Clin Exp Otorhinolaryngol.  2010 Jun;3(2):107-109. 10.3342/ceo.2010.3.2.107.

Delayed Treatment of Zygomatic Tetrapod Fracture

• Baek MK
• Jung JH
• Kim ST
• Kang IG

• KMID: 1460598
• DOI: http://doi.org/10.3342/ceo.2010.3.2.107

Abstract

Since maxillofacial injury is frequently accompanied by other diseases, its evaluation and treatment are open delayed. When the evaluation is delayed, the surgical treatment can be difficult or impossible. A 21-yr-old man presented with right facial swelling and deformity after injury. We planned immediate surgical repair for his right tetrapod fracture, but the operation was delayed for two months due to severe hyperthyroidism. During the operation, we reducted and fixed the deviated bone after refracture of the zygomatic arch with an osteotome to achieve mobility. The facial deformity and difficulty in mouth opening were improved after the operation. Even in the presence of accompanying fractures, early evaluation and proper management can prevent complications and achieve acceptable cosmetic outcomes in maxillofacial trauma patients. In patients with malunion of fracture sites, fixation after refracture using an osteotome can be a good treatment option for obtaining good mobility.

Keyword

Maxillofacial injuries; Facial injuries; Fracture fixation

MeSH Terms

Congenital Abnormalities
Cosmetics
Facial Injuries
Fracture Fixation
Humans
Hyperthyroidism
Maxillofacial Injuries
Mouth
Zygoma
Cosmetics

Figure

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  Fig. 1 A 21-yr-old patient. (A, B) Preoperative photograph shows right malar eminence flattening and right facial deformity. (C, D) Photograph taken 2 months after surgery shows elevated malar depression.

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  Fig. 2 (A, B) Preoperative computed tomography shows a fracture of the anterior wall of the right maxilla with depression. (C, D) The follow-up three-dimensional computed tomography shows a corrected fracture of the anterior wall of the right maxilla after surgery.

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  Fig. 3 Surgical procedures. (A) intermaxillary fixation, (B) lateral eyebrow incision, (C) sublabial approach, (D) gillies approach.

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