Minimization of zygomatic complex fracture treatment.

The aims of this non-randomized prospective study were to establish and justify minimized therapy for zygomatic complex fractures. Fifty-two consecutive patients were examined and classified with conventional routine radiographs. Preoperative symptoms were recorded. Treatment of zygomatic fractures was by percutaneous hook reduction and miniplate fixation along the frontozygomatic suture. Exploration of the orbital floor was carried out only in cases of primary diplopia or comminuted fractures. Postoperatively, patients were followed for 12 months. Clinical and radiologic assessment of reduction was symmetric and stable in all cases. Preoperative symptoms disappeared completely except for sensitivity disturbance in five patients. Patients with no post-trauma diplopia did not develop eye motility disturbances or enophthalmos. The treatment of a zygomatic fracture is possible by the described technique. Exploration of the orbital floor is indicated only in cases of preoperative diplopia. Therefore, a patient with a zygomatic fracture and diplopia should be classified as having a orbitozygomatic fracture. In cases of comminuted fractures, exploration of the orbital floor remains mandatory.