The Zygomatic Arch as a Guide to Reconstruction of Comminuted Malar Fractures

Abstract

\s=b\Traditional three-point reduction may not restore proper projection of the malar prominence following a fracture dislocation of the zygoma if two of the three anterior points of realignment are comminuted. In such cases, reconstruction of the fourth or posterior projection, the zygomatic arch, increases the accuracy of the multidimensional reconstruction. Although the extended access approach required to repair the arch increases operative time and possibly length of hospitalization, its use is justified by the improved results in selected patients with severe in-

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

“…Perfection in restoration of ZAF is important in the management of midface fractures and Zygoma fractures. 22 Adequate and effective management of ZAF is absolutely important due to the risk of ankylosis with Coronoid process of the mandible.…”

Novel Surgical Technique for Repair of Zygomatic Fractures: Lever Technique

“…This direct approach carries the risk of leaving a long scar, scalp numbness, alopecia, and injury to the temporal branch of the facial nerve. 19 These risks are present in addition to the usual risks associated with the long operation time. 20…”

The Comprehensive AOCMF Classification System: Midface Fractures - Level 3 Tutorial

“…In major midface trauma, the zygomatic arch is an acknowledged guide to redefine the sagittal projection of the zygoma. 67,84 Isolated zygomatic arch fractures usually present as a clinical entity of minor severity leading to contour depression at the lateral cheek and trismus due to a V-shaped indentation of the fragments toward the coronoid process. Bilateral isolated zygomatic arch fractures, however, are associated with skull or skull base fractures and an ominous sign for serious injury.…”

“…Various terminology, such as frontobasal, frontofacial, frontal sinus, frontocranial fractures, and according classifications are in common use for a topographical assignment. 23,67,[88][89][90][91][92][93][94] The association of (subcranial) midface fractures and cranial base and/or cranial vault fractures can be captured in the level 3 classification system (►Fig. 10).…”

“…Irrespective of the vertical fracture level of the three classic Le Fort fracture types, the lower portion of the process stays in connection to the maxilla. 67 This contiguity is responsible for the retrodisplacement in central midface fractures due to the pull of the medial pterygoid muscle inserting in the pterygoid fossa at the back.…”