title: Zygomaticomaxillary complex fractures and their association with naso-orbito-ethmoid fractures:  a 5-year review.
abstract: BACKGROUND
  Zygomaticomaxillary complex fractures associated with ipsilateral naso-orbito-ethmoidal fractures are more complex injuries than isolated zygomaticomaxillary complex fractures. This injury pattern can have significant long-term morbidity if not recognized and treated appropriately during the initial operation. The purpose of this study is to compare mechanisms of injury, treatment, and outcome between patients with zygomaticomaxillary complex fractures and those with zygomaticomaxillary complex and ipsilateral naso-orbito-ethmoidal fractures.
  
  
  METHODS
  A 5-year retrospective review of all patients treated with zygomaticomaxillary complex fractures at a level I trauma center was performed. Computed tomographic scans were reviewed to divide patients into those with zygomaticomaxillary complex fractures alone and those with zygomaticomaxillary complex and ipsilateral naso-orbito-ethmoidal fractures. Demographics, treatment protocols, outcomes, complications, reoperations, and length of follow-up were identified for both groups and compared to determine differences between these populations.
  
  
  RESULTS
  A total of 245 patients were identified by the Current Procedural Terminology codes for zygomaticomaxillary complex fractures. One hundred eighty-five patients had zygomaticomaxillary complex fractures and 60 patients had zygomaticomaxillary complex/naso-orbito-ethmoidal injuries. The demographics for both populations were similar. There are differences between the groups with regard to mechanism of injury, operative findings, and techniques. The patients with zygomaticomaxillary complex/naso-orbito-ethmoidal fractures had higher rates of postoperative complications and deformities.
  
  
  CONCLUSIONS
  Patients who sustain a zygomaticomaxillary complex fracture associated with an ipsilateral naso-orbito-ethmoidal fracture have a higher incidence of postoperative complications and deformities. It is important to recognize this fracture pattern early to help minimize postoperative morbidity.
  
  
  METHODS
  Risk, II.
authors.affiliation: Seattle, Wash. From the Division of Plastic Surgery, Harborview Medical Center.
authors.forename: Edward P
authors.initials: EP
authors.lastname: Buchanan
authors.forename: Richard A
authors.initials: RA
authors.lastname: Hopper
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Suver
authors.forename: Austin G
authors.initials: AG
authors.lastname: Hayes
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Gruss
authors.forename: Craig B
authors.initials: CB
authors.lastname: Birgfeld
mesh_terms: D000328:Adult; D005004:Ethmoid Bone / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008440:Maxillary Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D008446:Maxillofacial Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D009104:Multiple Trauma / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D009917:Orbital Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012887:Skull Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014861:Washington / Q000453:epidemiology; D015051:Zygomatic Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000601:surgery