One-hundred-two (76.1%) males and 32 (23.9%) females were recorded during the study period, giving a malerfemale ratio of 3.2:1. They ranged in age from 18-70 years, with a mean age of 32 years. Patients in the 21-30-year age group (62 or 46.3%) were most often involved (Table 1). The etiology of zygomatic complex fractures are shown in Table 2. There was a significant association between road traffic accidents and fractures among the age groups (%²=38.919, df=24, p<0.05) but none between road traffic accidents and sex (%²=3.574, df =3, p>0.05).

Table 1. Age and Gender Distribution of Patients

Table 2. Etiology of Zygomatic Fractures

One-hundred-nineteen (88.8%) patients sustained fractures of the zygomatic bone, 11 (8.2%) had fractures of the zygomatic arch and four (3.0%) patients had fractures of both the arch and the zygomatic bone. There was a significant association between fractures of the zygomatic bone and road traffic accidents (x²=35.519, df=6, pO.001). Fifty-nine (44.0%) patients sustained other maxillofacial fractures (Table 3). There was no significant association between these fractures and age (%²=18.714, df=12, p>0.05), sex (%²=5.855, df=4, p>0.05) or site of zygomatic complex fracture (%²=2.053, df=4, p>0.05).
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Table 3. Distribution of Associated Maxillofacial Fractures

Table 4. Clinical Features of Zygomatic Complex Fractures

The presenting features of zygomatic complex fractures are shown in Table 4, and Table 5 shows the radiographic views requested for diagnosis of these fractures. The radiological findings are shown in Table 6. The majority 113 (84.3%) of fractures were treated under endotracheal general anesthesia. Eight (6.0%) were treated under local anesthesia and intravenous sedation. In 13 (9.7%) patients, no active treatment of the fracture was performed (Table 7).
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Table 5. Distribution of Radiographic Investigations

Table 6. Radiologic Findings Associated with Zygomatic Complex Fractures

The approaches and methods of management of zygomatic complex fractures are shown in Table 7. The Gillies approach in 34 (25.4%) was the commonest method of reduction. The upper buccal sulcus approach was used in only one (0.7%) patient. Where internal fixation was required, transosseous wiring with 0.5 mm diameter soft stainless wire was performed. The duration of follow-up ranged from four weeks to two years. The following postoperative complications were recorded—blindness in four (3.0%), persistent flattening of the cheek in four (3.0%), and persistent enophthalmos in one (0.7%).
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Table 7. Approaches and Treatment for Zygomatic Complex Fractures