Comparison of 1-point fixation with 2-point fixation in treating tripod fractures of the zygoma.

PURPOSE: Zygomatic tripod fracture is relatively common and generally requires open reduction-internal fixation through several incisions. However, lateral eyebrow incisions have sometimes left unsightly scars, and thus we have used 1-point fixation through a buccogingival incision so as not to leave scars in selected cases. The aim of this study was to compare 1-point fixation in the zygomaticomaxillary (ZM) area with 2-point fixation in the ZM and frontozygomatic (FZ) areas in tripod fractures. MATERIALS AND METHODS: This study is retrospective and was approved by the institutional review board of our hospital. From November 2005 to March 2010, 30 patients were enrolled in this study. We investigated 14 patients with 1-point fixation in the ZM area (group 1), 1 of whom had bilateral tripod fractures, and 16 patients with 2-point fixation in the ZM and FZ area (group 2). We postoperatively checked for 1) unfavorable scars; 2) bony movement, pain, and palpability in the FZ area; 3) satisfaction with surgical outcomes; 4) presence or absence of surgeries for plate removal; and 5) anxiety about no fixation of the FZ area. RESULTS: Of 16 patients in group 2, 10 (63%) complained of unsightly scars in the lateral eyebrow incision site, whereas none of the patients in group 1 complained of external scarring. None of the patients complained of bony movement and pain in the FZ area in either group. In group 2, 4 of 16 patients (25%) complained of palpability in the FZ area, whereas none in group 1 complained of palpability. The satisfaction score for surgery was 9.4 ± 1.6 in group 1 and 7.7 ± 2.6 in group 2 (P < .05). Two patients underwent surgery for plate removal in group 2. None of the patients in group 1 complained of any cosmetic problems, with no fixation in the FZ area. CONCLUSIONS: One-point fixation in the ZM area in zygomatic tripod fractures can avoid unsightly scars and give high satisfaction with surgical outcomes in selected patients with tripod fractures.