抄録
Among maxillofacial fractures, zygomatic and zygomatic arch (ZZA) fractures are treated by multiple clinical departments, which makes it more difficult to fully characterize ZZA fractures compared to maxillary and mandibular fractures. Clinical statistical reports on ZZA fractures have not been published from oral and maxillofacial surgery institutions in the past 20 years. This study aimed to analyze the characteristics of patients with ZZA fractures by examining general matters such as injury causes and fracture sites, and also by introducing a visual assessment method using superimposed fracture lines.
This study included 112 patients with ZZA fractures who visited our department between January 2008 and December 2017. Medical records and radiographic images were reviewed to investigate sex, age, injury causes, fracture types, associated fractures, symptoms, treatment methods, and operation timing. Additionally, fracture lines from the 112 cases were superimposed on standardized diagrams to evaluate fracture patterns. The superimposition was performed by simplifying fracture lines into straight lines and mapping them onto anterior and lateral views of the craniofacial skeleton.
The mean age was 47.3 years, with a male-to-female ratio of 2.5:1. According to Knight and North’s severity classification, type Ⅲ fractures were the most common. Fractures involving the zygomaticotemporal (75 cases), zygomaticofrontal (68 cases), and zygomaticomaxillary (37 cases) sutures were observed in this order. Complex fractures involving the maxilla were observed in 79.5% of cases, while 12.5% showed concurrent mandibular fractures. The leading causes of injury were traffic accidents (42.9%) and falls (31.3%). In patients aged 65 years and older, falls accounted for 66.7% of cases. Superimposed evaluations revealed that maxillary fracture lines tended to be more vertical than horizontal, with horizontal fractures varying in their position from upper to lower regions. Mandibular fractures predominantly occurred in the body and upper ramus regions, while no fractures were observed in the angle region.
This study clarified that ZZA fractures occur less frequently at the zygomaticomaxillary suture than other sutures, that patterns of associated maxillary fracture are diverse, and that 20.8% of traffic accident cases are accompanied by mandibular fractures. Additionally, falls were identified as the primary cause of injury among elderly patients. These findings provide valuable insights into the characteristics of ZZA fractures.
