Management of Zygomatic Complex Residual Deformity Due to War in Iraq

Abstract

Since March 20, 2003, maxillofacial surgeons in Iraq encounter several trauma cases, part of which are zygomatic residual deformities that result from conventional war, civil unrest, crimes, and car explosions. This study aimed to determine the relationship between etiological factors and severity of posttraumatic zygomatic residual deformity and to investigate methods of surgical repairs, treatment modalities, and any complications that may have occurred during this critical time in Iraq. There were a total of 40 patients with posttraumatic deformity of the zygoma included in this study. Records of these patients (29 men and 11 women) who have been treated in the maxillofacial unit of a specialized surgery hospital (Medical City Hospital, Baghdad) between 2006 and 2011 were collected. Of all patients, 28 (70%) had injuries from missile whereas 12 patients (30%) had injuries from other causes (aggressive social behavior). According to the causes of delayed treatment, 30 patients (60%) were untreated previously (15 patients [50%] of them had delay because severe comminution, severe damage, or loss of the overlying soft tissue; 3 patients [10%] were undiagnosed; and 12 patients [40%] had treatment delayed as a result of major damage to other body parts or medical condition), 3 patients (30%) had improper reduction, and 7 patients (70%) had improper fixation. Our definitive treatment was as follows: 13 patients (32.5%) were treated by osteotomy, 10 patients (25%) were treated by onlay bone graft, 14 patients (35 %) were treated by both methods, and 3 patients (7.5%) were untreated. [corrected] We recommend that every surgeon who deals with residual deformity should clinically evaluate the residual deformity.