C-Arm Assisted Zygoma Fracture Repair: A Critical Analysis of the First 20 Cases

Purpose Currently used open reduction and internal fixation techniques of zygoma fracture repair are not optimal. Surgical exposure of those sites needed to allow for accurate reduction and for rigid fixation has a high possibility of negative consequences. The objective of the present study was to present a single-incision, single-fixation site zygoma fracture repair technique using a single zygoma c-arm view to quantitatively determine its accuracy, complication rate, and practical aspects in a clinical series. Materials and Methods In a prospective study, consecutive patients with isolated, unilateral, displaced zygoma fractures not requiring orbital floor exploration treated using a c-arm–assisted repair technique at the author's institution from 2009 to 2011 were included. Objective outcomes assessed included accuracy of zygoma realignment (on postoperative computed tomogram), ocular globe projection symmetry (using a Naugle exophthalmometer), complication rate, and operative duration. Statistical analysis was performed using the Student t test. Results Twenty patients were included. Differences in zygoma projection, width, and height between the uninjured and repaired sides of the face were clinically noteworthy (>3 mm) in the first patient only. Average differences of these parameters for all 20 patients were clinically and statistically insignificant. Differences in ocular globe projection between the uninjured and repaired sides of the face for each patient were no greater than 2 mm. The average difference in globe projection for all 20 patients was also clinically and statistically insignificant. No major complications occurred, and the average operative duration was 76 minutes. Conclusions The present study shows that the c-arm–assisted zygoma fracture repair technique is accurate, has a low complication rate, can be performed quickly, and has a relatively low level of difficulty.