Retrospective Analysis On Changing Norms in Zygomatic Maxillary Complex Fractures.

Abstract

The zygomaticomaxillary complex fracture is unique and difficult to treat fracture, mostly because of its pentapod anatomic form which may necessitate a patient-specific treatment approach. This retrospective study aims at evaluating the changing trends in ZMC fractures. A total of 245 cases were included in this retrospective study, treated either surgically or conservatively, for ZMC fractures in the time period of 3 years (2017-2019). All the patients were assessed and compared based on these parameters- gender, age, aetiology, anatomic site of the fracture and type of treatment given and associated maxillofacial fractures. Fracture aetiology was segregated into: motorised road traffic accidents, road traffic accidents under the influence of alcohol, interpersonal violence, domestic violence, sports injury and self falls. 94.3% of the 245 study participants were men, while 5.7% were women. The most common age group was 21 to 40 years (60.8%). In our study, the most common cause of Zygomatic fracture was road traffic accidents with or without the influence of alcohol (41.6%). ORIF - 3 point fixation (32.7%) was the most commonly used treatment, followed by 4 point fixation (27.3%). The Maxillary buttress region was the most frequent site of fracture (93.5%), followed by the other sites. Due to the shifting patterns of injuries, most surgeons no longer see conventional fracture lines. Instead, patients have unusual and hybrid fracture lines, which necessitate more fixations due to the injury's complexity. The tendency is now shifting toward tailoring treatment choices for individual patients.