TREATMENT AND CONSEQUENCES OF 345 ZYGOMA COMPLEX FRACTURES

Abstract

BACKGROUND The zygoma complex fracture is common injury of the middle facial skeleton. Moderntreatment of zygoma complex fractures includes open reposition and fixation with titanium mini plates. The purpose of our study was to analyse the postoperative complicationsand consequences of zygoma complex fractures treated between 1999 and 2003 in theClinical Department of Maxillofacial and Oral Surgery at University Clinical Centre inLjubljana. We hypothesised that the longer the time between injury of zygoma complexand treatment the bigger the chance for the injury to the infraorbital nerve. Another hypothesis was that the outcome of the treatment is dependent upon the surgical approach. METHODS There were 345 patients treated at the Clinical Department for Maxillofacial and OralSurgery because of the zygoma fractures between 1999 and 2003. Different surgicalmethods were used. The data were obtained retrospectivelly, pre- and postoperativeimages were assesed. At least 2-year follow-up was taken in account. All patients were sentthe questionnaire about their sensitivity of the infraorbital nerve. The data were revised bysimple statistics for mean values and standard deviations and ANOVA statistics for regression analysis with linear, multiple regression, hystogram, Chi-squared tests. RESULTS Between observed 345 patients men were predominant in 80 %, the average age was 38.2years, more than 65 % of patients were between 20 and 65 years old. The most commoncauses of zygoma complex fractures in Slovenian population are traffic accidents in 26 %and assaults in 22 %; sports accidents had increased in this period. The mean timebetween the injury and surgery was 9 days, but the part of operated patients in first weekafter fracture had significantly increased in observed period. Treatment by closed reposition decreased from 59 % in 1999 to 17 % in 2003. The operative complications as bleedingand infections were extremly rare, but the infraorbital nerve injury was present in 31 % ofpatients, but mostly in less extent as before treatment. The risk for injury of the infraorbitalnerve is 1.8 times bigger if time between the injury and treatment is longer than 8 days. CONCLUSIONS The best results of treatment come with a short time between the injury and surgical treatment. There is a statistical significant reduction of the injuries of the infraorbiral nervewhen using an open reposition and fixation with titanium miniplates, where one can seethe infraorbital nerve and decompress it if neccessary. We also found out that the risk forthe injury of the infraorbital nerve is correlated to the age of the patient, being 2 % biggerfor each year of the patient