Factors affecting pattern of zygomatic arch fractures in patients with Craniofacial trauma: An institutional study in a teritiary care hospital

Abstract

Facial trauma deserves prompt attention because of its enormous functional and cosmetic importance. Aim of the study was to study the causes and treatmentof patients admitted with Zygomatic fractures and to evaluate the pattern for surgicaltreatment . To highlight on the indications for closed and open reduction. Material and Methods: This is a prospective study which was done on 32 patients over a period of 20 months. Patients with isolated zygomatic fractures, both sexes and all age groups were included. Results: This study encompassed a total number of 32 patients with Zygoma fractures 30(96.15%) patients were Male and 2 (3.85%) patients were Female with Male to Female ratio of 26:1. Most common age group involved in this study was 20-30years (57.69%). Most common risk factors identified in this study was Road traffic accidents which accounted for majority of the cases (83%) followed by interpersonal violence cases (10%) and accidental falls (7%). In our study out of 32 Zygomatic bone fractures. The most prevalent fractures were on right side. In our study the commonest presenting feature is subconjuctival haemorrhage (92%) followed by circum orbital echymossis (90%), Trismus (61%), malar flattening (60%) and numbness in the infra orbital nerve distribution (5%). In our study 18 patients underwent closed reduction by Gilles method and 10 patients underwent open reduction and internal fixation with miniplates and screws. 2 patients were treated with both Gilles elevation and ORIF. Zygomatic Arch fractures were 18 and Zygomatic comlex fractures were 12 Single point fixation was done in 17 patients at Zygomaticomaxillary buttress and 3 patients had 2 point fixation at ZygomaticoMaxillary and Zygomatico Frontal sutures. Single point fixation in the ZM area in Zygomatic complex fractures can avoid unsightly scars and give high satisfaction with surgical outcomes in selected patients with fracture displacement. Conclusion: It was concluded that the high frequency of Zygomatic fractures due to RTA in our population highlights the need for the strict enforcement of traffic rules and regulations. In view of the avoidable morbidity and mortality due to inadequate treatment, we advocate the establishment of regionalized, efficient, and focused trauma centers in various parts of the state particularly for acute trauma