Reduction Of Zygomatic Arch Fractures Research Articles

Evaluation of the Relationship Between Zygomatic Arch Fracture Reduction and Mandibular Movements.

The aim of this study was to evaluate the relationship between surgical zygomatic arch fracture reduction and mandibular movements in different fracture types. Fractures were classified according to the Yamamoto classification. The extent of zygomatic arch reduction after surgery was evaluated by measuring three reference points on both fractured and normal side both before and after surgery. The selected reference points were: the most anterior (A1), the most posterior (B1) and the midpoint (C1) relative to midsagittal plane on the fracture side and the same points on the normal side (a1, b1, c1). Mouth opening, movements to right and left were recorded in these patients. The highest extent of zygomatic arch reduction was observed at the midpoint of the arch (p = 0.041). Surgery did not significantly alter other points of the zygomatic arch. The extent of reduction of the zygomatic arch was not significantly associated with mandibular movements. However, type of fracture correlated with lateral excursion to the right and left (p = 0.002 and p = 0.031, respectively). This study showed that the amount of post-surgical changes in zygomatic arch reduction was not significantly related to mandibular movements. In addition, the amount of lateral excursion two weeks after surgical correction of more severe types of zygomatic arch fractures was less compared with other fracture types. Patients with more severe fractures may need to be followed for a longer period of time in order to regain the normal mandibular movement range.

Role of Intraoperative Imaging in Improving Closed Reduction of Zygomatic Arch Fractures: A Systematic Review and Meta-analysis

The use of intraoperative imaging (IOI) to improve the reduction adequacy of zygomatic arch (ZMA) fractures has been reported, but few systematic reviews have examined this topic. The aim of this review was to investigate and compare the value of IOI with conventional methods without IOI (N-IOI) for the closed reduction of ZMA fractures. Electronic retrieval of MEDLINE, Embase, Cochrane Library, Web of Science, Scopus, and citation search until December 2, 2022, was used to identify controlled clinical trials that employed IOI for improving adequacy in closed reduction of ZMA fractures. The predictor variable was the use of IOI-yes/no (IOI vs N-IOI). The covariates included imaging technique (ultrasound, C-arm, and cone beam computed tomography) and ZMA fracture type (M-shape fracture, mechanistic force in 1 direction; variable fracture, mechanistic force in 2 directions). The primary outcome variables were the reduction adequacy of ZMA fractures (the remaining cortical step and dislocation angle) compared with the ideal mirrored position. Weighted or mean differences, risk ratios, and corresponding 95% confidence intervals were calculated, where P >.05 and I2＜50% fixed effect model was adopted, and a vice versa random effect model was adopted. A total of 1250 studies were identified, of which 6 studies with 259 participants were included. The meta-analysis results indicated that compared with N-IOI, IOI yielded fewer cortical steps (-1.76 [-2.42, 1.10], P ＜.00001, fixed model) and dislocation angles (-5.60 [-8.08, 3.12], P＜.00001, fixed model) in patients with variable ZMA fractures, while no significant difference was detected in the M-shape ZMA fracture (-0.72, [-2.93, 1.48], P=.52; -1.48, [-3.51, 0.55], P=.15). Although there was no significant difference in postoperative correction (0.35, [0.06, 2.01] P=.24, fixed model), all secondary revision cases occurred in the N-IOI group. Descriptive analysis showed that IOI yielded better symmetry and appearance satisfaction. IOI improved the adequacy of the procedure and led to a better postoperative appearance, especially for patients with variable ZMA fractures. Furthermore, the use of IOI avoided the risk of secondary surgery. In future studies, researchers should standardize the scale and outcomes to facilitate the intuitive evaluation of reduction adequacy.

Discrepancy of the location of depression on the soft tissue and the bone in isolated zygomatic arch fracture.

When performing reduction of zygomatic arch fractures, locating the inward portion of the fracture can be difficult. Therefore, this study investigated the discrepancy between the locations of the depression on the soft tissue and bone and sought to identify how to determine the inward portion of the fracture on the patient's face. We conducted a retrospective review of chart with isolated zygomatic arch fractures of type V in the Nam and Jung classification from March 2013 to February 2022. For consistent measurements, a reference point (RP), at the intersection between a vertical line passing through the end point of the root of the ear helix in the patient's side-view photograph and a transverse line passing through the longest horizontal axis of the external meatus opening, was established. We then measured the distance between the RP and the soft tissue depression in a portrait and the bone depression on a computed tomography (CT) scan. The discrepancy between these distances was quantified. Among the patients with isolated zygomatic arch fractures, only those with a fully visible ear on a side-view photograph were included. Twenty-four patients met the inclusion criteria. There were four types of discrepancies in the location of the soft tissue depression compared to the bone depression: type I, forward and upward discrepancy (7.45 and 3.28 mm), type II, backward and upward (4.29 and 4.21 mm), type III, forward and downward (10.06 and 5.15 mm), and type IV, backward and downward (2.61 and 3.27 mm). This study showed that discrepancy between the locations of the depressions on the soft tissue and bone exists in various directions. Therefore, applying the transverse and vertical distances measured from a bone image of the CT scan onto the patient's face at the indicated RP will be helpful for predicting the reduction location.

Preauricular Incision Approach as a Management of Zygomaticomaxillary Complex Fracture Reduction: A Case Report

Introduction: A zygomatico maxillary complex fracture is a facial bone fracture that commonly occurs as a centrally and laterally protruding zygomatic area. The effective surgical approach and exact reduction of the displaced fracture is the most important task in the treatment of a zygomatic fracture, from the aesthetic point of view. Determination of surgical approach and the fixation point of zygomatic arch fracture is one of the most challenging procedure. The purpose of this case report is to find out that the preauricular incison approach is one of the effective methods for reduction of zygomaticomaxillary complex fracture. Case Report: A 53 years old male patient presented with right zygomatico maxillary complex fractures. Diagnosis of right side tetrapod zygomatico maxillary complex fracture deformity was done by clinical examination and confirmed by computed tomography which included 3-D reconstruction view. The authors performed 4-point fixation using the preauricular approach to counter the disadvantages of the coronal approach. The results and usefulness of preauricular approach with 4-point fixation are reported in this study. Conclusion: Preauricular incision is an effective surgical approach for the reduction of zygomatic arch fracture. 4-point fixation using the easier-to-manipulate preauricular approach would be more useful than the conventional method that uses the coronal approach. Satisfactory reduction that showed exact correction was observed. In an outpatient follow-up, no complication such as nonunion or malunion was found, and facial symmetry was also shown. In addition, the preauricular scar was hardly observed. Keywords: zygomaticomaxillary complex fracture, preauricular incision, reduction, fixation

The Relationship Between Morphometric Measurements, Severity, and Success of Zygomatic Arch Fracture Reduction

Identify associations between preoperative radiographic measurements and clinical findings of zygomatic arch fractures and postoperative radiographic measurements. Based on those findings, propose a comprehensive treatment algorithm for the solitary zygomatic arch fracture and combined zygomatic arch-zygomatic complex fracture. Retrospective cohort study with patients referred to our department for zygomatic arch fractures between 2013 and 2018. Data analyzed included patient demographics, clinical evaluation, and radiographic information. Predictor variables were preoperative morphometric measurements: the initial latero-lateral (LL) defect was determined by the difference between the preoperative LL distances of the fractured and the healthy arches, LL distance was measured from the midsagittal plane in the cranium to the inner cortex of the most displaced arch segment, initial arch coronoid distances were measured from the medial part of the most dislocated arch fragment to the lateral aspect of the coronoid, and the anterior-posterior telescoping was measured as the distance between the 2 points in the arch that lost continuity and overlapped as a result of the fracture. The outcome was defined as the residual defect. It was calculated as the ratio between the postoperative remaining LL distance and the initial LL defect. A total of 179 cases were enrolled, all involving head residual defects. Statistical analysis was performed only on 149 medially displaced fractures. Results show that an initial LL defect larger than 3.5mm has an 86.3% chance of remaining with a better residual defect (<84.1%), P=.001. Cases with antero-posterior (AP) telescoping > 1.45mm showed a 72.4% chance of remaining with a poor residual defect >84% (P=.003). Arch-coronoid initial distance showed little effect on the chance of remaining with a large remining defect (P=.417, CI=95%) CONCLUSION: Based on our results, we found that morphometric measurements can be used to predict the reduction results and can assist the clinician in choosing the optimal reduction method and thus increasing the success rate.

Closed Isolated Zygomatic Arch Fracture Management Made Easy.

Zygomatic arch fractures can occur either as isolated fractures or as a part of multiple facial fractures. There are several techniques available for reduction of zygomatic arch fractures, which include closed reduction and open reduction with fixation using metallic splints, closed reduction via Gillies or a gingivobuccal approach is preferred for minimal invasiveness, short operative time, and low complication rate. The aim of the present study is to present a simple, easy, and reliable method for closed reduction of isolated zygomatic arch fractures. This study included twenty patients presented with isolated zygomatic arch fractures between January of 2017 and December of 2018. All patients were evaluated based on the clinical and radiographic findings. Closed reduction of the zygomatic arches was carried on by a stainless steel wire. Surgical outcomes were subjected for objective assessment based on the postoperative alignment of the zygomatic arch in the computed tomography (CT scan) immediately after surgery and after 3 months. Subjective evaluation was carried out comparing preoperative, 1 and 3 months photographs assessing facial symmetry, as well as the patients' satisfaction. After a period of 3 to 6 months follow-up between January 2017 and December 2019, all patients were satisfied by the overall results, no major complications were recorded and no additional surgery needed for them. The suture wire method is quick, simple, easy, and effective for the reduction of isolated, depressed fractures of the zygomatic arch.

USE OF ULTRASONOGRAPHY IN REDUCTION OF ISOLATED ZYGOMATIC ARCH FRACTURE

Background: Isolated zygomatic arch fractures, managed by closed methods, can be inadequate leading to facial asymmetry. Assessment of the reduction and ensuring correct alignment of frac­tured fragments in the operation table always avoids next surgery. This study aims to determine intraoperative, adequacy of reduction of by use of ultrasound in isolated zygomatic arch fracture.&#x0D; Methods: During the closed reduction of isolated zygomatic arch linear probe of ultrasound was used to check the continuity of the echogenic line. The intraoperative ultrasound finding was com­pared with the gold standard CT scan.&#x0D; Results: Ultrasound has 100% sensitivity and 80 % specificity. It also has high precision and accu­racy to determine the reduction of the fractured bone.&#x0D; Conclusions: Ultrasound is a handy tool in the reduction of zygomatic arch fracture. It not only shows but also guides to adequate reduction.

Use of ultrasonography in reduction of isolated zygomatic arch fracture

Background: Isolated zygomatic arch fractures, managed by closed methods, can be inadequate leading to facial asymmetry. Assessment of the reduction and ensuring correct alignment of frac­tured fragments in the operation table always avoids next surgery. This study aims to determine intraoperative, adequacy of reduction of by use of ultrasound in isolated zygomatic arch fracture.&#x0D; Methods: During the closed reduction of isolated zygomatic arch linear probe of ultrasound was used to check the continuity of the echogenic line. The intraoperative ultrasound finding was com­pared with the gold standard CT scan.&#x0D; Results: Ultrasound has 100% sensitivity and 80 % specificity. It also has high precision and accu­racy to determine the reduction of the fractured bone.&#x0D; Conclusions: Ultrasound is a handy tool in the reduction of zygomatic arch fracture. It not only shows but also guides to adequate reduction.

Closed reduction of zygomatic arch fractures by using Tubbs-Logan mitral valve dilator

Objective: To present technical details and experiences regarding the use of a Tubbs-Logan mitral valve dilator for the closed reduction of zygomatic arch fractures.Method: Over a period of about three years, closed reduction was indicated and performed in 22 patients with a zygomatic arch fracture. In all patients, depressed fracture segments were reduced using a Tubbs-Logan mitral valve dilator via the Gillies’ temporal approach.Results: The majority of the injuries were due to motor vehicle collisions (n=8, 36.4%). The zygomatic arch fracture was isolated in 12 patients (54.5%). However, it was a component of a zygomatic complex fracture in 10 patients (45.5%). Of those, rigid internal fixation of the zygomatic body was performed in 8 and the zygomatic body was only closely reduced by a bone hook in 2 patients. Repair of a concomitant orbital floor fracture was performed in 2, a mandibular angle fracture in 1 and a frontal sinus fracture in 1 patient. The reduction status of the zygomatic arch was excellent in 12 (54.5%), good in 8 (36.4%) and fair in 2 patients (9.1%). During the follow-ups, no functional or cosmetic sequelae regarding repaired fractures of the zygomatic arch, zygomatic body or other facial bones were recorded.Conclusion: We suggest that the Tubbs-Logan mitral valve dilator is a safe and effective alternative in terms of closed reduction of zygomatic arch fractures, whether they are isolated or not. We think that further ergonomic modifications would be beneficial to improve the positioning of the instrument in restricted areas observed due to severe depression of the zygomatic arch.

Improved Results in Closed Reduction of Zygomatic Arch Fractures by the Use of Intraoperative Cone-Beam Computed Tomography Imaging

The use of intraoperative imaging could help overcome the insufficiency of closed reduction that can result from the absence of visible feedback to evaluate the accuracy of the reduction in isolated zygomatic arch fractures. The aim of the present study was to evaluate the use of intraoperative 3-dimensional cone-beam computed tomography (CBCT) to improve the accuracy of reduction, by measuring the remaining cortical step and dislocation angle. We also evaluated the effect of CBCT on the need for repeat surgery. We performed a retrospective cohort study of patients who had undergone zygomatic arch reduction surgery from January 2008 to May 2018. The patients were grouped according to the predictor variables into group A (postoperative radiologic follow-up studies) and group B (intraoperative CBCT imaging studies). The primary outcome variables were the remaining cortical step and dislocation angle compared with the ideal virtually mirrored position. These were assessed as measures of reduction accuracy. The secondary variables included age, gender, surgery duration, and fracture type. Statistical analysis was performed using a robust multiple regression analysis. The 45 patients were divided into 2 subgroups with 18 patients in the no intraoperative imaging (control) group and 27 patients in the intraoperative imaging group. Insufficient reduction occurred in 1 patient in the group without intraoperative imaging, leading to repeat surgery. No repeat surgery was necessary in the intraoperative imaging group. The remaining cortical step of the intraoperative imaging group was significantly lower than that of the control group (0.18 vs 2.03mm; P<.001). For the remaining dislocation angle, similar findings were observed but without statistical significance (3.93° vs 7.75°; P=.58). The use of intraoperative CBCT significantly increased the accuracy of the reduction. Furthermore, the need for repeat surgery was not required for any patient in the intraoperative imaging group with CBCT-guided reduction.

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.

The relation between morphometric measurements, severity and success of zygomatic arch fracture reduction

Background: Current classification for zygomatic arch displacement and successful reduction are based on subjective assessment. We believe this approach should be refined.

Does C-Arm Guidance Improve Reduction of Zygomatic Arch Fractures?—A Randomized Controlled Trial

Traditionally, in the assessment of the reduction of zygomatic arch fractures, the surgeon uses subjective measures such as palpation of a bony step deformity, the anecdotal "pop" sounds, and visual confirmation of symmetry. In the present study, we sought to objectively assess the accuracy of reduction and improvement in form and function after C-arm-guided reduction of isolated zygomatic arch fractures (IZAFs) and to compare these results with those obtained conventionally. A prospective, randomization of patients scheduled for surgical closed reduction of IZAF was performed. The test group underwent C-arm-guided reduction of the fracture until the arch contour was re-established and visualized on fluoroscopic images. In the control group, palpation, auditory cues, and visualization of symmetry determined the adequacy of the reduction. The patients and evaluator were both unaware of the treatment technique used. The primary outcome measures were the maximum interincisal distance (IID), standardized measurements on computed tomography (CT), and measures of symmetry on facial photographs. Variables such as intragroup differences and patient-evaluator agreement were also studied. The data were analyzed using SPSS software, version21. The study sample consisted of 20 patients (10 each in the test and control groups). Significant improvement in facial symmetry was observed in all 20 patients (P<.001) from preoperatively to 30days postoperatively. The CT measurements confirmed acceptable symmetry, with insignificant differences between the 2 groups (C-arm group, P<.001; vs control group, P=.004 for intragroup improvement in symmetry). The IID had improved significantly (P<.001) at the end of follow-up in both groups. Although significantly superior outcomes were not inferred in the symmetry-related and CT measurements, C-arm-guided reduction provided an opportunity to instantaneously confirm the accuracy of bony reduction. Thus, the need for postoperative imaging and secondary surgery can be overcome, enabling even inexperienced surgeons to attain precise and reproducible results.

Use of a Balloon Catheter With Intraoperative C-Arm Fluoroscan for Reduction of Zygomatic Arch Fractures.

The purpose of this study was to evaluate the usefulness of C-arm fluoroscan with a balloon catheter in patients undergoing closed reduction of zygomatic arch fractures. All patients who had zygomatic arch reduction surgery between 2006 and 2015 were identified and classified into 2 groups. Group A included those patients who underwent closed reduction of zygomatic arch fractures. Group B included those who underwent zygomatic arch reduction surgery with a C-arm fluoroscan and supporting balloon. A balloon catheter was used to stabilize the zygomatic bone after reduction. Results were scored from 1 (poor) to 3 (good) to assess surgical outcomes based on 3 criteria: alignment of the zygomatic arch on a postoperative computed tomography scan, facial asymmetry in photography, and the patient's subjective satisfaction. The authors enrolled 32 patients with zygomatic arch fractures. 18 patients underwent closed reduction for zygomatic arch fractures (group A), while 14 patients underwent closed reduction with C-arm fluoroscan and balloon support (group B). The average score for group A was 2.00 for alignment, 2.56 for facial asymmetry, and 2.67 for subjective satisfaction compared with 2.64 for alignment, 2.86 for facial asymmetry, and 2.79 for subjective satisfaction in group B. There were statistically significant differences in the alignment and facial asymmetry scores between the 2 groups. The authors suggest that C-arm fluoroscan with balloon support is a useful modality for reduction of zygomatic arch fractures that provides better surgical outcomes than conventional closed reduction surgery.

Diagnostic validity of ultrasonogaraphy in zygomatic arch fractures: A clinical study

Objective: The Objective of the present study was to investigate the uses of ultrasonography in the diagnosis of zygomatic arch fractures and to identify the acoustic pattern between ultrasound image and true morphology of zygomatic arch. Method: Once the patient was positioned, the acoustic coupler was applied to the patients control side i.e., the normal zygomatic arch and a similar scanning was carried out on the fractured side using a linear array transducer utilizing a frequency of 11 MHz. The areas of interest were scanned under both transverse and longitudinal sections, findings were entered into the proforma and then the printouts of the ultrasound pictures were printed using Sony type 1 (normal) high quality printing paper using a B&W Thermal Printer UP-895CE Sony. Results: All the 16 patients were subjected to ultrasonography and in all 16 cases fracture of the zygomatic arch was confirmed, implying there is 100% accuracy. Conclusion: Ultrasound offers a safe, inexpensive, accurate adjunct to conventional radiography of the facial bones and is well tolerated by recently injured patients. Ultrasound may also be considered as an alternative to repeating plain X-ray films to answer any doubts about the configuration or displacements of fractures, as ultrasound is noninvasive and overcomes the disadvantages of radiography. This study emphasizes the need of the hour in diagnostic imaging and its possible role in intraoperative reduction of zygomatic arch fractures. The present study was also able to distinguish the patterns of zygomatic arch fractures as given by Honig Merten. Keywords: Diagnostic ultrasound, Real time imaging, Zygomatic arch fracture

Intra-oral reduction of zygomatic fractures.

Zygomatico-maxillary complex fractures present a challenging diagnostic and reconstructive task to the surgeon. Gillie's temporal approach has been a commonly used technique for zygomatic arch reduction, but surgeons have been commonly using a buccal sulcus approach for the reduction of zygomatic arch fractures as well as for combined zygomatico-maxillary complex fractures. This article outlines the use of Rowe's elevator (modification of Bristow's elevator) intra-orally to reduce zygomatic arch fractures and, if required, simultaneously plate the zygoma through the same approach. A retrospective analysis of 379 patients treated with this technique in the last 10 years has been presented along with a comprehensive treatment protocol including a description of its advantages over the Gillie's approach. Based on the inclusion criteria, the study group consisted of 327 patients. In 281 patients, the zygomatic complex was fractured, whereas 46 patients presented with a solitary zygomatic arch fracture. Two hundred and three cases were successfully treated with the buccal sulcus approach, whereas 124 cases required both the buccal sulcus and the extra-oral lateral orbital approaches. The described approach has advantages over Gillie's temporal approach by being simple, faster and cost-effective, can be performed under local anesthesia, and is more esthetic as it does not leave any scars.

Applications of Computer-Assisted Navigation for the Minimally Invasive Reduction of Isolated Zygomatic Arch Fractures

Computer-assisted navigation has been widely used in oral and maxillofacial surgery. The purpose of this study was to describe the applications of computer-assisted navigation for the minimally invasive reduction of isolated zygomatic arch fractures. All patients identified as having isolated zygomatic arch fractures presenting to the authors' department from April 2013 through November 2014 were included in this prospective study. Minimally invasive reductions of isolated zygomatic arch fractures were performed on these patients under the guidance of computer-assisted navigation. The reduction status was evaluated by postoperative computed tomography (CT) 1 week after the operation. Postoperative complications and facial contours were evaluated during follow-up. Functional recovery was evaluated by the difference between the preoperative maximum interincisal mouth opening and that at the final follow-up. Twenty-three patients were included in this case series. The operation proceeded well in all patients. Postoperatively, all patients displayed uneventful healing without postoperative complication. Postoperative CT showed exact reduction in all cases. Satisfactory facial contour and functional recovery were observed in all patients. The preoperative maximal mouth opening ranged from 8 to 25 mm, and the maximal mouth opening at the final follow-up ranged from 36 to 42 mm. Computer-assisted navigation can be used not only for guiding zygomatic arch fracture reduction, but also for assessing reduction. Computer-assisted navigation is an effective and minimally invasive technique that can be applied in the reduction of isolated zygomatic arch fractures.

Computed tomography scan evaluation of adequacy for reduction of zygomatic arch fracture using Gillie's temporal approach

Aim: The zygomatic bone is the key component of the structural facial aesthetics as it constitutes the prominence of the cheek bone. Also, the most frequent clinical findings in zygomatic arch fracture includes limitation of jaw movement and flattening of cheek. So it is necessary to elevate the arch precisely. Therefore, a prospective study was conducted toevaluate adequacy for reduction of zygomatic arch fracture using Gillie’s temporal approach with the help of pre-operative and post-operative CT scan. Materials & methods: 4 patients, who received surgical treatment of zygomatico-maxillary complex (ZMC) fractures at the Department of Oral and Maxillofacial Surgery were examined for displacement of zygomatic arch pre-operatively with CT scan then re-evaluated the same site post-operatively. Results: The pre-operative mean displacement at the zygomatic arch, in millimetres (mm), was M = 2.8, SD = 3.011. After reduction, the post-operative displacement was M = 0.4, SD = 0.699. The percentage of reduction was M = 85, SD = 24.15. Conclusion: Gillie’s temporal approach for zygomatic arch fracture reduction is precisely considerable due to its simple and effective method and cosmetically more acceptable. Keywords: Zygomatic fractures, Zygomatico-maxillary complex, Fracture

Zygomatic Arch Fracture Reduction via Gillie's (Temporal) Approach—Report of 3 Cases

In mid-face, the zygomatic bone and arch represents the bridge between the maxilla, orbital cavity and temporal bone anterosuperior and posterior, respectively. Zygomatic arch plays a potential relation with the maxilla, petrous part of temporal bone, orbits and the multitude of structures contained within and posterior to it make the temporomandibular joint functionally. Fracture of the zygomatic arch of the bone is potentially disturb the function of the mandibular jaw while opening and closing as well as disfi gure by forming depression on face even in case of undisplaced. In time and reduction of arch fracture provides the best chance to avoid facial deformity, jaw dysfunction and prevents unfavorable sequelae. We conclude that, Gillies approach for undisplaced arch fracture reduction will be considerable due to simple and effective method and cosmetically more acceptable.

“Roller Coaster Maneuver via Lateral Orbital Approach” for Reduction of Isolated Zygomatic Arch Fractures

Numerous techniques have been reported for the reduction of zygomatic arch fractures. In this article, we aimed to describe a technique we named as "roller coaster maneuver via lateral orbital approach" to closed reduction of the isolated-type zygomatic arch fractures. Surgical outcomes of 14 patients treated with this method were outlined.