Background Zygomatic fractures are some of the most frequently encountered facial fractures. However, the relationships between the trauma etiology, the zygomatic fracture patterns, and patient ages have not been described. Methods Patients treated for isolated malar fractures, between 2004 and 2011, at Keio University Hospital were reviewed in this study. Comparative statistical analyses were conducted, based on the classification of the zygomatic fractures, their causes, and patient ages; p < 0.05 was considered significant. Results In total, 113 patients, aged 16–82-years-old (mean age (SD), 39.8 (17.0)-years-old), including 74 men were analyzed. Patients in their teens and 20s had injuries that were predominantly sports-related (48.8%). With increasing age, the ratio of sports injuries decreased and the number of falls causing injury increased. The frequency of injuries caused by motor vehicle collisions remained reasonably constant across the age groups. Comparing the ratio of shear type fractures with patient ages revealed that 4/13 injuries among patients in their 20s and 30s were of this type, whereas the proportion of shear fractures increased in patients over 40 (17/28, p < 0.05). Conclusion The severities of the zygomatic fractures, their causes, and the associated patient ages were closely related. Based on this study, possible prevention strategies for zygomatic fractures need to be considered.
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