Zygomatic fracture characteristics and their association with brain injury: Evidences from a 10-year retrospective study in northern Taiwan.

BACKGROUND/PURPOSE: Few studies have systematically examined the relationship between zygomatic fracture patterns or patient demographics and head injury. This study investigates the epidemiology of zygomatic fractures, their association with brain injury, and the influence of patient age, focusing on fracture classification and injury mechanisms.

MATERIALS AND

METHODS

A retrospective analysis of 272 patients with zygomatic fractures treated between 2012 and 2021 at a medical center in northern Taiwan was conducted. Fractures were classified using the Zingg system. Clinical data including age, injury etiology, concomitant injuries, and brain injury were analyzed. Statistical methods included chi-square tests, one-way ANOVA, and multiple logistic regression.

RESULTS

Motorcycle accidents were the most common cause of zygomatic fractures (43.4 %), followed by falls (27.9 %). The highest incidence occurred in patients aged 61-70 years. Older patients had significantly lower surgical intervention rates (P < 0.05). Type B fractures were most common (51.8 %), and bilateral fractures were significantly associated with higher rates of brain injury (58.3 % vs. 26.6 %, P < 0.05). Among patients with fall-related fractures, those with brain injury were significantly older than those without (P = 0.008). Even low-energy trauma, such as ground-level falls, led to brain injury in elderly patients. In younger individuals, brain injury was associated with bilateral fractures and concomitant injuries, whereas in older patients, age itself was a major risk factor for brain injury.

CONCLUSION

Falls are increasingly associated with zygomatic fractures in older adults, and even minor trauma can result in brain injury. Bilateral fractures and high-energy mechanisms remain key predictors of brain injury in younger patients.