Evaluation of treatment of zygomatic bone and zygomatic arch fractures: a retrospective study of 10 years

Abstract

Objective: The aim of this study was to investigate the treatment of zygomatic bone and zygomatic arch fractures without other facial fractures.

Patients and methods: A 10 year (2000-2010) retrospective study involving 310 patients admitted and treated for zygomatic bone and zygomatic arch fractures at the department of oral and maxillofacial surgery was done. The data collection protocol included: age, gender, site, type of fracture. Other data presented included clinical diagnosis, radiographic examination findings as well as preoperative and postoperative imaging for evaluation of the fracture. Descriptive statistics was performed with SPSS version 16.

Results: The ages of the patients ranged from 10 to 76 years old, mean age was 32.33 years. 237(80.6%) of the patients were males and 73 (19.4%) were females (Table 1). According to the site of fracture, the patients were divided into three groups: group A, with zygomatic bone fracture, group B with zygomatic arch fracture and group C with co-existing zygomatic bone and zygomatic arch fracture. Regarding the site of fracture 57.7% of the patients had fractures of the zygomatic bone, 13.8% had fractures of the zygomatic arch and 28.4% had fractures of both zygomatic bone and zygomatic arch. [Table: see text] The treatment of both fractures was: closed reduction for isolated zygomatic arch fractures; open reduction and internal rigid fixation through a coronal incision was performed in comminuted arch fractures and displaced fractures.

Conclusion: In this study, the majority of the patients were young adult men; road traffic accidents were the leading cause of fractures. According to the site of fracture, various modalities of treatment were used and all the patients achieved satisfactory results without any complications after operation.

Keywords: Evaluation; Fracture; Treatment; Zygomatic arch.

Fig. 1

Preoperative view of different patients with zygomatic bone and arch fracture: a axial CT scan demonstrating a segmental fracture of zygomatic arch left side, b a coronal CT scan demonstrates the fronto-zygomatic bone and orbito-zygomatic bone fracture

Fig. 2

Preoperative view of patient with zygomatic bone fracture: a before operation showing asymmetry of the face of patient, b preoperative 3D-CT view of zygomatic bone fracture and c The postoperative 3D- reconstructed CT image showing fixation with screws and miniplates of zygomatico maxillary complex

Fig. 3

CT scan view: a before operation, b after operation showing anatomic reduction and fixation of fracture using screws and miniplates

Fig. 4

Hemi-coronal approach of zygomatic arch fracture: a preoperative design, b exposition and reduction of the fracture, c fixation using miniplates and screws