A Comparison of Three Surgical Approaches to Zygomaticomaxillary Fractures

The study is a randomized controlled clinical trial, following the Consolidated Standards of Reporting Trials (CONSORT) guidelines. The study is intended to compare between the subtarsal approach, conventional transconjuctival approach and the Y- modification of the transconjuctival approach in the management of zygomatico-maxillay complex fracture.

The study is a randomized controlled clinical trial. Twenty-four patients with age range of 20-50 years requiring open reduction and fixation of a fractured zygomatic complex were randomly divided into three equal groups according to the approach used: Group A: subtarsal approach group. Group B: conventional transconjuctival approach group. Group C: Y- modification of the transconjuctival approach group.

Adequate exposure provided by the incision and accessiblity to proper fracture reduction and fixation was assigned as Yes or No

computed tomography was requested for adequacy of fracture reduction assessment and this outcome was assigned as Yes or No

Pain was evaluated at 24 hours and at 1 week according to a 10-point Visual Analogue Scale (VAS), (0-1=none,2-4=mild,5-7=moderate,8-10=severe).

Subjective assessment of the infraorbital nerve sensation by patient questioning about any alteration in sensation at 3 months postoperatively. Objective assessment by dental probe pressure to assess sensory changes along the distribution of the infraorbital nerve with contralateral side comparison

Inclusion Criteria: Patients with ZMC fractures requiring open reduction and internal fixation. Adult patients aged between 20 and 50 years with no gender predilection. Exclusion Criteria: An existing laceration in the inferior and lateral periorbital site. Infection at the fracture line. Comminuted fracture with bone loss. Acute and chronic conjunctival diseases.