients reported to the Department of Oral & Maxillofacial Surgery Cairo University. for evaluation and management of ZMC fracture from 2021 to 2023. 24 eligible patients were included: Twelve patients received 2point fixation at zygomaticofronal and zygomaticomaxillary buttress region. (Group A). Twelve patients received 3-point fixation at zygomaticofronal, zygomaticomaxillary buttress and additional fixation was done in the infraorbital region. (Group B) Facial asymmetry was evaluated using zygomatic complex projection (ZCP) comparison on both sides & comparison between the location of the most prominent point of the zygoma, malar eminence (ME) to establish mid-facial symmetry, before and after surgery in both groups. Results: For facial asymmetry index measurements in Group (A) the Mean value was 5.63±1.365 preoperatively then reduced to 2.28±0.432 postoperatively showing highly statistical significant decrease (P ≤ 0.05).For facial asymmetry index measurements in Group (B), the Mean value was 4.68±1.102 preoperatively then reduced to 2.36±0.498 postoperatively showing highly statistical significant decrease (P ≤ 0.05). When the two groups were compared to each other's, the variations between them regarding mean of ZCP and facial asymmetry were statistically non-significant (P ≤ 0.05) pre & post operatively. Conclusion:Fractured ZMC can be managed successfully using 2 or 3 point fixation with improved postoperative facial symmetry results. Both surgical techniques showed similar results yet with fewer surgical incisions in 2 points fixation group.