Etiology and pattern of zygomatic complex fractures: a retrospective study.

PURPOSE: To document the etiology and clinical data of patients with fractures of the zygomatic complex seen in two university teaching hospitals in Nigeria and to compare the findings with other studies in the literature.

PATIENTS AND METHODS: A six-year retrospective study involving 134 patients with zygomatic complex fractures. These patients were selected from a pool of 960 patients who sustained maxillofacial fractures during the period under review. Recorded were demographic, etiologic and clinical data as well as radiologic findings, treatment and postoperative complications. The Chi-squared test was used to test for significance and p values < 0.05 were regarded as significant.

RESULTS: 76.1% were males and 23.9% females. Most (46.3%) patients were aged 21-30 years and road traffic accidents (82.1%) caused the most injuries (p < 0.05). Regarding the site of fracture, 88.8% of the patients had fractures of the zygomatic bone, 8.2% had fractures of the arch, and 3.0% had fractures of both the zygomatic bone and arch. The most frequently associated maxillofacial fracture was mandibular (21.0%). The commonest clinical feature was subconjunctival ecchymosis (63.4%), while the commonest radiologic findings were fractures at the zygomatico-frontal and zygomatico-maxillary sutures (38.8%). The Gillies approach (23.4%) was the commonest method of reduction.

CONCLUSION: This study has shown that road traffic accidents are responsible for most zygomatic complex fractures in our environment. Urgent enforcement of road traffic legislation is therefore necessary to minimize zygomatic complex fractures due to road traffic accidents. It also showed a low utilization of technological advances in the imaging and treatment of these fractures. These may play a role in the frequency of postoperative complications.