Three-point fixation of displaced tripod zygomaticomaxillary complex fracture: a modified surgical technique

Displaced tripod zygomaticomaxillary complex (ZMC) fractures are generally treated with open reduction and 3-point rigid internal fixation at the frontozygomatic suture, zygomaticomaxillary buttress, and inferior orbital rim. However, a clinical dilemma still exists in the postoperative morbidities such as ectropion of the lower eyelid and palpability of the Ti-plate at the inferior orbital rim area. In this study, we describe a modified3-point fixation method through the lateral eyebrow and gingival-buccal sulcus incisions in one displaced tripod ZMC fracture case. Open reduction and rigid internal fixation at frontozygomatic suture, zygomaticomaxillary buttress and sphenozygomatic suture was performed and good repositioning of the zygoma was achieved. No obvious complication was recorded during the 24-month follow-up. Although further investigation on this technique might be needed, this report illustrated the feasibility and treatment advantages of our modified method in selective displaced tripod ZMC fracture cases.