• Osteosynthesis

• Antral support

• External pin fixation

• Internal pin fixation

Osteosythesis

•  Miniplate fixation at F-Z suture
•  Microplate fixation at Infra-Orbital rim
•  Miniplate fixation at zygomatic buttress
•  Microplate fixation at zygomatic arch
•  Transosseous wires less rigid and less stable 

Antral Support

•  Rarely used
•  Gross comminution of zygoma and antral walls
•  Antral pack of gauze soaked in Whiteheads Varnish
•  Antral balloon
•  If comminuted orbital floor ? Risk of displacement of bony fragment and trauma to optic nerve

External Pin Fixation

•  Frontal-Zygomatic sutures
•  Pin placed in body of zygoma
•  Pin placed in supra-orbital ridge
•  Pins connected rigidly by vertical rod and universal joints 

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Internal Pin Fixation

•  Transnasal K wire—opposite unfractured zygoma used as stable base to rigidly hold fractured zygoma via transversely placed K wire
•  Removal at 3—6 weeks

Zygomatic complex