Araujo-Azcue AF, Ríos-Lara LRL, Morales-Rentería JM, Ortiz-Chang E, Ramírez-García ED, Ugalde-Vitelly JA, Cienfuegos-Monroy R

Language: Spanish
References: 12
Page: 120-124
PDF size: 891.18 Kb.

ABSTRACT

Midfacial fractures involving the zygomatic complex and orbit have a high incidence in emergency department rooms. Historically, the Knight & North classification (1961), that is based on plain radiography, has been the standard; however, this system lacks precision in assessing involvement of the internal orbit (floor and medial wall), which is crucial for functional prognosis. We performed a retrospective, descriptive, and cross-sectional study at the "Dr. Eduardo Liceaga" General Hospital of Mexico (2019-2024). Adult patients with facial trauma and zygomatic complex fractures confirmed by high-resolution computed tomography were included. Pediatric patients were excluded owing to biomechanical differences. Zygomatic fracture patterns were correlated with internal orbital injuries to put forward a subclassification. A final sample of adult patients (mean age 35.17 years) with male predominance (87.2%) was analyzed. The most frequent mechanism of injury was physical assault (group 1 of Knight & North). A significant correlation was observed between zygomatic displacement and rotation (groups IV, V, and VI), with combined fractures of the orbital floor and medial wall. We conclude that the traditional classification is inadequate for current surgical planning. We propose a modification of the Knight & North classification, integrating tomographic findings of the internal orbit (floor and medial wall), allowing more precise severity stratification and better guidance for surgical approach.

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