Results of a Clinical Scoring System Regarding Symptoms andSurgical Treatment of Isolated Unilateral Zygomatico-OrbitalFractures: A Single-Centre Retrospective Analysis of 461 Cases

Systematic assessment of computed tomography (CT) scans and clinical symptoms isnecessary to quickly indicate the correct treatment of zygomatico-orbital (ZMO) fractures. For thispurpose, a clinical scoring system (=Clinical Score) was developed and correlated with CT scans toanalyse its validity. Every operated, isolated, and unilateral ZMO fracture between January 2012 andDecember 2016 was screened retrospectively, including patient and treatment data. All availableCT scans were analysed, and the grade of dislocation was measured for each case and plane. Fourhundred and sixty-one cases were included and showed a median surgery time of 66.0 min (5.0–361.0)and a median postoperative hospital stay of three days (0–25). The distribution of gender, aetiologiesand age groups was significantly different (each p = 0.001), and the aetiology had a significantinfluence on the Clinical Score (p = 0.038). The degree of dislocation in the coronary and sagittalplanes correlated significantly with the Clinical Score with regard to the orbital involvement (p < 0.001,p = 0.566; p < 0.001, p = 0.609). The simple, quick, and easy-to-apply Clinical Score showed asignificant correlation with the most important planes in CT scans as well as with the clinical course.It may facilitate fast risk stratification of the patient. However, the validity of the proposed score indetermining indications must now be evaluated in a prospective setting, including both operatedand non-operated fractures.