I recently had a zmc fracture. What are the consequences of waiting beyond 2 weeks? Will I get the same result?

Osteotomies, will it ultimately still be the same result?

Doctor Answers 5

Facial Fracture should be treated within 2 weeks of injury

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Dear Jake6055,

I am a little puzzled that you put two separate postings on the same day. I assume then that you had your surgery five weeks ago and that that surgery was longer than two weeks after the accident. Is that the case?

I think most surgeons would agree that a facial fracture is ideally treated within two weeks of injury. If not, there is a chance the bone can begin to stick or set in the incorrect position and make it a bit more difficult to align. That is certainly not a hard and fast rule but only a guideline. In general, surgeons prefer to fix this type of fracture either immediately within the first 12 or 24 hours or else delay the repair five days or more to allow swelling to go down.

I hope this has been helpful.

Robert D. Wilcox, M.D.

Timing repair of zygoma fractures

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I would encourage you to have the repair done sooner than later (if it is necessary). Depending on the position of the bones, some patients do not have to have surgery. If you were told that surgery is indicated, there is no magic time period to have the surgery done. If done in the first weeks after the injury there is a higher likelihood of quick surgery with an excellent result. As the bone heals in the wrong position and gets sticky, surgery becomes more difficult. If you wait until osteotomies are needed, the corrective surgery would not be impossible, but much more challenging. 

The simple answer is: the sooner the better. 

Best of luck!

Earlier the better

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Facial fracture repair generally is dictated by the displaced or nondisplaced nature of the fracture. Said simply, if the bone pieces are out of normal alignment, they should be repaired, especially in the circumstance of a ZMC fracture. Ongoing displacement of a ZMC fracture, from the strong pull of the masseter muscle, can result in negative canthal tilt (a.k.a. outside corner of the eyelids pulled towards your mouth). At 2 weeks, the fibrotic process of wound/bone healing is well underway, so as the bones become more sticky, and stick in abnormal alignment, they may need to be separated operatively with what is known as an osteotomy, potentially with the need for bone grafting in conjunction with the repair. While this increases the complexity of the operation, acceptable cosmetic results can be obtained. I recommend consultation with a plastic surgeon certified by the American Board of Plastic Surgery.

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ZMC fracture

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The surgery will be more difficult but appropriate reduction and fixation is still possible without osteotomies beyond 2 weeks. 2 weeks is a rough guideline for timing of the repair of a ZMC fracture. The fracture segments can still be mobile for 3 or 4 weeks depending on the degree of displacement of the fracture segments. 

Good luck. 

I recently had a zmc fracture. What are the consequences of waiting beyond 2 weeks? Will I get the same result?

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It is definitely harder to repair at a later date, but your surgeon knows exactly how well the surgery went.

Kenneth Hughes, MD

Los Angeles, CA

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.