Associated Injuries Are Frequent and Severe Among Geriatric Patients With Zygomatico-Orbital Fractures

Abstract

Associated injuries (AIs) are hypothesized to be frequent in geriatric zygomatico-orbital (ZMO) fractures. The study aim was to determine the relation between ZMO fractures and AIs in geriatric patients compared with younger adult patients. A retrospective case-and-control study was carried out on geriatric patients at least 65years of age (n=93) and younger adult patients 20 to 30years of age (n=68) diagnosed with pure unilateral ZMO fractures. The main exposure was age, the primary outcome was AI outside the face, and the secondary outcomes were type and severity of AI, ocular injuries, restriction of mandibular movement, and ZMO buttress asymmetry. The confounding variables were gender, trauma mechanism, type of ZMO fracture, and dislocation. Statistical analyses included χ2 tests, risk evaluation with 2×2 tables, and logistic regression analysis. AIs outside the face, and particularly brain injuries, were significantly more frequent in the geriatric group than in the control group (P<.001). The significant predictors of AIs outside the face were fall from a height (66.7%), motor vehicle accidents (66.7%), and absence of ZMO dislocation (59.5%; P<.001). The adjusted risk of brain injury was 2.5-fold in the absence of dislocation. The geriatric group had a more than 5-fold higher risk of brain injuries compared with the younger control group (P=.003). AIs in general, and particularly brain injuries, are frequent in geriatric ZMO fractures. Intracranial injuries should be ruled out, particularly in geriatric patients diagnosed with a non-dislocated ZMO fracture.