Refracture of untreated fractures of the zygomatic bone.

Experience gained in the treatment of 16 patients with refracture of untreated fractures of the zygomatic bone is presented. Refracture, repositioning and wire fixation is the method of choice in the correction of facial deformity after untreated displaced fractures of the zygomatic bone. If necessary, osteoplasty of the orbital floor and raising of the globe by a thick iliac bone graft can be performed at the same time. Usually, it is not so difficult to perform refracture since at the site of fracture, where a large dislocated fragment exists, a solid callus is not formed but rather some kind of fibrous union. If the displaced bone is completely united then an osteotomy of the whole zygomatic bone is performed through the lateral part of the eyebrow, lower eyelid and a wide incision in the upper buccal sulcus, using a sharp chisel or a small round bur. Refracture of the zygomatic arch can be done through the mouth after making a wide incision in the upper buccal sulcus which enables exploration of the zygomatic arch, or by a hand saw after tunnelling from the eyebrow incision to the zygomatic arch. If the zygomatic arch is broken in two or more places then the refracture should be done through a short incision on the face followed by direct interosseous wire fixation.