Reliability of three-point fixation and orbital floor reconstruction based on changes in orbital volume measurements and enophthalmos in patients with zygomaticomaxillary complex fractures

This retrospective cohort study aimed to calculate the amount of enophthalmos and volume difference between the repaired and intact orbits after 3-point fixation of unilateral zygomatic complex fractures (ZMCFs) with the reconstruction of the orbital floor. It was conducted between 2015 and 2020. The orbital volume (OV) was measured by manual tracing methods on pre- and postoperative CT scans. The OV were categorized into OV Intact/pre , OV Intact/post , OV Fractured, and OV Repaired . The OV Intact/pre , OV Intact/post , OV Fractured were used as control groups. Outcome variables were the mean of the OV, volume difference between repaired and intact orbits, correction rate, and measurements of enophthalmos. The results are considered significant with p-values < .05. The study included 63 patients, and the results showed that the study’s treatment protocol significantly changed the OV Fractured from 26.10 ± 1.14 to 21.93 ± 1.25 cc. The volume difference between intact and repaired orbits was ranged from 0.34 ± 0.03 to 0.35 ± 0.02 cc with 98.40% correction rate. Also, the mean of enophthalmos was reduced from 2.48 ± 0.41 to 0.47 ± 0.42 mm. So, it could be concluded that after 3-point fixation of ZMCFs with the reconstruction of the orbital floors, the OV is significantly restored with a minimal volume difference between both orbits about 0.34 ± 0.03 cc and 0.47 ± 0.42 mm enophthalmos.