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Introduction
Zygomatic or Malar bone fractures are (2 nd most
common) after nasal bone fractures among facial
skeletal Injures. 1,2 The high incidence of these fractures
may probably be attributed to the fact that Zygoma’s
occupy an anatomically prominent position within the
facial skeleton which frequently exposes it to traumatic
forces. The prominent convex shape of the zygoma
makes it vulnerable to traumatic injury. Even minimally
displaced zygomatic-complex fractures can result in
functional and aesthetic deformities. All traumas to the
face, particularly above the level of the mouth, require
a careful ocular examination including an estimation
of visual acuity of each eye, and zygomatic-complex
fractures are frequently complicated by injury to the orbit
and eye adnexae, which are the most serious negative
outcomes of zygomatic complex fractures. 3
Patients and Methods
Information for the study was gathered from patient
records and a self-administrated patient questionnaire
over a period of six months from 10-1-2005 to 20-
7-2005. Fifty patients, who had sustained zygomaticcomplex
fractures were examined clinically, radiographicaly,
and also underwent orthoptic investigations.
A written informed consent was obtained from the
patient or attendant. The treatment of fractures was done
by standard methods of reduction and fixation. Data
was analyzed in statistical program for social sciences
(SPSS) version 11.0. The frequency and percentage
was computed for qualitative variables, like gender,
etiologies, pattern and management modalities. Mean±
standard deviation was computed for qualitative
Variables, like age. Ethical approval was gained from the
local research ethics.
Results
The results of this study were described in sequence of
the objectives. Detailed description of separate results is
shown in figures and tables.
Discussion
The zygomatic complex gives the cheek prominence, and
it is the second most common mid-facial bone fractured
after the nasal bone and, overall, represents 13% of
craniofacial fractures. 4 Zygomatic complex fractures are
almost always associated with fractures of the floor of the
orbit. Typically, a fracture line extends from the inferior
orbital fissure antero-medially along the orbital process
of the maxilla, toward the infra-orbital rim.
Fifty patients attended with zygomatic complex fractures
over a six months period. The age of the patients ranged
from 17 to 75 years. Seventy six percent of patients were
male, and the mean and median ages were (32.3; 30.5)
for males, and (33.4; 30.5) for females respectively. The
male to female ratio was 3:1 as shown in table 1.
Age
Range
Number
of patient
Male Female Total
%
Number
of patient
Assault was the major cause of zygomatic complex
fractures, (35 patients [70%]), and the second most
common cause was sport (8 patients [16%]). The
majority of assault cases were in the 24-28 age groups.
This corresponds with results in comparable studies 5-8 as
shown in figure 1.
Of the patients who required surgical intervention,
8 (16%) were treated within 4-7 days and 19 (38%)
in 8-13 days. In 23 patients (46%) surgery was not
undertaken until 14 days. The reasons for this may
include allowing the oedema and ecchymosis to settle
and for the general condition of the patients to improve 9
as shown in figure 2.
We also evaluated the site of injury to whether it was
left-side or right, and compared this to aetiology of the
fracture. There was a statistically significant difference
between aetiologies and sites of injuries with left side
%
Total
number of
patient
14-18 4 8 0 0 4 8
19-23 2 4 2 4 4 8
24-28 12 24 4 8 16 32
29-33 5 10 1 2 6 12
34-38 6 12 2 4 8 16
39-43 4 8 1 2 5 10
44-48 3 6 0 0 3 6
Over
48
2 4 2 4 4 8
Total 38 76 12 24 50 100
(Table 1) Age and sex of study group
16
14
12
10
8
6
4
2
0
14-18
19-23
24-28
29-33
34-38
39-43
(Fig. 1) Aetiology by age distribution
44-48
Over 48
%
Total
Others
Industrial
Road Trafic
Accident
Sport
Fall
Assault
Smile Dental Journal | Volume 6, Issue 4 - 2011| 33 |