SPECTRUM AND MANAGEMENT OF ISOLATED ZYGOMATICOMAXILLARY COMPLEX FRACTURES- A RETROSPECTIVE REVIEW FROM A TERTIARY CARE HOSPITAL IN PUNJAB, INDIA

Abstract

Introduction - Zygoma forms a centrolateral bony prominence of midface. The contour of the cheek, midface width and height are attributed to the normal anatomy of this bone along with its articulation with surrounding bones. Injury to zygoma is common and its management has various options. We planned to retrospectively study the spectrum of zygomatic fractures presenting to our tertiary care hospital and to enumerate the various types of treatments given to them. This study was retrospectively planned to study the epidemiology of patientsMaterial and methods- who presented to hospital from January 2015 to December 2019 and were diagnosed with isolated Zygomaticomaxillary Complex (ZMC) fractures. The type and clinical features of zygoma fractures, CT ndings, Indications, Surgical or Non Surgical treatment given to them and timing of surgery were enumerated. Post operative complications like enopthalmos, diplopia, scarring were recorded. A total number of 320 patients were found to have isolated Zygoma fractures duringResults- the duration of these 5 years. Males outnumbered females in this study group. Road trafc accident was the most common etiology followed by assault. Tetrapod fracture was reported in 288 patients (p<0.005). Most of the surgeries were done between 3 to 7 days of injury. Most common surgical procedure done was Open reduction and internal xation with titanium miniplates. Post operative residual enopthlomos was seen in 10 patients, diplopia in 5 patients, scleral show in 4 patients. There was not a single plate infection reported and 92.5 % patients were satised with the aesthetic recovery. ClinicalDiscusion- features, radiological ndings along with intraoperative ndings play an important role in deciding fracture management of different parts of ZMC fracture. Besides isolated arch fracture and undisplaced low velocity ZF fractures, all other sites need open reduction and internal xation for maintaining strong lateral midface buttress and orbital anatomy. WeConclusion- concluded that surgical management and approach should be customized for each patient, the decision of which can be reached following a stair case approach pre and intra operatively.