Postoperative Outcomes and Complication Risk Factors in Zygomaticomaxillary Complex (ZMC) Fractures - A One-Year Retrospective Study of Surgical Management Approaches

Q: What is the main purpose of this one-year retrospective study on ZMC fractures?

To evaluate demographic patterns, etiological factors, fracture distribution, and surgical approaches, and to identify predictors of postoperative complications using multivariate analysis and survival methods.

Q: How was postoperative complication risk assessed?

Associations between clinical variables and complication risk were tested using Chi-square tests and multivariate logistic regression, while time-to-resolution was analyzed with Kaplan-Meier survival curves.

Q: Which factors were significant predictors of postoperative complications?

Significant predictors included age ≥50 years, infraorbital fractures, infraorbital incisions, and alcohol-related trauma (p < 0.05).

Sep 30, 2026

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Zygomaticomaxillary complex (ZMC) fractures are common midfacial injuries from high-energy trauma, requiring a balance of aesthetic reconstruction and functional rehabilitation while postoperative complications remain a concern. This one-year retrospective study evaluates demographics, etiological factors, fracture distribution, and surgical approaches, and identifies postoperative complication predictors using multivariate analysis and survival methods in 77 surgically treated patients.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages13

Reading Time33 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusions

Introduction

Review began 11/21/2025 Review ended 11/28/2025 Published 12/10/2025 © Copyright 2025 PS et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited. DOI: 10.7759/cureus.98866 Open Access Original Article Postoperative Outcomes and Complication Risk Factors in Zygomaticomaxillary Complex (ZMC) Fractures: A One-Year Retrospective Study of Surgical Management Approaches Priyadharsana PS 1, 2, Samuel Sugantharaj L 1, Prabhusankar K 1, Effie Edsor 1, Vigneshwar S 1, Vignesh K 1 1. Department of Oral and Maxillofacial Surgery, RVS Dental College and Hospital, Coimbatore, IND 2. Department of Oral and Maxillofacial Surgery, AB Shetty Memorial Institute of Dental Sciences, Nitte, Mangalore, IND Corresponding author: Samuel Sugantharaj L, [drsamsuganth99@gmail.com](drsamsuganth99@gmail.com) Abstract Background Zygomaticomaxillary complex (ZMC) fractures are among the most frequently encountered midfacial injuries, often resulting from high-energy trauma such as road traffic accidents or assaults. Effective management requires a balance between aesthetic reconstruction and functional rehabilitation. Despite advancements in surgical techniques, postoperative complications remain a concern. This study aims to evaluate demographic patterns, etiological factors, fracture distribution, and surgical approaches, and to identify predictors of postoperative complications using multivariate analysis and survival methods. Methods A retrospective observational study was conducted on 77 patients surgically treated for ZMC fractures between 2021 and 2024 . Data regarding patient demographics, mechanism of injury, fracture classification, incision type, and postoperative complications were extracted from hospital records. Chi-square tests and multivariate logistic regression were employed to assess associations between clinical variables and complication risk. Time-to-resolution of complications was analyzed using Kaplan-Meier (KM) survival curves. Relative risks (RR) were computed for each surgical incision type. Results ZMC fractures predominantly affected males (n=69, 90%), most frequently in the 20-29-year age group (n=22, 28.6%) . Road traffic accidents, assaults, and falls were the primary causes. Maxillary fractures were most common (n=25, 32.4%), and the buccal sulcus incision was preferred (n=36, 46. 7%) . Infraorbital paresthesia was the most frequent complication (n=5, 27%) . Significant predictors of complications included age ≥50 years, infraorbital fractures, infraorbital incisions, and alcohol-related trauma (p < 0 .05) . KM analysis revealed delayed resolution of paresthesia and diplopia; hemianopia persisted at 12 weeks. Overall, open reduction and internal fixation (ORIF) demonstrated a favorable safety profile. Conclusions ZMC fractures primarily affect young adult males and are most often trauma-induced. While ORIF remains the standard for managing displaced fractures, increased complication risks in older adults and alcoholrelated injuries highlight the need for individualized surgical planning and targeted postoperative care. Categories: Palliative Care, Dentistry Keywords: facial trauma, open reduction and internal fixation, postoperative complications, retrospective study, zygomaticomaxillary complex Introduction The zygomatic bone, or zygoma, serves as a critical component of the midfacial skeleton, conferring facial width, structural support to the orbital framework, and acting as an essential buttress for mastication and facial expression [1] . As the principal midfacial buttress, the zygoma not only contributes to craniofacial aesthetics but also maintains functional integrity through its articulation with adjacent bones and its role asa key attachment site for masticatory muscles.

FAQs

What is the main purpose of this one-year retrospective study on ZMC fractures?

To evaluate demographic patterns, etiological factors, fracture distribution, and surgical approaches, and to identify predictors of postoperative complications using multivariate analysis and survival methods.

How was postoperative complication risk assessed?

Associations between clinical variables and complication risk were tested using Chi-square tests and multivariate logistic regression, while time-to-resolution was analyzed with Kaplan-Meier survival curves.

Which factors were significant predictors of postoperative complications?

Significant predictors included age ≥50 years, infraorbital fractures, infraorbital incisions, and alcohol-related trauma (p < 0.05).

Sep 30, 2026

Uploaded by Callum