Changing patterns in the epidemiology and treatment of zygoma fractures: 10-year review.

A ten year retrospective review of 259 zygoma fractures is presented to highlight changes in epidemiology and treatment. Motor vehicle-related trauma resulted in a majority of the injuries (80.6%), with a high incidence of multiple facial fractures (43.2%). The number of zygomatic and other facial fractures decreased over the duration of the study (by 50.0% and 20.1%, respectively, p < 0.05), perhaps reflecting lowered speed limits and the increased use of seat belts. The proportion of fractures receiving open reduction and internal fixation (ORIF) remained relatively constant (46.3%). At present, miniplate fixation is the preferred surgical treatment, accounting for 61.5% of cases in 1988 and 1989. There was a trend toward the use of multiple fixation sites and more frequent use of the lateral maxillary buttress (20.0% increase over the study period). The need for orbital floor exploration decreased by almost half, possibly reflecting improved preoperative radiologic evaluation. Despite the recent popularity of cranial bone grafting for facial reconstruction, silicone rubber was the preferred material for orbital floor repair (59.6% of cases). Although overall surgical complications were few (1.5%) there was a high incidence of associated ocular injuries (36.3%).