Arch Craniofac Surg.  2014 Aug;15(2):59-62. 10.7181/acfs.2014.15.2.59.

Effectiveness of Dual-Maneuver Using K-Wire and Dingman Elevator for the Reduction of Unstable Zygomatic Arch Fracture

• Yoon H
• Kim J
• Chung S
• Chung YK

• KMID: 2134162
• DOI: http://doi.org/10.7181/acfs.2014.15.2.59

Abstract

BACKGROUND
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.
METHODS
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.
RESULTS
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.
CONCLUSION
We were able to reduce unstable and difficult zygomatic arch fractures without an open incision or any external fixation device.

Keyword

Zygomatic fractures; Facial injuries; Maxillofacial injuries

MeSH Terms

Elevators and Escalators*
External Fixators
Facial Bones
Facial Injuries
Gangwon-do
Humans
Maxillofacial Injuries
Retrospective Studies
Zygoma*
Zygomatic Fractures