Introduction: Zygomaticomaxillary complex (ZMC) fractures are among the most common maxillofacial injuries due to its prominent position and buttress anatomy of the zygoma. The zygoma articulates with multiple facial bones, and fracture patterns typically involve disruption of these articulations, now termed pentapod fractures. ZMC fractures affect facial contour, orbital integrity, and masticatory function, making accurate diagnosis and management essential. Young adult males are most commonly affected, with road traffic accidents and assaults being the leading causes. Computed tomography is the gold standard for diagnosis and surgical planning, guiding the extent of intervention. Open reduction and internal fixation remains the preferred treatment for displaced fractures, with ongoing debate regarding optimal fixation points, including the use of microplates to reduce morbidity. Material & Methodology: A total of 56 patients meeting the inclusion criteria were enrolled in the study, and informed consent was obtained from all participants prior to surgery. The patients were randomly divided into two equal groups of 28 each. Group A underwent two-point fixation using microplates at the zygomaticomaxillary buttress and frontozygomatic region. Group B underwent three-point fixation using microplates at the zygomaticomaxillary buttress, frontozygomatic region, and infraorbital rim. Result: We found that postoperative facial assessement are better in three-point fixation also postoperative complications are minimal in three-point fixation. Based on this study, open reduction and internal fixation using three-point fixation using microplates is sufficient and best available treatment of choice for the management of zygomaticomaxillary complex fracture. Discussion: The zygomaticomaxillary complex (ZMC) is crucial for facial structure and aesthetics and is frequently involved in maxillofacial trauma. In this study, 56 patients were randomly assigned to two-point or three-point fixation groups. Group B demonstrated superior facial aesthetics at 1 week (p = 0.041) and 12 weeks (p = 0.05), and significantly greater postoperative mouth opening at all follow-ups (1 week p = 0.012; 4 weeks p < 0.001). Intraoperative stability was comparable between groups (p = 0.217), and overall complication rates showed no statistically significant difference. Microplates provided stable fixation with improved esthetics due to their low profile. Overall, three-point fixation yielded better functional and aesthetic outcomes.
Introduction: Zygomaticomaxillary complex (ZMC) fractures are among the most common maxillofacial injuries due to its prominent position and buttress anatomy of the zygoma. The zygoma articulates with multiple facial bones, and fracture patterns typically involve disruption of these articulations, now termed pentapod fractures. ZMC fractures affect facial contour, orbital integrity, and masticatory function, making accurate diagnosis and management essential. Young adult males are most commonly affected, with road traffic accidents and assaults being the leading causes. Computed tomography is the gold standard for diagnosis and surgical planning, guiding the extent of intervention. Open reduction and internal fixation remains the preferred treatment for displaced fractures, with ongoing debate regarding optimal fixation points, including the use of microplates to reduce morbidity. Material & Methodology: A total of 56 patients meeting the inclusion criteria were enrolled in the study, and informed consent was obtained from all participants prior to surgery. The patients were randomly divided into two equal groups of 28 each. Group A underwent two-point fixation using microplates at the zygomaticomaxillary buttress and frontozygomatic region. Group B underwent three-point fixation using microplates at the zygomaticomaxillary buttress, frontozygomatic region, and infraorbital rim. Result: We found that postoperative facial assessement are better in three-point fixation also postoperative complications are minimal in three-point fixation. Based on this study, open reduction and internal fixation using three-point fixation using microplates is sufficient and best available treatment of choice for the management of zygomaticomaxillary complex fracture. Discussion: The zygomaticomaxillary complex (ZMC) is crucial for facial structure and aesthetics and is frequently involved in maxillofacial trauma. In this study, 56 patients were randomly assigned to two-point or three-point fixation groups. Group B demonstrated superior facial aesthetics at 1 week (p = 0.041) and 12 weeks (p = 0.05), and significantly greater postoperative mouth opening at all follow-ups (1 week p = 0.012; 4 weeks p < 0.001). Intraoperative stability was comparable between groups (p = 0.217), and overall complication rates showed no statistically significant difference. Microplates provided stable fixation with improved esthetics due to their low profile. Overall, three-point fixation yielded better functional and aesthetic outcomes.