Traditional wire fixation for zygomaticomaxillary complex fracture (ZMC fracture) using Kirshner wire and soft wire became obsolete following the advent of the plate fixation technique. Titanium plates, the gold standard treatment for facial fractures, have the advantages of strength and handling; however, they remain permanently in the body as foreign materials. On the other hand, absorbable materials are useful for spontaneous resolution and do not require additional surgery for removal. However, absorbable plates may result in insufficient fixation for unstable ZMC fractures due to insufficient strength and stiffness. We performed hybrid fixation using absorbable plates and transmalar Kirschner wire for unstable ZMC fractures, and examined 53 patients (38 with absorbable plate fixation and 15 with hybrid fixation) . A preoperative diagnosis of unstable ZMC fracture is important for hybrid fixation. Three situations should be evaluated: deviation of zygomatic frontal sutures, multiple fractures of the zygomatic arch, and comminuted condition at the plate fixation point. Hybrid fixation using traditional transmalar wire in combination with absorbable plates is useful for unstable ZMC fractures as it provides additional fixation and facilitates the procedure.
