Management Of Zygomatic Arch Fractures Research Articles

Retrospective Study over 15-years Period on Zygomathic arch Fractures: A Single Center Experience.

The purpose of this study was to do a retrospective analysis about patients with zygomatic arch who were treated at the department of Maxillofacial Surgery, Regional University Hospital of Ancona, Italy, between 2007 and 2021. Patients were evaluated based on various parameters including age, sex, aetiology, symptoms, comorbidity, clinical findings, zygomatic arch fracture type, other facial fractures, treatment, waiting time before the operation, complications and sequelae. In the period described we recorded 103 zygomatic arch fractures. Of the patients, 64 were male (65,92%) and 39 were female (34,08%). The average age of the patients was 47,02 years (ranging from 8 to 93 years). The leading cause of these fractures was sports-related injury (n = 24; 23,30%), and isolated zygomatic arch fractures were the most frequent (63,1%). The most common clinical signs and symptoms were, pain, depression of the facial profile, difficulty in chewing, limitation of the buccal opening, difficulty in protrusion movements and mandibular lateralization. 93% of patients underwent surgery under local anesthesia, almost exclusively patients undergoing an open approach to internal fixation. The successful and effective management of zygomatic arch fractures requires a solid understanding of its anatomy, pathophysiology and related biomechanical structures and forces. The continuous research in epidemiology, aetiology, materials and techniques will further refine our treatments which are nowadays more and more customized according to the type of trauma.

Modified Temporal Incision for the Management of Zygomatic Arch fractures-A Retrospective Study for 7 Years.

Retrospective cross-sectional study. The objective of this retrospective study was to evaluate the clinical outcomes of Modified temporal incision in the management of zygomatic arch fractures (ZAF). Records of 34 patients who underwent open reduction for zygomatic arch fractures were retrieved and included in the study between 2011 and 2018. These patients were followed up at 4 weeks, 8 weeks and 12 weeks respectively. Clinical parameters such as post-operative infection, hematoma, scarring, degree of mouth opening, palpability of plates, alopecia and weakness of temporal branch of Facial nerve recorded were analyzed for complications of modified temporal incision in the management of ZAF. A thorough analysis of the clinical parameters revealed that at the end of 4 weeks scarring was present in 4 patients and temporal branch of Facial nerve weakness was present in 21 patients. None of the patients had hematoma, infection or palpability of miniplates. At the end of 8 weeks the only complication recorded was weakness of temporal branch of Facial nerve in 21 patients. By 12 weeks, all patients had complete recovery and none of the patient had weakness of temporal branch of Facial nerve. The results obtained proved that the Modified temporal incision can be considered as a reliable method in the management of zygomatic arch fractures. The incision can be adopted with confidence in suitable cases of zygomatic arch fractures without any permanent morbidity.

Management of Zygomatic Arch Fractures by Intraoral Open Reduction and Transbuccal Fixation: A Technical Note.

Fractures of the zygomatic arch are common due to its anatomical prominence. The post-traumatic restoration of the arch form is important to maintain the midfacial symmetry and anteroposterior projection of the face. Open reduction and internal fixation (ORIF) of fractured arch is indicated in specific clinical presentations. The traditional methods of ORIF of zygomatic arch fractures require cutaneous incisions, which are associated with complications such as scarring and facial nerve injury. This article presents a simple technique of "intraoral reduction and transbuccal fixation" of the arch that negates the problems associated with the conventional approaches to ORIF.

Postoperative Management of Zygomatic Arch Fractures: In-House Rapid Prototyping System for the Manufacture of Protective Facial Shields

Zygomatic fractures account for 10% to 15% of all facial fractures. The surgical management of isolated zygomatic arch fractures usually requires open reduction treatment without fixation through an intraoral access. Therefore, the main problem in the non-fixed treatment of zygomatic arch fractures is related to the difficulty in obtaining a stable reduction for a period long enough to guarantee the physiological bone healing process. We propose an innovative "in-house" rapid prototyping (RP) protocol for the 3D-zygoma mask manufacture of a patient-specific protective device to apply after zygomatic arch fracture reduction. Our study includes 16 consecutive patients who underwent surgical open reduction for an isolated zygoma fracture without fixation between January 2017 and February 2018. The patients received regular postoperative checks at weeks 1 and 2. Before the device was removed, a multiple choice questionnaire was administered to measure the degree of wearability of the mask. The estimated cost of the production is around &OV0556;5 per case and the construction time is around 90 minutes. Based on the encouraging results, obtained in our experience, we hope that other studies can be conducted to confirm our procedure and improve its functionality in the field of facial trauma.

Minimal access percutaneous approach for the management of zygomatic arch fractures

Minimal access percutaneous approach for the management of zygomatic arch fractures

Simplified zygomatic arch radiographic technique to overcome the drawback of jug handle view

Introduction: The imaging of the zygomatic arch is very important in the diagnosis and management of zygomatic arch fractures. It is accomplished by jug handle radiography (a variation of the submentovertex view) and sometimes with modifications like the tangential or tea cup projection. For these techniques, the patient has to be positioned in a way which makes it non-applicable in cases having cervical injuries or suspected cervical injuries. Aims and Objectives: To devise a new approach with which the image of the zygomatic arch can be obtained with normal head position, in either sitting or supine position, using a dental X-ray machine and an occlusal film, which can even be used in patients with cervical injuries or suspected cervical injuries, without any complications. Materials and Methods: The present approach requires a dental X-ray machine and an occlusal X-ray film thereby eliminating the need for additional equipment like a general X-ray machine and extraoral film cassette. This approach can be carried out in a conventional dental setup to rule out zygomatic arch fractures. Conclusion: This technique can be applied in patients having cervical injuries or suspected cervical injuries, thus overcoming the drawback of the jug handle view, and is easy to master. This technique can be used in a conventional dental setup and holds good with the ALARA (as low as reasonably achievable) principle of radiation protection and safety.

Classification System and Treatment of Zygomatic Arch Fractures in the Clinical Setting

A new classification system and algorithm of zygomatic arch fractures is described that provides the surgeon with a useful starting point from which to organize a valid treatment plan and management of zygomatic arch fractures. Hönig Merten (HM) class I is defined as an isolated tripod fracture, HM class II as an isolated stick fracture of the arch, and HM class III is a combined fracture of the malar bone and the zygomatic arch. Although reduction of the class I and II is usually closed, open reduction is mandatory in class III zygomatic arch fractures.

Portable fluoroscopy in the management of zygomatic arch fractures.

Portable fluoroscopy in the management of zygomatic arch fractures.

Portable fluoroscopy in the management of zygomatic arch fractures.

Operative methods that do not allow intraoperative visualization of the fracture fragments in patients with isolated zygomatic arch fractures often result in inadequate reduction. This article describes a technique using a portable, surgeon-operated fluoroscopic machine that can be used preoperatively, intraoperatively, and postoperatively in patients with isolated zygomatic arch fractures. Using the portable fluoroscopic unit, reduction of isolated zygomatic arch fractures was performed in 9 consecutive patients over a period of 1.5 years. Postoperative alignment was confirmed using computed tomography (CT). These CT images were compared with the fluoroscopic images in several of the patients. Eight of the nine fractures were reduced via an intraoral approach and one through a Gillies approach. All nine fractures were easily visualized and their reductions were confirmed with intraoperative dynamic visualization using a portable fluoroscopic unit. Postoperative CT revealed images of the reduction that were comparable with intraoperative and postoperative fluoroscopic images. The use of portable fluoroscopy intraoperatively allows for dynamic visualization of instrumentation and the immediate confirmation of the adequacy of fracture reduction. Moreover, this technique may eliminate the need for postoperative CT in isolated zygomatic arch fractures. Portable fluoroscopy may also have a place in the management of certain zygomatic complex fractures.