Fractures of the Zygomaticomaxillary Complex

Abstract

Fractures of the Zygomatico Maxillary complex result in cosmetic deformity as well as functional deficits such as altered vision, restricted mouth opening and paresthesia. Accurate restitution of the form and function of the ZMC is challenging because of its multipoint- articulation within the cranio facial skeleton and the difficulty involved in intra-operative assessment of reduction at all articulations. Management of ZMC fractures is unique; (1) The approaches used for reduction may be different from those for fixation (2) Lack of complete visualization of fracture predisposes to over or under reduction resulting in sub optimal outcomes (3) Philosophies of fixation and stabilization are numerous and debatable. With advancements in the imaging technology, armamentarium and refinement of approaches to fracture, there is an emerging trend towards achieving utmost precision in reduction and fixation with minimally invasive surgical principles. This chapter aims at elaborating the biodynamics of ZMC fractures, the evolution of various techniques for reduction and fixation along with their rationale and finally the cutting-edge technology in management of fractured ZMC.