The patient is usually evaluated 1 week after initial presentation. If it is determined surgical intervention is required, the patient is then prepared.
Common indications for surgical management include trismus, significant restriction in lateral excursions, cosmetic concerns e.g. depression and flattening.
Common procedures for isolated zygomatic arch fractures or simple ZMC fractures include a Keen’s lift (intra-oral approach) or a Gillies lift,performed through a temporal approach to lift the arch.
For more complex ZMC fractures, alignment of the zygomatic-sphenoid suture at the lateral orbital wall is likely to ensure appropriate reduction of ZMC injuries. Exposure of the different fractures may be required for adequate fixation.