Management of Post-traumatic Zygomatic Orbital Deformity

Secondary deformities of orbitozygomatic region present a formidable challenge to surgeon in terms of restoration of form and function. Often times the reasons sited in literature for these deformities are inadequate management or misdiagnosis at the time of initial presentation. However all the patients in our series presented late to us on account of diffi cult terrain and poor means of transport, at the time of initial presentation only. These patients were provided primary fi rst aid at hospitals near the site of injury and were subsequently referred to our only tertiary care center of maxillofacial surgery often weeks after initial trauma. The average time of presentation ranged from four weeks to sixteen weeks in these patients by which time the fractures had already malunited. We carried out refracturing at malunited fracture sites in fractures four to six weeks old and osteotomy techniques in patients presenting later than six weeks after trauma. In this paper we present our experience of twenty three patients presenting over a period of seven years from 2005 to 2012. All the patients were evaluated clinically and radiographically and subsequently underwent ORIF with titanium bone plates and screws after refracture or osteotomy of the zygomatic orbital deformity. Follow up ranging from seven years to twelve months indicated stable surgical results with good functional and surgical outcome.