Surgical Management of Malunited Zygomaticomaxillary Complex Fracture: A Case Report
Keywords:
Zygomaticomaxillary complex fracture, Zygomaticomaxillary complex fracture, Facial asymmetry, Facial asymmetry, Rigid internal fixation, Rigid internal fixation, Frontozygomatic suture, Frontozygomatic suture, Malunion correction, Malunion correction, Maxillofacial trauma, Maxillofacial traumaAbstract
Introduction: The zygomaticomaxillary complex (ZMC) is a critical structural component of the midface, contributing to both facial aesthetics and function, particularly in maintaining orbital integrity. Fractures of the ZMC are common in high-impact trauma, such as road traffic accidents, and can lead to significant cosmetic and functional deficits if not managed appropriately.
Case Presentation: An 18-year-old male presented to the Department of Oral and Maxillofacial Surgery with complaints of facial asymmetry and restricted mouth opening following a road traffic accident 20 days prior. Clinical and radiographic examination revealed a frontozygomatic suture fracture, infraorbital rim fracture, and malunion of the zygomatic arch. Surgical correction was carried out using a lateral brow incision, intraoral vestibular approach, and a stab incision over the arch. The malunited segments were re-fractured, anatomically reduced, and fixed with titanium miniplates.
Discussion: Accurate diagnosis, surgical planning, and proper access to fracture sites are crucial for optimal results in ZMC fracture management. Literature supports multi-point fixation and emphasizes minimal scarring with intraoral approaches. Surgical expertise and tailored treatment plans significantly influence functional and aesthetic outcomes.
Conclusion: Timely intervention with appropriate surgical techniques can effectively restore facial symmetry and function in ZMC fractures. Rigid fixation using miniplates and strategic incisions offers a reliable approach to managing complex malunited midfacial injuries.
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References
Solanki R, Goel M, Mohan J, Bawane R, Tanwar R. Management of zygomaticomaxillary complex fracture: A case report. Int J Enhanc Res Med Dent Care. 2024 Mar;11(3):23-25.
Kumar A, Manas A, Singh D, Dhar S, Verma AK, Yadav P. Two point fixation in ZMC fracture – A case report. Int J Drug Res Dent Sci. 2020;2(2):3–7. doi:10.36437/ijdrd.2020.2.2.O
Salles LDS, Brito WF, Menezes VCB, Magalhães HT, Silva AHA. Zygomatic complex fracture: case report. J Case Rep Clin Images. 2019;2(1):1030.
Sasankar S, Kolhe S, Singh S, Potdukhe A. Case report on management and complications of zygomaticomaxillary complex (ZMC) fracture. Int J Early Child Spec Educ. 2022;14(5):4491–4494. doi:10.9756/INTJECSE/V14I5.534
Fonseca R.J, Walker R.V.W. Oral and maxillofacial trauma. 2nd ed. St. Louis: WB Saunders. 1997. 2980.
Gomes PP, Passeri LA, Barbosa JR. A 5-year retrospective study of zygomatico-orbital complex and zygomatic arch fractures in Sao Paulo state, Brazil. J Oral Maxillofac Surg 2006; 64:63-7.
Kim JH, Lee JH, Hong SM, Park CH .The Effectiveness of 1-Point Fixation for Zygomaticomaxillary Complex Fractures: ArchOtolaryngol Head Neck Surg. 2012;138(9):828 832.
Vatsa R, Priyadarshini P, Singh A.D.B. Comparison of One Point Fixation Versus Two Point Fixation in the Treatment of Zygomatico Maxillary Complex Fractures. Int Health c Res J 2018; 2(9):229-234. doi: https://doi.org/10.26440/ihrj.v2i9.177
Yamamoto K, Murakami K, Sugiura T, Fujimoto M, Inoue M, Kawakami M, et al. Clinical analysis of isolated zygomatic arch fractures. J Oral Maxillofac Surg 2007;65:457-61.
Parashar A, Sharma R K, Makkar S .Rigid internal fixation of zygoma fractures: A comparison of two-point and three-point fixation :Indian J PlastSurg January-June 2007 Vol 40 Issue 1
JiSY, KimSS, Kim MH, Yang WS. Surgical Methods of Zygomaticomaxillary Complex Fracture: Arch CraniofacSurg Vol.17 No.4, 206-210.
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