Background and objectives : A zygomatic fracture is one of the most common types of maxillofacial injuries. A lot of controversies are present regarding the surgical approaches, reduction and amount of fixation needed in repairing such fractures. The outcome of repair of high energy fractures had been studied.
Methods : Only high energy zygomatic fractures were included in the study (10 cases of total 60 zygomatic fractures). Preoperative and postoperative assessment of diplopia, enophthalmos and malar eminence malposition was done with registration of timing of repair, surgical access, fixation points and use of bone graft.
Results : 100% of cases had preoperative enophthalmos and malar eminence malposition and no case has diplopia. 90% of cases had three points fixation and 10% had four points fixation and all needed orbital reconstructions. 10% of cases had postoperative enophthalmos and malar eminence malposition and one patient had diplopia postoperatively. The early postoperative complication rate was 40% and late complication rate was 10%.
Conclusions : Meticulous multiple sites open reduction (specially the lateral orbital wall) with multiple points fixations (at least three points) and simultaneous orbital reconstruction provide the best aesthetic and functional results of repairing high energy zygomatic fractures.
Key words : high energy zygomatic fracture; orbital reconstruction