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Bradley et al. Plast Aesthet Res 2019;6:11 Plastic and
DOI: 10.20517/2347-9264.2019.06 Aesthetic Research

Original Article Open Access

Surgical management of zygomatic complex
fractures in a major trauma centre

Daniel Bradley , Billy Leung , Shobhit Saxena , Mohammed Dungarwalla , David Chapireau , Kathleen
2
1
2
1
1
Fan 2
1 Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London SE1 1UL, United Kingdom.
2 Department of Oral & Maxillofacial Surgery, King’s College London Hospital NHS Foundation Trust, London SE5 9RS, United
Kingdom.
Correspondence to: Dr. Daniel Bradley, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London SE1
1UL, United Kingdom. E-mail: drdanielrobinbradley@hotmail.com
How to cite this article: Bradley D, Leung B, Saxena S, Dungarwalla M, Chapireau D, Fan K. Surgical management of zygomatic
complex fractures in a major trauma centre. Plast Aesthet Res 2019;6:11. http://dx.doi.org/10.20517/2347-9264.2019.06

Received: 27 Jan 2019 First Decision: 21 Apr 2019 Revised: 28 Apr 2019 Accepted: 16 May 2019 Published: 24 May 2019
Science Editor: Raúl González-García Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Aim: To analyse the epidemiology, aetiology, and surgical management of zygomatic complex (ZMC) fractures
in our major trauma centre, and to compare the number and location of fixation points and surgical access in our
patient cohort with the literature.

Methods: Retrospective analysis of all operative cases (Open Reduction and Internal Fixation) of zygomatic complex
fractures over a one year period (2016).

Results: A greater proportion of patients in our cohort (54%) were treated with one-point fixation compared to the
literature, with the zygomaticomaxillary (ZM) buttress being the most popular fixation point (90%). ZM buttress
and frontozygomatic (FZ) suture were the commonest choices for two-point fixations (70%). Buccal sulcus incision
was used for ZM access in all cases. For FZ access, upper blepharoplasty incision was the most common (56%).
For infra-orbital margin access, transconjunctival incision was the most common (75%). There was no significant
association between number of fixation points and presence of associated injuries, impact of injury, or time to
operation. There were no post-operative complications.

Conclusion: A greater proportion of patients in our cohort were successfully treated with one point fixation compared
to the literature, and fewer patients underwent orbital floor exploration and repair in our cohort compared to the
literature. This study highlights the ongoing variation in the surgical management of ZMC fractures.

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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