Yoon Hyungwoo, Kim Jiye, Chung Seum, Chung Yoon-Kyu
Department of Plastic and Reconstructive Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea.
National Health Insurance Corporation Ilsan Hospital, Ilsan, Korea.
Arch Craniofac Surg. 2014 Aug;15(2):59-62. doi: 10.7181/acfs.2014.15.2.59. Epub 2014 Aug 14.
The zygoma is the most prominent portion of the face. Almost all simple zygomatic arch fractures are treated in a closed fashion with a Dingman elevator. However, the open approach should be considered for unstable zygomatic arch fractures. The coronal approach for a zygomatic arch fracture has complications. In this study, we introduce our method to reduce a special type of unstable zygomatic fracture.
We retrospectively reviewed zygomatic arch view and facial bone computed tomography scans of 424 patients who visited the Wonju Severance Christian Hospital from 2007 to 2010 with zygomaticomaxillary fractures, among whom 15 patients met the inclusion criteria.
We used a Dingman elevator and K-wire simultaneously to manage this type of zygomatic arch fracture. Simple medial rotation force usually collapses the posterior fractured segment, and the fracture becomes unstable. Thus, the posterior fracture segment must be concurrently elevated with a Dingman elevator through Keen's approach with rotation force applied through the K-wire. All fractures were reduced without any instability using this method.
We were able to reduce unstable and difficult zygomatic arch fractures without an open incision or any external fixation device.
颧骨是面部最突出的部分。几乎所有单纯的颧弓骨折都采用丁曼骨膜剥离子以闭合方式进行治疗。然而，对于不稳定的颧弓骨折应考虑采用开放入路。颧弓骨折的冠状入路存在并发症。在本研究中，我们介绍了一种用于复位一种特殊类型不稳定颧骨骨折的方法。
我们回顾性分析了2007年至2010年期间到原州Severance基督教医院就诊的424例颧上颌骨骨折患者的颧弓位片和面部骨计算机断层扫描，其中15例符合纳入标准。
我们同时使用丁曼骨膜剥离子和克氏针来处理这种类型的颧弓骨折。单纯的向内旋转力通常会使骨折后段塌陷，骨折变得不稳定。因此，必须通过丁曼骨膜剥离子经基恩入路同时抬高骨折后段，并通过克氏针施加旋转力。使用这种方法，所有骨折均复位且无任何不稳定情况。
我们能够在不进行开放切口或使用任何外固定装置的情况下复位不稳定且复杂的颧弓骨折。
