Aim: The aim of this study is to study the efficacy of single point (ZF) fixation in selected cases of Tripod fractures of zygoma in achieving anatomical reduction of the zygomatic bone complex in restoration of normal function & aesthetics.

Materials and Methods: This prospective clinical study was conducted in the department of Plastic & Reconstructive Surgery, Gandhi Medical College & Hospital, Secunderabad, Andhra Pradesh. Total of 13 patients who reported in the Department of Plastic & Reconstructive Surgery with clinical and radiological evidence of unstable and displaced tripod fracture of zygoma. Inclusion Criteria: Displaced tripod fracture of zygoma as seen clinically and radiologically (3D CT). Tripod fracture of zygoma with or without associated maxillofacial fractures. Patients above 18 years of age. Presentation within 15 days of injury were included in the study. Exclusion Criteria: Associated fractures of maxilla, frontal bones which can destabilise mid facial skeleton. Bilateral displaced fractures of zygoma. Comminuted fractures of zygoma. Zygoma fractures with visual disturbances. Patients medically unfit for surgery to undergo general anaesthesia. Foreseeable missing opportunity of follow up examination were excluded in the study.

Results: Road traffic accidents were the common cause of fracture zygoma. Most of the patients were between 18-25 yrs age group. Associated fractures were noticed in less than 23% (3cases) of patients in our group. 50% (7cases) of the fractures were compound. 3Dimensional computed Tomography was used to identify the pattern of fracture. Group 3 fracture was noted in 7% (1) patient. Group 4 fracture was noted in 53% (7) patients. Group 5 fracture was noted in 23% (3) patients. Group 6 fracture was noted in 15% (2) patients. Single point fixation done using 2 holed, 1.5 mm plate & 8mm screws in 23% (3) of patients. Single point fixation done using 3 holed, 1.5 mm plate & 8mm screws in 69% (9) of patients. Single point fixation done using 4 holed, 1.5 mm plate & 8mm screws in 7% (1) of patients. Malar symmetry obtained in 47% (6) of patients. Grade 2 malar symmetry obtained in 38% (5) of patients. Grade 3 malar symmetry obtained in 15% (2) of patients. Enophthalmos was noticed in 30% (4) of patients. All patients achieved >3cm mouth opening towards the end of 2 months. None of the patients developed clinical infra orbital step. 5 (38%) patients had radiologically detectable infra orbital step. None of the patients developed post operative infection. Dental occlusion was normal in all patients.

Conclusion: It can be concluded that single point fixation has a definite place in the management of tripod fractures of zygoma with minimal to moderate displacement of infraorbital margin.