Multi-fragmentary comminuted

zygomatic bone fracture is a rare trauma manifestation

frequently correlated with facial deformity and functional deficits.

Utmost precision in selecting the surgical modality is warranted for

such fractures, particularly in patients with concurrent medical

conditions, as observed in this case. A 54-year-old patient with

controlled type 2 diabetes presented with a multi-fragmentary

Henderson class VII is a comminuted fracture by definition zygomatic

bone fracture after falling into a wheelbarrow. The patient had

no loss of consciousness or eye injury but showed cheek oedema,

impaired function of the temporal branch of the facial nerve, and

reduced sensation in the V2 branch on the right side. Computed

tomography scans confirmed multi-fragmentary comminuted

zygomatic bone fracture and additional fractures of the zygomatic

arch and maxillary sinus walls. Ophthalmologic consultation ruled out

eyeball injuries and diplopia. The surgical intervention included

meticulous debridement, removal of foreign bodies, and osteosynthesis

with eight plates and 36 screws, using the old wound to minimize new

scarring. Postoperative recovery was favourable, improving facial

symmetry and ocular function despite minor complications with eyelid

closure. A multidisciplinary approach to a diabetic

patient’s complex zygomatic fracture due to high-force trauma led

to a successful outcome without the need for additional

corrective surgery. The risk associated with foreign bodies, such as

wood fragments left in a patient with type 2 diabetes, is high

and can impede wound healing and lead to abscess formation. The case

highlights the importance of individualized treatment plans and the

potential for favourable outcomes despite comorbidities and

postoperative complications such as minor eyelid closure issues.