Zygomatic and orbitozygomatic fractures

RESUMO

Zygomatic fractures may cause major inconveniences for patients both functionally and esthetically. Orbitozygomatic fractures are characterized chiefly by involvement of the orbit, and they often lead to some ocular dysfunction. Zygomatic fractures, on the other hand, correspond chiefly to damage to the zygoma with anatomic involvement of the orbit. With the objective of rationalizing the treatment of zygomatic fractures, this paper suggests a classification based on the experience of treating and following-up 148 cases for at least three months in the Instituto da Face, in São Paulo, Brazil. Etiology of the trauma, gender, age,direction of the vector, time after the fracture and the presence of functional changes were taken into consideration. Fractures were classified as type I (51 cases or 34 percent), type II (59 cases or 40 percent) and type III (38 cases or 26 percent). Type I fractures were treated with transcutaneous reduction, and 48 cases (94 percent) evolved with good projection of the zygoma. Fractures types II and III underwent direct reduction with visualization of the fracture line, and 55 cases (92 percent) and 34 cases (89,5 percent) evolved, respectively, with good projection of the zygoma.