Reduction and fixation of tetrapod zygomatic fractures with a stable medial end of fracture segment

Abstract

Abstract: PURPOSE : Zygomatic fractures usually need reduction and fixation of all the fracture segments through coronal, subciliary, or transconjunctival, and intraoral approach. The purpose of this paper was to explore a technique of fracture management without subciliary and intraoral approach and fixation for certain type of tetrapod zygomatic fracture. METHODS : In cases of type B zygomatic fractures by Zingg classification, with a stable maxillary structure inward and an inconspicuously displaced medial end of fracture segment, half-coronal approach was used. Sequential reduction and fixation was performed in zygomatic arch posterior-anteriorly. Alignment of fracture segments at the site of fronto-zygomatic suture was checked, and then synthesis was done. There was no need for subciliary, intraoral approach and fixation at infraorbital edge and zygomaticomaxillary buttresses. RESULTS : Reduction and fixationn of fractures was accomplished successfully in a series of 6 patients, postoperative CT scan showed anatomical reduction of the bone segments and firm fixation in all patients. Facial width and zygomatic prominence recovered symmetry and facial configuration restored satisfactorily. Mouth opening was normal. No injury was found in temporomandibular joint, eyes and facial nerves. CONCLUSIONS : Anatomical reduction and firm fixation of the bone segments could be achieved by this simplified management in certain type of tripod zygomatic fractures with a stable maxillary structure inward and an inconspicuously displaced medial end of fracture segment.

Key words: Facial trauma, Fracture of zygomatic bone, Fracture of zygomatic arch, Bone reduction and fixation

CLC Number:

R782.4

YANG Li-juan¹, LIU Chun-ming², DUAN Hai-nan¹, WANG Kai¹, LIU Wei-dong, ZHANG Zhan-le¹, LI Mei-fang¹. Reduction and fixation of tetrapod zygomatic fractures with a stable medial end of fracture segment[J]. China Journal of Oral and Maxillofacial Surgery, 2014, 12(6): 549-553.

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