الفهرس 
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Abstract
Despite the high frequency of the zygomaticomaxillary complex (ZMC) fractures, there is no consensus among surgeons regarding the best surgical management. Thus, the surgical treatment of these fractures remains challenging. Basically, four principles must be considered when undertaking the repair of a facial fracture including adequate exposure, proper reduction, stable fixation, and minimal complications.
This study was conducted at Beni-Suef University Hospital to compare between two-point and three-point fixation techniques in management of zygomatic fractures. The mean age of patients managed with two point fixation was 24.2±10.9 years and those managed with three point fixation was 26.6±7.3. The majority of patients were males (90.9%) in each group. Road traffic accidents was the most common cause of facial fracture in both groups (72.7% Vs 81.8%) for two-point fixation and three-point fixation groups respectively.
Assessment of the aesthetic outcomes in our study revealed that there was no significant difference between the studied groups regarding the patient satisfaction. There was a significant increase in patients’ satisfaction from pre to after 3 months. After 3 months all patients in three-point fixation group were satisfied and 90.9% in two-point fixation group.
Facial examination of patients under the study demonstrated that the orbital volume at the fracture site and at the normal site did not differ significantly between both groups but in each group there was a significant difference between the normal and the fractured side. After the surgery, both groups reached to insignificant difference between the normal side and the affected side after the procedure.
There was a significant improvement in the facial symmetry till 3 months with insignificant difference in both groups. After 3 months all patients in three-point fixation group showed good facial symmetry and 81.8% in two-point fixation group showed good facial symmetry. There was no significant difference between the studied groups regarding the mouth occlusion and TMJ disorders. All cases reported good occlusion in both groups and no cases reported TMJ disorders.
The malar prominence was significantly higher in two-point fixation group without clinical significance. There was a significant decrease of the malar prominence in both groups after the intervention with significantly lower malar prominence in three-point fixation group but it was due to the difference in baseline so the percentage of decline in both groups didn’t differ significantly (49.4% in two-point fixation group and 49.8% in three-point fixation group).
As regards to the facial width, there was no significant differences between both groups. After the surgery, there was a significant decrease of the facial width in both groups after the intervention with significantly lower facial width in two-point fixation group and higher percentage of decline (52% in two-point fixation group and 42.9% in three-point fixation group).
Hypoethesia was reported in (36.4%) of patients undergoing two-point fixation group and (27.3%) of patients in three-point fixation group. There was no significant difference between the studied groups regarding the occurrence of hypoesthesia in addition to the insignificant difference between pre and post 3 months.