Early and delayed repair of orbitozygomatic complex fractures.
OBJECTIVE
The goal of this study was to review experience with early and delayed repair of orbitozygomatic complex fractures and develop guidelines for repair based on timing and extent of injury.


METHODS
Records of patients with orbitozygomatic complex fractures over a 10-year period were reviewed for cause of injury, signs and symptoms, length of time from injury to repair, and method of repair. Results were evaluated by office examination and telephone interviews at least 6 months to 10 years after surgery.


RESULTS
Seventy-eight patients who had undergone 81 surgical procedures were analyzed. The series consisted of 49 primary repairs (1 to 22 days postinjury), 10 delayed repairs using osteotomies at 21 days to 5 months postinjury, and 22 delayed repairs requiring onlay bone grafting from 4 months to 16 years postinjury. Forty patients (43 procedures) were available for follow-up. Early surgical intervention dramatically improved esthetic and functional outcomes, whereas late repair was less satisfactory. Hypoesthesia was not improved by surgery. Osteotomy and onlay grafting techniques were necessary for delayed treatment.


CONCLUSIONS
Orbitozygomatic fractures can be repaired up to 21 days postinjury using primary reduction and fixation techniques. Osteotomies are required after 21 days and can be used successfully up to 4 months postinjury. After 4 months, successful repair requires onlay bone grafting.
Carr
R M
RM
Department of Otolaryngology-Head and Neck Surgery, Wayne State University, Detroit, MI, USA.
Mathog
R H
RH
D000293:Adolescent; D000328:Adult; D000368:Aged; D016025:Bone Transplantation; D002648:Child; D004954:Esthetics; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods; D006801:Humans; D006987:Hypesthesia / Q000601:surgery; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009917:Orbital Fractures / Q000145:classification / Q000503:physiopathology / Q000601:surgery*; D010027:Osteotomy / Q000379:methods; D010347:Patient Care Planning; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D015051:Zygomatic Fractures / Q000145:classification / Q000503:physiopathology / Q000601:surgery*