Rigid internal fixation of zygoma fractures: A comparison of two-point and three-point fixation

Background: Displaced fractures of the zygomatic bone can result in signi›cant functional and aesthetic sequelae. Therefore the treatment must achieve adequate and stable reduction at fracture sites so as to restore the complex multidimensional relationship of the zygoma to the surrounding craniofacial skeleton. Many experimental biophysical studies have compared stability of zygoma after one, two and three-point ›xation with mini plates. We conducted a prospective clinical study comparing functional and aesthetic results of two-point and three-point ›xation with mini plates in patients with fractures of zygoma. Materials and Methods: Twenty-two patients with isolated zygomatic fractures over a period of one year were randomly assigned into two-point and three-point ›xation groups. Results of ›xation were analyzed after completion of three months. This included clinical, radiological and photographic evaluation. Results: The three-point ›xation group maintained better stability at fracture sites resulting in decreased incidence of dystopia and enophthal os. This group also had better malar projection and malar height as measured radiologically, when compared with the two-point › xation group. Conclusion: We recommend three-point rigid ›xation of fractured zygoma after accurate reduction so as to maintain adequate stabilization against masticatory forces during fracture healing phase.