EARLY AND DELAYED REPAIR OF ORBITOZYGOMATIC COMPLEX FRACTURES

Purpose: The goal of this study was to review experience with early an d delayed repair of orbitozygomatic complex fractures and develop guid elines for repair based on timing and extent of injury. Patients and M ethods, Records of patients with orbitozygomatic complex fractures ove r a 10-year period were reviewed for cause of injury, signs and sympto ms, length of time from injury to repair, and method of repair, Result s were evaluated by office examination and telephone interviews at lea st 6 months to 10 years after surgery. Results: Seventy-eight patients who had undergone 81 surgical procedures were analysed, The series co nsisted of 49 primary repairs (1 to 22 days postinjury), 10 delayed re pairs using osteotomies at 21 days to 5 months postinjury: and 22 dela yed repairs requiring onlay bone grafting from 4 months to 16 years po stinjury. Forty patients (43 procedures) were available for follow-up, Early surgical intervention dramatically improved esthetic and functi onal outcomes, whereas late repair was less satisfactory, Hypoesthesia was not improved by surgery. Osteotomy and onlay grafting techniques were necessary for delayed treatment. Conclusion: Orbitozygomatic frac tures can be repaired up to 21 days postinjury using primary reduction and fixation techniques, Osteotomies are required after 21 days and c an be used successfully up to 4 months postinjury, After 4 months, suc cessful repair requires onlay bone grafting.