Orbitozygomatic Complex Fracture Reduction Under Local Anesthesia and Light Oral Sedation

Abstract

Closed hook reduction is a well-accepted approach in reducing selected cases of isolated orbitozygomatic complex fractures. The potential of achieving such reductions under light sedation and local anesthesia has many potential benefits over general anesthesia and should therefore not be overlooked. The goal of this study was to verify if closed reduction under local anesthesia is a feasible alternative to reduction under general anesthesia for selected cases of orbitozygomatic complex fractures. Furthermore, an attempt was made at identifying those who would benefit from such an option without compromising end results as opposed to those who would require open reduction with the use of internal fixation devices (ORIF) to ensure favorable outcomes. Over the period of July to October 2005, we attempted to reduce 8 consecutive orbitozygomatic complex fractures on an outpatient basis with the use of local anesthesia. We have successfully reduced 6 of 8 such fractures. Closed hook reduction under light sedation and local anesthesia is a feasible and safe procedure in selected cases of noncomminuted zygomatic fractures. Coupling both physical examination and immediate postoperative radiographic evaluation ensures substantiation of accurate reduction and permits immediate final corrections if considered necessary.