Zygomatico maxillary complex fractures. What osteosynthesis? 1, 2, 3 or 4 point fixation

B. ABIR*, M. LAKOUICHMI, A. ABOUCHADI.
Page No. 13-23

The zygomatico maxillary complex (ZMC) is a major buttress of the midfacial skeleton. The ZMC is important to structural, functional, and aesthetic appearances of the facial skeleton. A ZMC fracture is also known as a tripod, tetrapod, or quadripod fracture, trimalar fracture or malar fracture [1],[2]. Zygomatico maxillary complex is the second most common mid-facial bone fractured after the nasal bones and overall represents 45% of all midface fractures[3].The architectural pattern of zygomatic bone allows it to withstand blows of great forces without fracturing. Because of such heavy forces zygomatic bone gets separated from adjacent bone at or near the suture lines. It may be separated from its four articulations, resulting in a zygomatico-maxillary complex, zygomatic-complex or orbito-zygomatic fracture. These articulations encompass an area which has the horizontal and vertical lines of osteosynthesis as described by Gruss and Mackinnon [4].