A patient has trismus, flattening of the malar prominence and infraorbital numbness after trauma. CT confirms a displaced zygomaticomaxillary-complex fracture without muscle entrapment. What most determines the indication for operative reduction?
The decision is not based on one symptom alone: globe position, ocular motility, mouth opening, malar projection and the patient’s functional/cosmetic goals must be integrated.
A. Infraorbital numbness alone always mandates surgery: Sensory change may recover and must be considered with the whole injury.
B. Functional disturbance or meaningful displacement causing facial asymmetry, after ophthalmic assessment: The decision is not based on one symptom alone: globe position, ocular motility, mouth opening, malar projection and the patient’s functional/cosmetic goals must be integrated.
C. Every CT-visible fracture requires fixation: Non-displaced fractures without functional deficit may be observed.
D. Wait until malunion is established: Delayed correction is more difficult and should not be the default.
E. Treat trismus with physiotherapy only: Mechanical impingement from displacement may require reduction.
If there were diplopia, enophthalmos or entrapment, orbital assessment would become urgent.
Draft Clinora educational material only; not official JCIE content or clinical advice.
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