The role of intraoperative ultrasonography in zygomatic complex fracture repair

Gülicher, D.; Krimmel, Michael; Reinert, Siegmar

doi:10.1016/j.ijom.2005.10.005

Cited by 48 publications

(42 citation statements)

References 17 publications

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“…3,7,8,10,13 The application of ultrasound in midfacial injuries is most useful for visualization of the zygomatic arch with immediate imaging after closed reduction. 6,7,12 The technique may be useful as an accurate adjunct to conventional radiography of facial bones by reducing the overall amount of radiation. 3 It can be considered as the imaging of choice when there is a contraindication to CT or plain films, for example in pregnant women and patients with cervical spine injuries.…”

Section: Resultsmentioning

confidence: 99%

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Comparison of ultrasonography with submentovertex films and computed tomography scan in the diagnosis of zygomatic arch fractures

Nezafati

Javadrashid²,

Rad³

et al. 2010

Dentomaxillofacial Radiology

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Objectives: The aim of this study was to compare ultrasonography with CT scan and submentovertex films in the visualization of zygomatic arch fractures. Methods: 17 patients, 10 men and 7 women, with suspected fracture of the zygomatic arch were studied. The data from CT and plain films were compared with the ultrasonographic findings (Aloka 3500 (Tokyo, Japan) ultrasound equipment with a 7.5 MHz transducer). The probe was situated over the fractured arch transversely to evaluate its whole length. All of the sonograms were taken and interpreted by the same sonologist, who was not aware of the results of the CT and the plain films. Results: Ultrasound was accurate in assessing the fractured arches with sensitivity of 88.2% (15 of the 17 patients, with two false negatives) and specificity of 100% (no false positives). Conclusion: Ultrasound is accurate in the visualization of zygomatic arch fractures and can be used as an adjunct to plain films to reduce the overall radiation exposure.

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Section: Resultsmentioning

confidence: 99%

“…3,8,9,12 Gross swelling and tenderness over the fracture can make the procedure uncomfortable for the patient and can also make scanning of the bony outlines difficult, decreasing the accuracy of the process. 3,8 None of the patients found the procedure painful or uncomfortable.…”

Section: Diagnosis Of Zygomatic Arch Fractures Using Ultrasoundmentioning

confidence: 99%

Comparison of ultrasonography with submentovertex films and computed tomography scan in the diagnosis of zygomatic arch fractures

Nezafati

Javadrashid²,

Rad³

et al. 2010

Dentomaxillofacial Radiology

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“…However, the clinical significance of a displaced zygomatic arch differs between isolated and ZMC-combined arch fractures; the latter displacement indicates failure of the midfacial outer frame. The exposed lateral orbital rim with fracture lines does not sufficiently reflect the zygomatic rotation, 15 and the zygomaticomaxillary buttress is frequently comminuted. Thus, the definitive measurement required to confirm the proper anteroposterior projection of the zygomatic bone requires intraoperative zygomatic imaging and the effective reduction control it enables.…”

Section: Discussionmentioning

confidence: 99%

C-Arm-Guided Reduction of Zygomatic Fractures Revisited

Imai

Michizawa

Fujita

et al. 2011

Journal of Trauma: Injury, Infection &Amp; Critical Care

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Background: Anatomic reduction of the zygomatic arch, a key surgical landmark for midfacial width and projection, is essential for the treatment of combined fractures of the zygomaticomaxillary complex and zygomatic arch. Reduction control in surgery for this common facial fracture would be facilitated by intraoperative real-time assessment using widely available and reliable equipment. Although C-arm fluoroscopy is routinely used in the repair of orthopedic fractures, its use in the maxillofacial region, particularly for combined zygomatic fractures, has been scarcely reported. Methods: We prospectively evaluated C-arm-guided reduction in 38 patients of combined zygomatic fracture without concurrent craniofacial fractures. Patients were classified according to the presence or absence of bone contact in the displaced zygomatic arch, namely as conserved (C) and loss (L) types, respectively. Reduction status was determined by the degree of recovery of the malar prominence and arch shape. Results: In all cases, C-arm imaging clearly displayed the displaced zygomatic arch and body in a single image. Cumulative fluoroscopic time was a few minutes in all cases. Total reduction status was excellent in 21 patients and good in 17. No case was classified as fair or poor. Repair was significantly more favorable in type C than in type L cases (p ϭ 0.0016). Conclusions: In combined zygomatic fractures, the C-arm technique provides easy, flexible, and time-efficient adjustment. Its comprehensive imaging for zygomatic arch shape and body contour markedly facilitates the control of fracture reduction and protects against unexpected, unsatisfactory outcomes.

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“…Postoperatively, all patients displayed uneventful healing 18 without postoperative complication. Postoperative CT showed exact reduction in all 19 cases. Satisfactory facial contour and functional recovery was observed in all patients.…”

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confidence: 82%