Comparison of the modified lateral orbitotomy approach and modified hemicoronal approach in the treatment of unstable malunions of zygomatic complex fractures.

OBJECTIVE: The objective of this study was to evaluate immediate and late postoperative complications in treating zygomatic complex fractures by 2 modified approaches; namely, the modified lateral orbitotomy approach and the modified hemicoronal approach.

STUDY DESIGN: Twenty zygomatic complex fractures were treated, with 10 being treated with the modified lateral orbitotomy approach and the other 10 by the modified hemicoronal approach. Both groups were evaluated for postoperative complications, ie, hematoma, infection, swelling, and nerve injury. The incisions were also evaluated in all patients using clinical evaluation and visual analogue scales.

RESULTS: Patients in both groups had temporary facial nerve injury that was primarily related to retraction of the nerve. There were no hematomas observed in any of the groups. As compared to the modified lateral orbitotomy approach, swelling was observed on more occasions with the modified hemicoronal approach. Infection was not observed in any of the groups. As far as the esthetics in relation to the incision was concerned, the patients accepted the modified hemicoronal approach more strongly as compared with the modified lateral orbitotomy approach.

CONCLUSION: The modified hemicoronal approach seems to be preferred to the modified lateral orbitotomy approach with respect to treating zygomatic complex fractures.