Efficacy of modified two point fixation versus three point fixation in management of moderate energy orbitozygomatic complex fractures (Clinical and radiographic study) Background: Orbitozygomatic complex (OZC) fractures are second most common fracture among facial skeletal injuries. It has been reported that three point fixation is the most acceptable technique for management of moderate energy OZC fractures. However, it has several drawbacks such as skin scare and palpable hardware over lateral orbital rim. Aim: The purpose of current study was to compare modified two point (the ZM buttress and infraorbital rim) and three point method of internal fixation in moderate energy OZC fractures. Patients and Methods: This randomized controlled trial was conducted on of 32 patients with unilateral moderate energy OZC fractures of both genders. They were divided into equal two groups (group I, three point fixation and group II, modified two point fixation). Patient demographics and both clinical and CT radiographical assessments were done postoperatively after 6 months to evaluate postoperative complications, patient satisfaction score ,and quality of bone reduction. Results: Clinically There was highly statistical significant difference between groups in aspects of mean operation time, numbers of postoperative complications and values of patient satisfaction score (p value = 0.015, 0.003, 0.0016 respectively). Postoperative radiographic measurements and means of difference between affected and unaffected sides revealed nonsignificant difference between groups (p > 0.05). Conclusion: Modified two point fixation technique is effective alternative to three point fixation technique in management of moderate energy OZC fractures with advantages of reduced operation time, fewer complications, higher patient satisfaction