Classification and treatment of orbitozygomatic and orbitoethmoid fractures. The place of bone grafting and plate fixation

Abstract

The classification of orbitozygomatic fractures is presented, and, using this, a decision can be made as to when to examine the fracture with CT scans and how to decide on employing a coronal approach for exposure. Three-point fixation is advocated using wires and miniplates. All portions of the fracture should be stabilized. In this way, the complications of enophthalmos, diplopia, dystopia, and flattening of the nose and cheek may be avoided. The method of treating late deformity resulting from orbitozygomatic and orbitoethmoid fractures is presented, stressing wide exposure, good fixation of osteotomies with miniplates, and cranial bone grafting to reduce orbital volume and correct enophthalmos.