Facial Asymmetry After Management of Unilateral Zygomaticomaxillary Complex Fractures Using Two-Point Fixation Technique

Abstract

Background: It is crucial to correctly identify and treat zygomatic bone injuries because of the zygoma's functional and aesthetic importance in the face contour. Zygomatic fractures can cause disfigurement, which necessitates operation to restore face symmetry. Objective: To evaluate the facial asymmetry after management of unilateral zygomaticomaxillary complex fracture using a two-point fixation technique. Patients and Methods: This study was conducted on 20 patients with unilateral zygomaticomaxillary complex (ZMC) fractures managed by a two-point fixation technique. The zygomaticomaxillary (ZM) buttress was used as a key point of fixation through an intra-oral approach for all patients and either the infraorbital rim (IOR) or the frontozygomatic (FZ) suture area was used as a second point of fixation. Radiographic assessment of the computed tomography (CT) scans was done by measuring the malar width, malar projection, and malar height on the fracture side and the normal side both preoperatively and postoperatively after 1 week and after 1 month. The asymmetry index comparing the normal side with the fracture side was measured both preoperatively and postoperatively. Results: The difference between preoperative and 1-week, 1-month postoperative malar width and malar projection was highly significant, while the malar height difference wasn't significant. The asymmetry index decreased significantly postoperatively by 1 week and 1 month by using the 2-point fixation technique. Conclusions: Stable fixation results and adequate aesthetic outcomes can be obtained by using the 2-point fixation technique in the management of ZMC fractures.