Group C [
fracture
CONJUNCTIVA

A corneal shield was placed.A Y-shaped line was marked on the lateral aspect of the lateral canthal angle at the skin crease.Local anaesthesia vasoconstrictor was injected subcutanoeusly below the marked line at the zygomatic area across the infraorbital rim.Traction sutures were performed for tarsorrhaphy, or a lower eyelid retractor was used.The skin incision was made in a Y-shaped manner and the lateral canthal was cut to separate the tarsal plates.With one arm of the scissor placed inside the tunnel and the other arm on the outside of the conjunctiva, sectioning of the conjunctiva was executed with caution to stay 5 mm below the lower tarsal plate.After the canthotomy, the conjunctiva was exposed and a tunnel beneath the conjunctiva was created using blunt hemostat all the way toward the medial end of the incision.Transconjunctival incision and dissection were performed in the same manner as in group B to expose the fracture at the frontozygomatic region.The cutaneous Y incision transformed into a box when retracting its corners, widening field exposure and allowing better access to the fronto-zygomatic region, lateral orbital wall, and the orbital floor with one approach.Reduction and fixation of the fracture was accomplished using miniplates (Fig. The superficial portion of the lateral canthal ligament was sutured to the temporal aponeurosis using 3–0 vicryl. The conjunctiva was closed with 6–0 vicryl and the skin over the lateral canthus is sutured in the original Y shape with 6–0 prolene (Fig. The eye was cleaned and a frost suture was applied for 1 week.